From DTCA‐PD to patient information to health information: the complex politics and semantics of EU health policy

AbstractRationale, aims and objectivesBetween 2001 and 2011 the pharmaceutical industry, supported byDG Enterprise, was engaged in an ongoing campaign to repeal/amend theEuropeanUnion (EU) ban on direct‐to‐consumer advertising of prescription drugs (DTCA‐PD). As it became increasingly clear that the ban would not be repealed,DTCA‐PDsupporters tried to shift the debate away from advertising and towards the provision of ‘patient information’ and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported byDG SANCO, sought to maintain the ban and oppose the industry‐supported ‘patient information’ campaign. Instead, they promoted a concept of ‘health information’ that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition fromDTCA‐PDto patient information to health information and examine its implications forEUhealth policy as a complex policy space.MethodsThe article examines the emergence and development ofEUhealth policy and the evolution of theDTCA‐PDdebate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us aboutEUhealth policy and futureEUhealth legislation and how it may be understood from a complexity perspective.Results and conclusionsThe article concludes that the complexity framework is ideally suited for the field of public health and, in particular, theDTCA‐PDdebate. Having successfully shifted the policy‐focus of the debate to patients’ rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising.