Is it well-aimed public education or wasteful marketing overkill for a drug company to mail out to thousands of doctors unsolicited videocassettes describing the use of its anti-AIDS drug?
The drug is Retrovir, or azidothymidine (AZT), the only medicine approved by the Food and Drug Administration for treatment of AIDS. The pharmaceutical firm is Burroughs Wellcome Co., which sells AZT at $188 per 100 pills wholesale, or nearly $10,000 for a year's supply for one patient.
In a letter to The New England Journal of Medicine, a Chicago physician calls the AZT videocassette "the most lavish" unsolicited package she has received from a drug company this year.
AIDS treatment, the physician points out, is not only expensive but also raises complex policy and ethical questions.
"In this tenuous climate," wrote Dr. Abigail Zuger, of the University of Chicago Hospitals and Clinics, "to launch Retrovir with the usual costly marketing glitz seems to me to be a particularly unfortunate gesture."
But a spokesman for Burroughs Wellcome called the videocassette "a state-of-the-art educational tool that provides detailed information on a new therapy about which only limited information has yet been published."
The videotape, in which AIDS experts discuss their results in clinical studies of AZT, was sent to hematologists, oncologists and infectious disease specialists and selected doctors in the 12 U.S. cities where AIDS is most prevalent.
"The uniqueness of the disease and the rapidity with which new information becomes available make it essential that we all use every suitable method available to disseminate educational information," wrote Dr. S.W. Singleton, the Burroughs Wellcome representative, in a response in the journal.
Singleton said the videotape mailing was "not without cost" but is cost-effective when weighed against the "even higher costs to physicians and patients that could result from inadequate or inappropriate information."