Background

Healthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity.

Methods

We conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or more were compared with older comparators: (1) comparative evidence of added benefit; (2) Defined Daily Dose cost; (3) regulatory safety announcements; and (4) completed and ongoing post-marketing studies 3 years after advertising.

Results

We found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue (range 0 to 11). Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: (1) ‘no added benefit’ in 4 (29%) of 14 comparisons, ‘uncertain benefits’ in 7 (50%), and ‘no evidence’ in 3 (21%) comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; (2) advertised drugs were 2 to 196 times (median 6) more expensive per Defined Daily Dose; (3) 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; (4) 20 post-marketing studies (7 completed, 13 ongoing) were requested for the advertised drugs versus 10 studies (4 completed, 6 ongoing) for the comparator drugs, and 7 studies (2 completed, 5 ongoing) assessed both an advertised and a comparator drug at 3 year follow-up.

Conclusions and relevance

In this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements.

中文翻译：

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全国通用医学杂志中医学广告的横断面研究：广告，比较药物的证据，成本和安全使用

背景

医疗保健专业人员可以在医学期刊上看到处方药广告。这样的广告可能会以牺牲旧疗法为代价增加新药的处方，即使它们没有附加的好处，更有害并且更昂贵。因此，医疗广告的发布提出了与编辑诚信有关的道德问题。

方法

我们对2015年发表在《丹麦医学会杂志》上的所有医学广告进行了描述性的横断面研究。将广告6倍或以上的药物与较早的比较者进行了比较：（1）具有增加效益的比较证据；（2）确定的每日剂量费用；（3）监管安全公告；（4）广告刊登后3年内，已完成并正在进行的上市后研究。

结果

我们在2015年发现了158个医学广告，涉及35种处方药，共发布24期，每期中位数为7个广告（范围为0到11）。宣传4种药物和5种单一药物6次或以上，总共有10种适应症，我们与较旧的治疗方法进行了14次比较。我们发现：（1）在14个比较中，有4个（29％）为“无附加收益”，在7个（50％）中为“不确定收益”，有3个（21％）为“无证据”。在没有比较的情况下，我们没有发现新药具有“实质性增效”的证据。（2）标明每日剂量的广告药品价格要贵2到196倍（中位数为6）；（3）发布了5种广告药物的11条安全公告，而一种比较药物的安全公告则为1条；（4）20项上市后研究（已完成7项，

结论与相关性

在2015年发表于《丹麦医学会杂志》上的这项医学广告的横断面研究中，广告最多的药物并未证明比旧疗法具有更多的好处，而价格却高得多。从2021年1月起，丹麦医学协会杂志不再发布医学广告。