Continence Coach: The Age of Social Media and Marketing — For Sale: Incontinence Drugs and Devices

     In November, the Federal Drug Administration (FDA) called a hearing to discuss issues pertaining to disclosure rules for drug manufacturers on the Internet. In 2008, the pharmaceutical industry spent $4.4 billion on television and print ads combined; just over 3% of this amount was spent on Internet advertising. Industry is eager to expand use of the Web to advertise its branded prescription drugs in hopes of driving increasing numbers of consumers to their physicians with symptoms and subsequent demands for advertised medications. A looming obstacle lies in the lack of FDA guidance about how to apply existing drug-marketing rules to new-age media and marketing. At the urging of Pfizer and others, the FDA agreed to host the hearing to air the views of patient safety groups, industry, and policymakers.

     The FDA has long-established, strict rules for drug advertising, requiring disclosures about the advertised condition and potential side effects from the promoted drug. The federal agency says that certain aspects of online marketing such as social media marketing are not sufficiently covered by existing regulations and thus could warrant additional guidance. The problem is: Just what is missing and what additional regulations are needed? Are links enough for the manufacturer, when vast numbers of individuals are sharing information by forwarding messages on Twitter and Facebook and LinkedIn? How can this all be monitored or best controlled efficiently and effectively by the government?

     Or should it be? A more fundamental question is whether control and surveillance are appropriate and within the realm of US constitutional freedoms. Consumer safety watchdog groups caution that links are not only insufficient, they are downright dangerous. These groups maintain that post-market surveillance, already inadequate on the FDA’s part, will become impossible. Meanwhile, an even more difficult question is whether pharmaceutical brand teams should be held responsible for consumer-created content on YouTube and other electronic social communication sites concerning false information about their products.

     Plenty of companies already are looking the other way, pushing the envelope with unofficial satellite sites that are brand-specific yet completely separate from their corporate “mother” sites. Companies are funding totally unbranded sites intended to draw attention to certain conditions, hoping to drive consumers to search out solutions in the form of prescription drugs and surgical devices. Patient advocacy organizations are hardly innocent bystanders, selling out pages and even sections of their proprietary sites to companies with branded or exclusive but still nonbranded messages about a condition and a remedy. The wording and thus the messaging are often crafted entirely by the sponsoring companies.

     Where does this circus end? Do European countries have the right equation? They bar all commercial advertising and promotion of drugs, keeping costs down so drug prices are far lower than they are in the US. Has our American economy, so dependent for decades on fueling demand for consumer products and services and granting freedom of press without restriction, lost its control over healthcare costs as well as patient safety as a result of uncontrolled branded marketing?

     In the end, the answer lies in public health education and elevating the health literacy of our citizens. Only by being an informed and watchful consumer can one know the questions to ask of physicians and nurses, the information to gather relative to diagnosis and treatment, and how open to leave oneself to claims made in the advertising messages.

     Who are our nation’s healthcare educators? We — readers, healthcare professionals and providers — are. Not a friend’s tweet, not a forwarded video, not a faceless blog. Healthcare professionals — all of us serving as public educators and patient advocates and those serving as healthcare providers of diagnosis, treatment, and care — are responsible for educating the public.

     The age of the Internet has augmented, not shrunk, the scope of our individual responsibility to our patients and to the public at large. It has engendered more complexity, not greater simplicity, in how we respond and what we must initiate each and every day in our communications with others, whether they are face-to-face or by telephone, email, websites, video, or television. It’s a challenge we must accept, hand in glove, as part of our fundamental rights and freedoms as US citizens and committed care providers.

The National Association For Continence is a national, private, non-profit organization dedicated to improving the quality of life of people with incontinence. The NAFC’s purpose is to be the leading source for public education and advocacy about the causes, prevention, diagnosis, treatments, and management alternatives for incontinence.

This article was not subject to the Ostomy Wound Management peer-review process.