Abstract
BackgroundThe balance of the benefits and risks of long term use of hormone replacement therapy (HRT) have been a matter of debate for decades. In Europe, HRT requires medical prescription and its advertising is only permitted when aimed at health professionals (direct to consumer advertising is allowed in some non European countries). The objective of this study is to analyse the appropriateness and quality of Internet advertising about HRT in Spain.MethodsA search was carried out on the Internet (January 2009) using the eight best-selling HRT drugs in Spain. The brand name of each drug was entered into Google's search engine. The web sites appearing on the first page of results and the corresponding companies were analysed using the European Code of Good Practice as the reference point.ResultsFive corporate web pages: none of them included bibliographic references or measures to ensure that the advertising was only accessible by health professionals. Regarding non-corporate web pages (n = 27): 41% did not include the company name or address, 44% made no distinction between patient and health professional information, 7% contained bibliographic references, 26% provided unspecific information for the use of HRT for osteoporosis and 19% included menstrual cycle regulation or boosting feminity as an indication. Two online pharmacies sold HRT drugs which could be bought online in Spain, did not include the name or contact details of the registered company, nor did they stipulate the need for a medical prescription or differentiate between patient and health professional information.ConclusionsEven though pharmaceutical companies have committed themselves to compliance with codes of good practice, deficiencies were observed regarding the identification, information and promotion of HRT medications on their web pages. Unaffected by legislation, non-corporate web pages are an ideal place for indirect HRT advertising, but they often contain misleading information. HRT can be bought online from Spain, without a medical consultation or prescription constituting a serious issue for public health. In our information society, it is the right and obligation of public health bodies to ensure that such information is not misleading.
Highlights
The balance of the benefits and risks of long term use of hormone replacement therapy (HRT) have been a matter of debate for decades
Out of a total of 70 web pages, corresponding to the eight HRT drugs studied were retrieved from Google
Despite important efforts by the European Union to regulate and control medicines, our study shows that the European Code of Good Practice for the Promotion of Medicines has not had the desired effect on the quality of the information available on the best selling pharmaceuticals in Spain
Summary
The balance of the benefits and risks of long term use of hormone replacement therapy (HRT) have been a matter of debate for decades. Since 2004, the Spanish Agency for Medicine and Health Care Products, in consonance with the regulatory agencies in other countries, leading health care institutions and most scientific societies, has considered HRT to be potentially indicated only in the treatment of severe climacteric symptoms with a negative effect on quality of life. In this case, they concur that the minimum effective dose should be used for the shortest possible duration [7,8]
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