On 8 April 2009, the Dutch Minister of Health provided parliament with his opinion on the evaluation of the Dutch rules on pharmaceutical advertising, as carried out in 2008.
The Minister endorses the functioning of the self-regulatory body on pharmaceutical advertising CGR ("Codecommissie Geneesmiddelenreclame"). Several topics should be addressed more strongly according to the Minister:
- influencing medical opinion leaders who play an important role in e.g. the development of treatment guidelines;
- influence of the pharmaceutical industry on continuous education of healthcare professionals; and
- "symptom advertising", i.e. advertisements in which attention is given to disease awareness without reference to a medicinal product.
The Minister asks the Healthcare Inspectorate to be more active in the enforcement of pharmaceutical advertising rules. Two additional inspectors will be added to the team entrusted with the enforcement of the advertising rules. The Minister further believes that the knowledge of the applicable advertising rules under healthcare professionals should be improved.
The Minister notes that nurses are not healthcare professionals within the meaning of the Dutch Medicines Act and that, therefore, they are considered to be general public. He believes that the consequence of the fact that nurses may not receive the information that physicians and pharmacists do, may be undesirable in view of the changing position of some nurses in the treatment of patients. Changes in the legislation are foreseen, providing certain nurses with the authority to prescribe certain medicinal products and thus allowing advertising for prescription-only medicines directed at those nurses.
The Minister refers to several initiatives by healthcare insurance companies, in which they influence the prescription and supply of medicinal products. He is of the opinion that certain of these initiatives serve the interest of rational use of medicinal products and are therefore in accordance with the purpose of the rules on pharmaceutical advertising. In general, the Minister confirms that healthcare insurers are equally bound to the pharmaceutical advertising rules.
It follows from the Minister's opinion and from the ECJ's Damgaard judgment, that healthcare insurance companies should take the advertising rules into account when issuing communication regarding medicinal products. Promoting the "rational use of medicinal products" is in our view not necessarily the same as promoting the cheapest medicinal product.
The Minister considers that the borderline between medicinal products and medical devices is not always clear and that the strict rules that apply to advertising of medicinal products do not apply to medical devices. The Minister will investigate the advertising of medical devices and encourages the use of a self-regulatory code for the advertising of medical devices.