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ADHD Ads Target Back-to-School Crowd



 
 
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Old August 26th 07, 06:42 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health,sci.med
Jan Drew
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Default ADHD Ads Target Back-to-School Crowd

http://www.abcnews.go.com/Health/Dru...3515271&page=1

ADHD Ads Target Back-to-School Crowd

By DAN CHILDS
ABC News Medical Unit
Aug. 23, 2007

Parents shopping for pencils, book bags and new clothes for their kids may
be tempted by recent advertisements to add yet another item to their
back-to-school cart -- a prescription for an ADHD drug.

So say critics of back-to-school themed ads for attention deficit
hyperactivity disorder (ADHD) drugs sponsored by companies that market the
medications.

Parents shopping for pencils, book bags and new clothes for their kids may
be tempted by recent advertisements to add yet another item to their
back-to-school cart -- a prescription for an ADHD drug.

So say critics of back-to-school themed ads for attention deficit
hyperactivity disorder (ADHD) drugs sponsored by companies that market the
medications.

"Given that parents obviously are anxious about their kids' school
performance, these ads really exploit these parents' concerns," said Dr.
Sidney Wolfe, director of the consumer advocacy group Public Citizen's
Health Research Group.

"This kind of ad is obviously not pushing for better teaching, better
schools or more counseling, but it is pushing for the easy fix, the drug
solution."

But a number of child and adolescent psychiatrists counter that the ads may
not be all bad -- and may even give children access to beneficial treatment
options of which their parents would not otherwise be aware.

Children with ADHD often have trouble sitting still and paying attention.
They may also act out at home and, more problematically, in the classroom.

On Monday, an editorial in the Los Angeles Times took drug makers to task
for advertisements featuring drugs used to treat the condition, which
routinely feature the medicines' branding splashed amid a background of
back-to-school imagery.

"Powerful psychotropic medications should be an option of last resort and
uninfluenced deliberation, not another brand-name product to add to the
back-to-school shopping list," the editorial reads.

The article points a finger at U.S. regulatory agencies for lax oversight of
such ads, some of which market candy-flavored versions of the powerful
drugs.

Industry representatives have already come out in defense of the
advertisements, which they say educate the public about a commonly
undertreated condition among children.

"[W]hat the author failed to mention is that while more Americans are
seeking treatment for mental illnesses, most of them fail to get adequate
care," said Ken Johnson, senior vice president of the industry group
Pharmaceutical Research and Manufacturers of America (PhRMA) in a statement
issued Wednesday.

"DTC advertising can help bridge this information gap by empowering
patients, improving patient understanding of disease and available
treatments, and fostering strong relationships between patients and their
health care providers," the statement continues.

Some Say Ads Prey on Vulnerable Population; Psychiatrists Argue They May Be
Beneficial
And some psychiatrists say that while ethical considerations do exist with
regard to the ads, they could be more beneficial than the public realizes.

"While the drug companies may be advertising their products, there is a
piece of this that could be educational," said Dr. John Walkup, associate
professor of child and adolescent psychiatry at Johns Hopkins Children's
Center in Baltimore, Md.

"It's an advertisement. No question, they're trying to sell their product,"
he said. "On the other hand, this is the time of year when kids start to
benefit from these products."

"It's a double-edged sword," said Dr. Sharon Hirsch, professor of child and
adolescent psychiatry at the University of Chicago Comer Children's
Hospital.

"Certainly they're out there to promote their medicines. But I think the
positive side of advertisements, especially for psychological medications,
is that you decrease some of the stigma of some of these conditions."


Overprescribed vs. Underserved
For anyone who has been paying any attention at all, it should come as
little surprise that drugs for ADHD are big business.

Psychological professionals who work with children and adolescents say there
is a notable spike in office visits for the condition -- and hence, ADHD
drug prescriptions -- at the beginning of the school year.

"We certainly see an increase," said Jennifer Kurth, adolescent psychiatrist
at Northwestern Memorial Hospital's Warren Wright Adolescent Center in
Chicago. "Usually our field in general starts to see a lot of kids
throughout the first few months of school."

ADHD is thought to affect anywhere from 3 to 12 percent of school-age
children -- a figure that works out to as many as 3.8 million kids. This
makes it one of the most common childhood disorders in the country.

And it is possibly also one of the most lucrative. Medicines to treat the
disorder -- such as Ritalin, manufactured by Novartis Pharmaceuticals Corp.,
Concerta by Johnson & Johnson and Adderall by Shire U.S. Inc. -- are
estimated to rake in more than $1 billion annually in sales.

So while researchers continue to point to a wide range of possible ADHD
causes ranging from prenatal alcohol exposure to genetics, some parents and
doctors suspect that the drugs for the condition may be overprescribed.

"If a child, after a proper diagnostic evaluation actually has ADHD, then
the drug may make sense," Wolfe said. "But it is always a poor balancing of
benefits and risks to prescribe a drug that is unnecessary, taking the risks
of the drug, which can be substantial, while getting no benefit."

Many physicians in the field, however, say that this is a dangerous
misapprehension.

"I think there were a couple of reports in early 2000 that showed a dramatic
rise in the prescription rates of these drugs. These reports, while
accurate, do not convey the whole picture," said Walkup, who added that up
to half of the children who have ADHD go untreated.

"I certainly think that it's important to remember that ADHD affects 8 to 10
percent of school-aged children," Kurth said. "We're prescribing the drug
more frequently because we are catching those who hadn't been treated in the
past."


To Advertise or Not to Advertise?
It's the fact that these drugs are advertised so heavily and in a targeted
way that has some researchers and regulators concerned. Currently, the
United States and New Zealand stand alone as the only nations that allow
drug companies to advertise their prescription-only products directly to
consumers.

And the very nature of ADHD drugs -- some which have been shown in the past
to have rare but potentially deadly side effects on the heart and
significant abuse potential -- may beg for stricter regulation.

Julie Donohue, assistant professor of health policy and management at the
University of Pittsburgh Graduate School of Public Health, published a study
in the New England Journal of Medicine on Aug. 16 of this year that found
that drug companies spending on advertising since such marketing became
legal in 2001 has more than tripled. Her research also suggests that
regulatory efforts by the FDA have decreased over time.

"Some people might have ethical issues with advertising prescription drugs
for children in the first place," she said. "My whole point is that the
rules that we have on the books are adequate, they just need to be
enforced."

But even with the enforcement of current drug advertising laws, she said
ADHD drugs may present a unique conundrum.

"This is a classic example of a class of drugs that is plagued by the
problems of both overuse and underuse," Donohue said. "It's hard to fix one
of these problems without exacerbating the other."

Even psychiatrists who view drug ads favorably note that there is a
possibility that they could be a source of confusion for some parents.

"There is obviously a lot of controversy in our using psychotropic
medications in children, and I think that the pharmaceutical industry can
make that a little more confusing for parents through advertising," Kurth
said.


Balancing Publicity with Need
Yet some say the controversy over the advertisements may provide a surrogate
form of regulation by putting the pressure on doctors to truly scrutinize
their scripts.

"Public attention to this issue forces physicians to maintain their
integrity in prescribing these drugs," Kurth said.

And Walkup added that in light of the undertreatment rate of kids with ADHD,
public concern should be aimed at the disorder itself, rather than the
marketing that promotes its treatments.

"I understand the concern of drug companies hitting a vulnerable population
at one time or another," he said. "But in this case they are targeting the
real concern of something that will happen to real kids this September.

"Over and over again studies have shown that this stuff is enormously
helpful."

Kurth agreed. "We would hope that it wouldn't be marketed to the equivalent
of a candy bar, and we hope that the pharmaceutical industry is not making
this seem like something everyone should check in with their doctor about,"
she said.

But she added, "I still see parents mostly coming in as a result of
problematic behavior on the part of their child, rather than as a result [of
drug ads]... I have not seen too many parents coming in and saying, 'You
must put my kid on this medicine.'"





 




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