title: Introduction of direct-to-consumer advertising of prescription drugs in Canada: an opinion survey on regulatory policy.
abstract: BACKGROUND
  Canada is strongly influenced by US cross-border direct-to-consumer advertising (DTCA) and has held consultations to discuss introduction of DTCA since 1996. This article describes a survey of Canadian drug policy experts carried out in 2001, during one such legislative review. The survey results are compared to more recent DTCA policy developments.
  
  
  METHODS
  We recruited key informants on pharmaceutical policy to complete a faxed questionnaire that queried their opinions on DTCA information quality, effects on drug and health care use, and regulatory issues. Respondents were asked about the evidence they had used to back their opinions. Analysis was descriptive.
  
  
  CONCLUSIONS
  Of 79 identified potential participants, 60 (76%) participated, 40% of whom were from federal and provincial government; 3% were private insurers; 18%, 15%, and 8% were from health professional groups, consumer groups, and patient groups, respectively; 8% and 7% were from pharmaceutical and advertising industries, respectively. Opinions were highly polarized on the effects of DTCA on drug and health care use. Advertising and pharmaceutical industry respondents were generally positive, public sector, health professional and consumer groups generally negative. Over 80% believed DTCA leads to higher private and public drug costs and more frequent physician visits. Fewer judged billboards or television to be appropriate media for DTCA than magazines or the Internet, and most believed that children and adolescents should not be targeted.
  
  
  CONCLUSIONS
  Given the polarization observed within this survey, we examined how DTCA policy has evolved in Canada since 2001. The federal government has legislative authority over DTCA, but bears few of the additional costs potentially incurred through policy change. These fall to the provinces, which provide an eroding patchwork of public coverage for prescription drugs in the face of rapidly increasing costs. No new federal legislation has been tabled since 2001. However, considerable shifts in administrative policy have occurred, all supportive of expanded advertising. Thus, the law continues to be restrictive but its application less so.
authors.affiliation: Centre for Health Services and Policy Research, University of British Columbia (UBC), Vancouver, BC Canada V6T 1Z3. bmintzes@chspr.ubc.ca
authors.forename: Barbara
authors.initials: B
authors.lastname: Mintzes
authors.forename: Morris
authors.initials: M
authors.lastname: Barer
authors.forename: Joel
authors.initials: J
authors.lastname: Lexchin
authors.forename: Ken L
authors.initials: KL
authors.lastname: Bassett
mesh_terms: D000329:Advertising; D002170:Canada; D003625:Data Collection; D004358:Drug Therapy; D004363:Drug Utilization; D006801:Humans; D007880:Legislation, Drug; D004364:Pharmaceutical Preparations; D010818:Practice Patterns, Physicians'; D011639:Public Opinion; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D004364:Pharmaceutical Preparations