Fact

Unfortunately, this myth is as pervasive as it is illogical. The PAAB code applies to all healthcare product advertising directed to Canadian HCPs in all media. We have been reviewing conference panels and auxiliary materials for several decades. To help address the pervasiveness of this myth, we are now monitoring digital conferences. We are also proactively reaching out to conference organizers and the suppliers who license their conference platforms. The PAAB has published advisories and guidances to help healthcare product manufacturers adhere to applicable standards and regulations.

Fact

The PAAB code applies to all healthcare product advertising directed to Canadian HCPs or created by a Canadian manufacturer.

International conferences are indeed exempted from Canadian advertising regulations and the PAAB Code. However, the fact that a conference takes place on the cloud as opposed to Canadian soil does not necessarily render it to be an international conference. This is true even if the hosting server is not Canadian. For the exemption to be applicable, the following provisions set out in the Health Canada document "The Distinction Between Advertising and Other Activities" must be met:

• a significant proportion of the conference delegates are from other jurisdictions
• the material must emanate from the parent company of the manufacturer
• the material must only be for use within the confines of the conference
• the material is prominently identified as not being authorized for sale in Canada

Fact

Although, those principles may sufficiently address regulatory issues pertaining to one-on-one chat during digital conferences, they are insufficient to address issues pertaining to group chat. Group chat enables any conference delegate to take part in the discussion asynchronously over time. The breadth of the audience participating in the discussion is therefore greater as conference delegates can continually see and contribute to the growing record of content. This increases the likelihood of misleading or off-label content being shared broadly in a chat room associated with a product booth. It is therefore important for manufacturers to ensure that group chats are monitored and moderated so as to secure the regulatory status of the advertising which is associated with that thread.

Stated plainly, the principles related to social media exchanges in manufacturer-controlled/influenced media apply in addition to the guiding principles governing in-person conferences.

It is also noteworthy that similar principles apply to medical and corporate booths, albeit for a different reason. The group chat characteristics outlined above increase the risk that product-centered discussion inherently brands the booth and the materials presented therein through linkage. Medical and corporate booths will be monitored by different personnel than product booths, but the monitoring & moderation should nonetheless take place.

Fact

Other Learning Activities (OLAs) are expressly intended to be non-promotional activities. That does not mean they always will be in practice. An OLA is exempt from PAAB preclearance provided the content does not promote the sale of a product. There is a simple litmus test to determine whether a particular OLA is subject to advertising regulations. Ask yourself either of the following questions based on the planned topics, slides, or whatever information you have prior to the activity:

• Would a standard HCP likely be able to guess which manufacturer sponsored the activity without having heard the sponsorship disclosure?

• Would your competitors theoretically be just as willing to sponsor this activity?

If the answers are no and yes respectively, the OLA is much less likely to be subject to advertising regulations. If the answers where yes or no respectively, the activity is likely subject to advertising activities. Keep in mind that, although one or more HCP(s) created the content, the manufacturer exerted control over selection of the HCP(s).

Fact

The litmus test applied by the manufacturer (or optionally by PAAB) as described in myth 4 was applied prior to the actual activity. The activity has now taken place. The speaker's actual words and the Q&A that ensued are now known and recorded. Before this recorded content is shared with an audience which is wider than those who participated in the session, the litmus test described in myth 4 must again be repeated in consideration of all content. Again, the PAAB is here to support you in this assessment if necessary.

Fact

The Health Canada policy document "The Distinction Between Advertising and Other Activities" does not distinguish between titles/roles within the company. If the activity does not fall under "other activities" per the Distinction Between Advertising and Other Activities document, it may be considered advertising regardless of the title the manufacturers participant holds. Key considerations are the role the moderator plays, the influence the sponsor has on the content, and the nature of the content.

Fact

The context of distribution can impact the regulatory status of the content that is being distributed. For example, handing out a branded APS at a corporate booth, may render the corporate booth now branded. Now all messages at the booth become messages for the brand. Similarly, handing out a PAAB approved unbranded piece at a branded booth, renders that piece branded (as it is being disseminated in the context of the brand). This is why it is important to always disclose attached/linked pieces.

Fact

This still creates a link between advertising and non-advertising and therefore renders the activity advertising, regardless of the title of the person/department partaking in the exchange or creating the content.