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PAAB Q&A

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PAAB Notice
The responses, guidance, and advisories provided by the Pharmaceutical Advertising Advisory Board (PAAB), including but not limited to those available through the PAAB Forum, the PAAB website, and any PAAB correspondences, are specifically intended to assist individuals navigating the PAAB preclearance system. Repurposing or reproducing this content without written consent from the PAAB Commissioner is strictly prohibited. This prohibition includes, but is not limited to, use in machine learning or AI models.

  • 239 Topics
    391 Posts
    C
    hi Paab! I would like to develop an APS to highlight all of the Rx products we have in our portfolio (all with the same indication). Provided I can find a compared prices must come from a single independent source (as described in question 438), would I be able to present the price as a unit cost? For example, the price of injectable pen X is $450 for 450 units, i.e. $1/unit.
  • 31 Topics
    57 Posts
    C
    @jennifer-carroll Thank you this helps!
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    7 Topics
    11 Posts
    Jennifer CarrollJ
    Hello @abhi-patel While consumer advertising for Schedule D health products (e.g., vaccine), and ethical schedule health products fall within the scope of PAAB services, consumer advertising for OTC and NHP products does not. Please note that Health Professional directed advertising of these products falls within the scope of the PAAB Code.
  • 38 Topics
    56 Posts
    Jennifer CarrollJ
    Hi @tk2022 Reprint holders are a common term we see in advertising for the “folder” which houses the reprint. This can be as simple as the brand name, study title, and fair balance, or house complex claim copy. The content that appears is at the discretion of the sponsor as long as it meets the advertising requirements. All requirements from Section 2 of the PAAB RWE Guidance would apply. Yes, it is applicable to virtual distributions. An unaccompanied (by any form of verbal or written information designed by or on behalf of the manufacturer for the purpose of promoting a health product) study reprint pdf in its original form (i.e. unaltered) is exempt from PAAB preclearance but not advertising regulations, however if additional verbal/written messages or context is added through the distribution channel, it may not be exempt as noted in our previous response. We suggest submitting for an opinion if you are unsure.
  • 84 Topics
    122 Posts
    Jennifer CarrollJ
    Hey @maryssa The relevant standards of the PAAB Code of Advertising Acceptance are applicable to APS directed at HCPs and APS directed at patients when there is HCP involvement. This remains true regardless of how else the APS may be used. In questions 1 and 2, leaving physical copies of APS in an HCP's practice constitutes distribution involving the HCP. The HCP maintains full control over which materials are allowed to remain in their practice. It would be prudent, as a best practice, to seek permission from the HCP before leaving such materials in their practice. In question 3, the messaging is directed specifically to the HCP. The fact that the messaging is about a consumer campaign does not exempt it from the applicable provisions of the PAAB Code for the message itself. If inclusion of the DTC website/material is for awareness only, it would not subject to PAAB review. However, should there be copy that suggests the material is intended for consumption by the HCP or disseminated to patients through the HCP, e.g. “Tools and resources…”, “Learn more at…”, then the website/material would be subject to PAAB review. Conversely, in question 4, the HCP is receiving the message as a member of the general public. Therefore, the PAAB Code does not apply. While the question may be framed humorously (I would hope), the general public includes individuals from all walks of life, even HCPs. Don't forget the Advisory - APS in Patient Interaction Areas as well.
  • 70 Topics
    117 Posts
    Jennifer CarrollJ
    Hey @cscholes We understand that LinkedIn is an ungated platform and open to consumers. As such, the site is subject to consumer regulations similar to PF question 458 and is highly restricted for prescription advertising. Targeting to HCPs within the open platform may not guarantee that consumers won’t see the ad as well. Please also see this linked PF question and our Guidance on Gating Mechanisms for Healthcare Professional Targeted Digital Assets and subsequent clarification document Gating Mechanisms for HCP Digital Assets (designed in collaboration with Health Canada) regarding HCP validation. How HCPs are identified and verified, the nature of the targeting and how well it can limit the audience to only validated HCPs would be information that is required as part of the review process. PAAB will provide advice and direction based on the Health Canada DTC regulations, the PAAB code principles and the information that the sponsor can provide for the restriction of the intended HCP audience within this consumer space.
  • 174 Topics
    218 Posts
    Jennifer CarrollJ
    Apologies for the delay @SMurcar. We were in the process of upgrading the forum over the last two days. As the piece would be moving from two sided to one sided this would change the flow. The content in the top section may set context for the bottom section depending on the formatting and flow. We would suggest submitting for a minor update (if the resizing is intended to replace the small postcard altogether) so that we can assess the revised visual flow to ensure all aspects of the Code remain met. The addition of the QR code as described above could be considered as a minor update. Please see the Submission Guidelines for more information
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    124 Topics
    194 Posts
    Jennifer CarrollJ
    Good Morning @HollyMed Pooled data is not acceptable even if part of a pre-planned long-term extension study.
  • 60 Topics
    72 Posts
    Jennifer CarrollJ
    Hey @dmauri Section 7.3 of the PAAB Code states “Advertising with Product Claim Link to Terms of Market Authorization: One of the following must appear prominently within the main advertising message of the APS: Electronic link(s) to the current TMA (and Health Canada endorsed risk communications issued since approval of the TMA, if relevant) URL(s) for a webpage containing the current TMA (and Health Canada endorsed risk communications issued since approval of the TMA, if relevant) accompanied by a statement that these documents are also available upon request through a stated phone number. The definition of “Terms of Market Authorization” can be found in the Code and reads as follows: Information in the Product Monograph, labeling and product license and the document that assigns a Drug Identification Number (DIN), Natural Health Product number (NPN) or homeopathic product number (DIN-HM), including related product labeling material and prescribing information, authorized by Health Canada. When a Product Monograph is the basis of authorization, it should be linked. If authorization was granted based on a Product License, providing a link to that document would meet the requirements of section 7.3. The TMA document would be the basis for review of the ad.
  • 8 Topics
    16 Posts
    Jennifer CarrollJ
    Hey @vt Yes, you should ensure that the 4 criteria are still followed. These criteria still exist in the distinction document, they are just mentioned across the document and therefore not repeated in this section. For example, the “Content and Context Factors” section in the “Overview” states: • A message involving unauthorized health products or unauthorized indications, in a context such as educational activities, may be considered promotional if: • the message does not caution that the product’s safety and effectiveness are still under investigation and that Health Canada has not yet granted market authorization Within the Educational Activities section, things that could make the piece promotional are: • The limitations of the data and of the health products are not adequately discussed • Reports, edited scripts or recorded videos of the proceedings, in whole or in part, that concern a health product are disseminated by the sponsor or its agent to a wider audience These are in addition to the copy under the revised heading of “Canadian and International Conferences”. In general, if it is a Canadian conference, the content should be created by the Canadian office. If it is an international conference, the content should be created by the parent company and should be adequately disclaimed. Remember that the distinction document is not intended to be an exhaustive list, but a set of guiding principles with examples throughout to help assess context and content. The examples in the “Overview” section should be considered when evaluating individual activities.
  • Inquiry on observational study material

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    Jennifer CarrollJ
    Hey @nimisha Unfortunately, we cannot provide this confirmation as it does not appear that the project will meet the criteria outlined in the Distinction Document (it will inherently be branded). We suggest submitting for an opinion to receive more specific feedback in this specific case.
  • Converting a full colour layout to B&W - does PAAB need to see this?

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    Jennifer CarrollJ
    Hello @maryssa If there are no other changes, the files should be submitted as an FYI. If the review of the FYI prompts comments, it would be required to be submitted as a new file. If no changes are required, it can be considered solely as an FYI. When preparing the black and white version, consider things like legibility of all copy (e.g., no reduced contrast).
  • Abstracts and HCP websites

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    Jennifer CarrollJ
    Hello @joao-borges When you link advertising and non-advertising, everything becomes advertising. Even though the abstracts are on a third-party site, you would be leading them there from an advertising space and in the context of promotional material; the abstract would become advertising. The abstracts would have to be reviewed to ensure that they meet advertising requirements. For example, you could not link to an abstract about off-label use of the product as this would be off-label promotions. Furthermore, the abstract content would be reviewed as if it were APS copy. A quick review of the Health Canada document “The distinction between advertising and other activities” may help provide additional information about questions to ask when assessing if an activity would be considered advertising.
  • Conferences

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    Jennifer CarrollJ
    @gmc PAAB does not regulate representative activities but agree with the primary principles of not promoting off label use for drug products and not distributing unbranded materials in a branded booth. The PAAB Code requires use of PAAB reviewed materials. Please note that respective pharmaceutical trade associations generally have a code of ethics/conduct that may help guide representative activities. In addition, the Food and Drug Regulations apply to all advertising activities.
  • Reminder tool for patient

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    Jennifer CarrollJ
    Hey @natbourre Without additional details, it’s difficult to provide specific direction. In general, providing an exhaustive list of things to keep in mind is not possible. As the tool is being given to patients, ensure it meets s.6 requirements for patient information, particularly regarding promotional claims, as well as the spirit of 2.8. If you are unsure if the tool would meet these criteria, we would recommend submitting for an opinion.
  • Journal Ad Query

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    J
    @jennifer-carroll sounds good, that is helpful to know.
  • Unbranded vaccine patient site with postal code tracker

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    Jennifer CarrollJ
    Hey @natbourre It appears that the intent is to develop a help-seeking message. What you’ve described does not meet the criteria of a help-seeking message per the Distinction Between Advertising and Other Activities as the addition of the company name would violate the requirements. The direct link to sites that only have the sponsors brand and listing the sponsors brand as what is offered at those sites would also brand the site. If you are going the help-seeking route, all criteria listing in the distinction document should be followed. Since this is a vaccine, DTC advertising which links the product to it’s therapeutic use could be considered. If this option is selected, all advertising regulations would be required to be met.
  • Formulary message - exemption confirmation

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    Jennifer CarrollJ
    @abyscat “The formulary status for Drug XYA has been updated” may potentially be exempt depending on the context in which it is presented. Our PAAB opinion service is available for exempt opinions.
  • Inclusion of trial patient characteristics within a Rep CVA

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    B
    @jennifer-carroll Thank you!
  • Unbranded patient counselling materials

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    Jennifer CarrollJ
    Hello @karen-taylor Code section 1.4.D states “The Code applies to all Advertising/Promotion Systems and corporate messages directed to licensed members of the professions of medicine, dentistry, naturopathy, homeopathy, nursing, pharmacy and related health disciplines, to institutions, and to patient information that will be distributed by or recommended by a healthcare professional.”. From the provided description, it appears that these pieces would be considered patient materials that are subject to the PAAB code.
  • 0 Votes
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    Jennifer CarrollJ
    Hello @danielle Independent third party lifestyle apps may be promoted within branded apps if they do not contradict copy within the brands TMA. PAAB would ask to see the app content to ensure the link is acceptable. The review of linked 3rd party apps focused on lifestyle and nutrition vs lifestyle, nutrition and disease information is not different however there is increased opportunity for content which is not acceptable to arise when disease information is discussed. Additional clarification would be required on the last question that would be better suited for an opinion submission so that all aspects of the activity can be assessed. For example, is the 3rd party app only accessible through the PSP (not open to the public)? When this is the case, clarity over influence, sponsorship and distribution may impact if the content requires PAAB review.
  • Tools promoting medical education program

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    Jennifer CarrollJ
    Hey @natbourre The answers to your questions hinge on whether the document is subject to the advertising provisions or not. The assessment of whether it is subject to the advertising provisions is made by applying the following 7 questions from the Health Canada policy document “The Distinction Between Advertising and Other Activities”: • What is the context in which the message is disseminated? • Who are the primary and secondary audiences? • Who delivers the message? (the provider) • Who sponsors the message and how? • What influence does the drug manufacturer have on the message content? • What is the content of the message? • With what frequency is the message delivered? Assuming that the audience is HCPs, you would need to assess who sponsored the program; what influence did the manufacturer have; what is the content of the message across the program; and the frequency of the messages throughout the learning program. It is important to consider each question as no single factor can determine whether the advertising provisions apply. This assessment can be done internally through the manufacturer’s own regulatory department. If you would like, PAAB can provide an objective opinion on any particular tool/material based on the aforementioned Health Canada policy document. If the activity was deemed to be advertising, the pieces would be subject to the PAAB code. Mention of the sponsor on content they create would be required unless precluded by other regulations (i.e. help seeking messages).
  • Disease information in Risk Management Materials

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    Jennifer CarrollJ
    Hey @xian50 The type of information within the piece would be dependent on the type of review you are looking for. An RMT should convey important risk information about the manufacturers product. If the proposed “disease information” does not appear to serve the intent of an RMT, it may be questioned. This would be assessed during the review. Patient information can contain disease information as well as risk information. Disease information which does not align with part III of the TMA would not be acceptable in the context of a branded patient information piece.
  • Promotion on use of device, but not medication nor disease

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    Yin ManY
    @natbourre Thanks for your question. If the device is a distinct Class I-IV “medical device”, it does not fall within the PAAB scope as defined in code section 1.3 and the definition of a “Health product” per PAAB scope in section 1.8. If it is not a Class I-IV “medical device” and is an extension of the corresponding drug product, then the training material, directed to HCPs, would be subject to PAAB review. Please also see PAAB Q&A #500 as well as this PAAB Forum post
  • Schedule C product advertising

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    Yin ManY
    Hi @alee, Yes, radiopharmaceuticals are drug products that fall under the Scope of the Code. Please see Code sections 1.3 and 1.4, and particularly 1.8 (definition of “healthcare product” which is covered by the Code).
  • Unbranded disease info + Guidelines (therapeutic categories)

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    Jennifer CarrollJ
    Good Morning @natbourre Please see Q&A 634, particularly the PAAB Advisory Guidance on which HCP materials require PAAB review, which contains a decision tree to describe the key elements in the assessment. To make an assessment, we would require further elaboration on the content, nature of the sponsorship and selection of the author group. We would also require elaboration on the “3rd party distribution”. If the sponsor has influence on choosing the topic and/or plays a role in the distribution by the 3rd party, we would recommend submitting for an opinion. The opinion would be to assess the influence of the sponsorship (as noted in the above guidance, examples of “influence” include control or input on the specific topic, content, author selection, audience, frequency, etc.) and the overall message of the piece. The standard litmus test is “could a reader identify the sponsor” and “would a competitor be equally as likely to promote this tool”.
  • Mention of positive LOI with pCPA

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    Jennifer CarrollJ
    Hello @karen-taylor Please see the response to Q&A Email update on CADTH recommendations. The letter of intent (LOI) is viewed similarly to the CADTH recommendation. It is not acceptable to position the pan-Canadian Pharmaceutical Alliance (pCPA) coverage negotiations as a positive feature of the product or suggest endorsement. Formulary messages should be restricted to clear, complete coverage criteria and not suggest the endorsement of a product.
  • 0 Votes
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    461 Views
    Jennifer CarrollJ
    Hi @smurcar The addition of such content would prompt a new review as you are changing the piece. While Class I-IV medical devices do not fall under the scope of PAAB review, the piece in question combines drug-related content and device-specific content. Any change to the former OR the latter would trigger the requirement for re-assessment. Changes in the device-specific content could potentially impair acceptability of the previously approved drug content through various contextual or linkage factors. Based on the information provided in the question, some of the key focuses of our review might include: Whether the added content is indeed device-specific. Whether the drug-related and device-specific content are separate and distinct from each other. For example, the device-specific content must not impact the meaning/interpretation of the drug content through context or linkage. Whether the device-specific content suggests therapeutic outcomes or contains promotional claims for the drug brand. For example, if the claim was to state “Drug Brand X: pain free injections with S-pen”, we would question the link between the drug brand and “pain” in the absence of support. For copy to be considered “device” claims, it should be limited to the device and not positioned as a feature of the drug brand. As the assessment is largely contextual in nature, references are not typically required for the Class I-IV medical device-specific content. Particularly as the manufacturer is solely responsible for ensuring that the medical device claims adhere with all applicable marketing rules and regulations. The reviewer will request references, on an as needed basis, wherever this content could potentially relate to the drug product.
  • Rep triggered email function disabled

    rte email rep triggered email
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    Jennifer CarrollJ
    Hi @nhem Change to copy post approval generally requires a new file and new fee. In the scenario described above, it sounds as though one option from the drop-down menu will be removed/de-activated. PAAB does not require that all options within the drop-down options list, remain active. If that is the intent of the revision and question, it would not require resubmission. However, addition of new content (e.g. replacing or adding options) that requires assessment post-approval requires a new file and new fee. If we have not fully captured the request, please reach out to admin to set up a call with the reviewer. It may be easier to assess the actions when looking at the file in question.
  • Email communication linking to unbranded event

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    Jennifer CarrollJ
    Hello @brendaarmit1 Yes, a pharma company can send emails with CME event links, guidelines or journal articles. The important thing to note is that these may fall under “advertising activities” and require review. Please see Q&A 481 and 435 for additional considerations and guidance. Note that “linking” refers to any activity that could be perceived to create a connection between two separate activities. This includes sending emails in a predictive manner as part of a large campaign. Q&A 38 may also be of interest. If you are unsure, you can submit for a PAAB opinion.