WORLD WIDE WEB
Prescription Drug Promotions Raise Questions
Pharmaceutical makers have begun to promote prescription drugs on the Internet's World Wide Web. At the same time, the U.S. Food and Drug Administration (FDA) "is just beginning to address the problems of regulating and monitoring the new interactive media," reports Greg Borzo in American Medical News.
In 1993 the FDA asked pharmaceutical companies to voluntarily submit for review promotional materials aimed at consumers. But it is unclear whether this extends to promotions on the Web, explains Borzo.
Also unclear is who initiates contact--the person who connects to the Web or the company that puts up a Web site. According to Borzo, initial contact is an area the FDA currently regulates in traditional media promotions.
In addition, the FDA requires drugmakers to list their products' pros and cons. But, Borzo points out, a question remains as to whether each screen of a drug promotion must display these with equal prominence.
These unanswered questions are keeping most pharmaceutical makers from promoting prescription drugs on the World Wide Web. So far only the Upjohn Company and Schering-Plough are promoting two noncontroversial products.
The FDA is also concerned about promotions on the Web of prescription drugs from companies outside the United States, over which the agency has no jurisdiction. Borzo questions, "What's to stop a company from launching a Web site from overseas that disregards all the FDA's rules?"
Until the FDA answers some of these questions, the number of prescription drugs promoted on the Web will continue to be low, asserts Peter S. Reichertz, an attorney in Washington, DC. One way drugmakers can play it safe on the Web is by not referring to information on an unapproved use for a drug, explains Reichertz. But Borzo points out that Congress is currently debating whether to "permit companies to distribute reprints from medical journals that discuss unapproved uses."
PREVENTIVE CARE
Women at High Risk
Life-style choices and failure to obtain routine clinical preventive services are jeopardizing the health of too many women, says a new Commonwealth Fund study prepared by the UCLA Center for Health Policy Research.
According to the study, a regular source of care and periodic checkups are important safeguards of good health. For many women, the lack of health insurance poses severe financial barriers to receiving regular care. Cultural and social norms can also discourage women from adopting health-promoting behaviors, such as regular exercise.
Physician communication is another important factor in helping women understand the effect of their behavior on their health, the study found. Most of the 25,000 women surveyed were not queried about smoking, diet, exercise, alcohol, and drug use during their last medical checkup. Yet three in five women reported risky behavior in one or more of those areas.
The study concludes there is a need for outreach and education programs for low-income and minority women in particular because they have the lowest screening rates for most preventive services. Providers and health plans can help by developing reminder systems to alert patients to their need for regular preventive care.
The study also recommends public policy changes to "provide incentives for providers, health plans, and programs to develop and implement protocols that screen, identify, and intervene for adverse health habits." Full insurance coverage and reorganization of both service delivery and financing are also important to eliminate barriers to screening and promote women's access to a regular source of care, the study maintains.
For copies of the full report--Women's Health-related Behaviors and Use of Clinical Preventive Services--contact the fund at 212-606-3840.
ENVIRONMENT
Senior Activism on the Rise
With government cutbacks almost certain to affect environmental and public health agencies, senior citizens--a growing force in the environmental movement--may become even more important. The Environmental Alliance for Senior Involvement (EASI), an organization that helps local communities tap the skills of active elders across the country, is growing rapidly, Hans Riemer writes in Aging Today.
EASI was founded three years ago by 16 organizations, including the American Association of Retired Persons, the U.S. Environmental Protection Agency, the Nature Conservancy, and the National Wildlife Federation. Today, it has an informational homepage on the World Wide Web; plans to partner with other organizations on different projects; and is creating a Senior Information Network, where older people nationwide will distribute information to local communities.
At EASI's recent national conference, one highlight was an effort to protect water supplies in El Paso, TX. Senior citizens helped educate the public about proper waste disposal, monitored the area for sources of groundwater pollution, and set up an advisory committee to work with regional agencies. "The public is much more cooperative with a smiling elderly person than with a government investigator," Riemer writes.
Another major EASI focus for the coming year will be global warming, which has a more adverse effect on the elderly than on other population groups. EASI is planning to disseminate information nationwide about global warming and its effects on health and the environment. It will also encourage seniors to become active in reducing their communities' contributions to the problem.
For more information, contact EASI at 540-788-3274. Its World Wide Web site is http://www.comet.chv.va.us/easi.
ADVOCACY
Public More Generous Than Legislators Believe
"This country is not as mean spirited as legislators say it is," said Robert Leitman at a St. Louis meeting held by the Health Care Outlook. In its end-of-the year report to sponsoring organizations (including the Catholic Health Association), the research consortium observed a wide disparity between what legislators believe their constituents want and what legislators believe is right for the nation.
A Health Care Outlook poll revealed that only 15 percent of legislators think there should be a decrease in states' federal revenues over the next five years. Yet 55 percent of legislators believe there will actually be a decrease.
According to Leitman, the perception that the public wants wide spread spending cuts caused legislators to propose budget measures in 1995 that would have been unthinkable in 1993. For example, "We're seeing them put more constraints on treatments and prescriptions for Medicaid recipients than there is for privately insured patients," he said.
He advised the audience of about 65 healthcare executives to be "heartened by that disparity and go after it. . . . The disjuncture between the country and the government is a lobbying issue."
Health Care Outlook is a joint venture of the Institute for the Future, Menlo Park, CA; Louis Harris & Associates, New York City; and the Harvard School of Public Health. Leitman is executive vice president, Lou Harris & Associates.
Mr. Roberts is chief executive officer of the Oregon region of PeaceHealth, Eugene, OR.
Copyright © 1996 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.