title: From DTCA-PD to patient information to health information: the complex politics and semantics of EU health policy.
abstract: OBJECTIVE
  Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct-to-consumer advertising of prescription drugs (DTCA-PD). As it became increasingly clear that the ban would not be repealed, DTCA-PD supporters tried to shift the debate away from advertising and towards the provision of 'patient information' and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry-supported 'patient information' campaign. Instead, they promoted a concept of 'health information' that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA-PD to patient information to health information and examine its implications for EU health policy as a complex policy space.
  
  
  METHODS
  The article examines the emergence and development of EU health policy and the evolution of the DTCA-PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective.
  
  
  CONCLUSIONS
  The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA-PD debate. Having successfully shifted the policy-focus of the debate to patients' rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising.
authors: Department of Politics, Philosophy and Religion, County South, Lancaster University, Lancaster, UK. e.brooks@lancaster.ac.uk
authors: Eleanor
authors: E
authors: Brooks
authors: Robert
authors: R
authors: Geyer
mesh_terms: D004345:Drug Industry / Q000331:legislation & jurisprudence / Q000379:methods*; D005062:European Union; D006291:Health Policy; D006801:Humans; D008389:Marketing of Health Services / Q000331:legislation & jurisprudence / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D028701:Patient Rights; D011057:Politics