Oct. 18, 2009 (United Press International) -- Some U.S. physicians say promotional mailings by CVS (NYSE:CVS) Caremark pharmacies on behalf of drug makers that resemble vital patient information are misleading.

The mailings to doctors, marked "Confidential -- May Include Protected Health Information," are promotions for Eli Lilly & Co. (NYSE:LLY) , Merck (NYSE:MRK) , AstraZeneca (NYSE:AZN) , Bayer and other pharmaceutical companies, The Indianapolis Star reported Sunday.

The newspaper said ethicists, privacy groups and consumer advocates have complained, saying the mailings are misleading. Consumers Union, the non-profit group that publishes Consumer Reports magazine, has claimed the promotional mailings increase the chances doctors will prescribe inappropriate pharmaceuticals.

"The idea that it's even permissible is atrocious," Eleanor Kinney, co director of the Center for Law and Health at Indiana University School of Law-Indianapolis, told the Star.

Lilly defended the mailings, telling the newspaper they are clearly marked as a paid communication in three places, including the bottom of the first page.