Case Summary
A pharmacist practitioner complained about an advertisement for Crestor (rosuvastatin) issued by AstraZeneca in GP, 7 November. The advertisement had a picture of a smaller than normal dartboard with the caption, 'Finding cholesterol targets harder to hit?'.
The complainant stated that the National Institute for Health and Clinical Excellence (NICE) guidance relating to lipid modification (Clinical Guidance (CG) 67) was published in May. The guidance recommended no target for patients being treated for primary prevention. Those being treated for secondary prevention were recommended for treatment with simvastatin 40mg. The audit level targets remained at 5mmol/L for total cholesterol and 3mmol/L for LDL cholesterol. These targets had not changed although the guidance recommended aspirational levels of 4mmol/L and 2mmol/L respectively after consideration of risks and benefits. Additionally, the guidance recommended using simvastatin 80mg or a statin of 'similar efficacy and cost'.
The complainant alleged that the advertisement was misleading in that it implied that targets had recently been reduced when in fact they had not. The advertisement also failed to mention the first line recommendations made by NICE.
The detailed response from AstraZeneca is given below.
The Panel noted that the advertisement featured a picture of a very small dartboard in the middle of an outline of a normal sized scoreboard. The dartboard had been shown in a much smaller scale than everything else around it. The only text in the advertisement, apart from the prescribing information and other required information was the product logo in the bottom right-hand corner together with the strap-line 'Finding cholesterol targets harder to hit?'.
The Panel noted that Crestor was indicated for the management of primary hypercholesterolaemia (type IIa including heterozygous familial hypercholesterolaemia) or mixed dyslipidaemia (type IIb) as an adjunct to diet when response to diet and other non-pharmacological treatments (eg exercise, weight reduction) was inadequate. Crestor could also be used for homozygous familial hypercholesterolaemia as an adjunct to diet and other lipid-lowering treatments (eg LDL apheresis) of if such treatments were not appropriate.
The Panel noted AstraZeneca's submission about the various guidance documents issued by NICEsince May 2008; inter alia, new cholesterol goals had been set for patients with diabetes and a new target had been set for patients with familial hypercholesterolaemia. NICE recommended high intensity statins in some patients. In the Panel's view there was a difference between overall targets which might be applicable to a patient population compared with a cholesterol target for a specific patient in a high risk group. The complainant's concerns appeared to be based only on the NICE clinical guideline 67 – Lipid Modification.
On balance, the Panel considered that the strapline 'Finding cholesterol targets harder to hit?' with the small dartboard might imply that targets had recently been reduced. However the advertisement might also be read as implying that it was more difficult to hit cholesterol targets generally. Lipid targets had now been set for a broad range of patients by a range of organisations. The strapline asked a question, it did not make a statement. If the reader's answer to the question was 'yes' then perhaps Crestor might be appropriate for some patients The Panel did not consider that the strapline was misleading as alleged. No breach of the Code was ruled.
The Panel noted that the advertisement did not mention NICE at all. Thus it did not consider that the failure to mention the first line recommendations made by NICE was misleading. No breach was ruled.
AUTH/2186/11/08 - Pharmacist Practitioner v AstraZeneca
No breach
Crestor journal advertisement
A pharmacist practitioner complained about an advertisement for Crestor (rosuvastatin) issued by AstraZeneca in GP, 7 November. The advertisement had a picture of a smaller than normal dartboard with the caption, 'Finding cholesterol targets harder to hit?'.
The complainant stated that the National Institute for Health and Clinical Excellence (NICE) guidance relating to lipid modification (Clinical Guidance (CG) 67) was published in May. The guidance recommended no target for patients being treated for primary prevention. Those being treated for secondary prevention were recommended for treatment with simvastatin 40mg. The audit level targets remained at 5mmol/L for total cholesterol and 3mmol/L for LDL cholesterol. These targets had not changed although the guidance recommended aspirational levels of 4mmol/L and 2mmol/L respectively after consideration of risks and benefits. Additionally, the guidance recommended using simvastatin 80mg or a statin of 'similar efficacy and cost'.
The complainant alleged that the advertisement was misleading in that it implied that targets had recently been reduced when in fact they had not. The advertisement also failed to mention the first line recommendations made by NICE.
The detailed response from AstraZeneca is given below.
The Panel noted that the advertisement featured a picture of a very small dartboard in the middle of an outline of a normal sized scoreboard. The dartboard had been shown in a much smaller scale than everything else around it. The only text in the advertisement, apart from the prescribing information and other required information was the product logo in the bottom right-hand corner together with the strap-line 'Finding cholesterol targets harder to hit?'.
The Panel noted that Crestor was indicated for the management of primary hypercholesterolaemia (type IIa including heterozygous familial hypercholesterolaemia) or mixed dyslipidaemia (type IIb) as an adjunct to diet when response to diet and other non-pharmacological treatments (eg exercise, weight reduction) was inadequate. Crestor could also be used for homozygous familial hypercholesterolaemia as an adjunct to diet and other lipid-lowering treatments (eg LDL apheresis) of if such treatments were not appropriate.
The Panel noted AstraZeneca's submission about the various guidance documents issued by NICE since May 2008; inter alia, new cholesterol goals had been set for patients with diabetes and a new target had been set for patients with familial hypercholesterolaemia. NICE recommended high intensity statins in some patients. In the Panel's view there was a difference between overall targets which might be applicable to a patient population compared with a cholesterol target for a specific patient in a high risk group. The complainant's concerns appeared to be based only on the NICE clinical guideline 67 – Lipid Modification.
On balance, the Panel considered that the strapline 'Finding cholesterol targets harder to hit?' with the small dartboard might imply that targets had recently been reduced. However the advertisement might also be read as implying that it was more difficult to hit cholesterol targets generally. Lipid targets had now been set for a broad range of patients by a range of organisations. The strapline asked a question, it did not make a statement. If the reader's answer to the question was 'yes' then perhaps Crestor might be appropriate for some patients The Panel did not consider that the strapline was misleading as alleged. No breach of the Code was ruled.
The Panel noted that the advertisement did not mention NICE at all. Thus it did not consider that the failure to mention the first line recommendations made by NICE was misleading. No breach was ruled.
