AS SEEN ON TV: Prescription Drug Advertisements

We’ve all seen the wide variety of prescription drugs advertised on television. They treat well-known conditions such as cancer, diabetes, depression, and insomnia. They also treat lesser known, or newly named “conditions”, such as Low T, thinning eyelashes, and opioid-induced constipation. These ads are ubiquitous, effective, and profitable.

Bypassing The Physician

This type of advertising is known as direct-to-consumer advertising or DTC. In the old days, pharmaceutical reps presented information to physicians about new drug products, and the physicians in turn prescribed them to the patients they felt would benefit from them. DTC has cut out the middleman, the physician, in this process, and is appealing to consumers who may or may not have a need for these drugs. DTCs medicalize and stigmatize normal conditions, such as changes associated with normal aging, and create a demand for the latest and greatest treatments, even when those drugs may not be appropriate. In effect, this is like being diagnosed by a TV pitchman and then going to the doctor to demand treatment.

“TELL YOUR DOCTOR IF…”

In the early 1980s, prescription drug ads appearing in magazines were required by the FDA to list all the drug’s side effects. These lists typically took up two pages of very fine print. In 1997, TV ads for prescription drugs began. The FDA relaxed the rules and allowed pharmaceutical companies to name only the most significant side effects of a given drug. This decision was a boon to the pharmaceutical company advertisers. A typical commercial will list the most common/significant side effects towards the end of the spot. A narrator starts with “tell your doctor if you have…” and then runs through the list quickly and quietly with due diligence. At the same time, cheerful music plays and the viewer watches happy patients (actors or cartoon characters) enjoying rich and fulfilling activities. This practice is repeated so often that the viewer becomes numb to phrases such as “suicidal thoughts or unusual behavior”, “yellowing of the skin or eyes”, and “temporary inability to move”.

Handsome Rewards

Every year the pharmaceutical industry spends over $3 billion on DTC advertisements. This often far exceeds the amount they spend on research and development. And it is working. Some experts estimate that that for every dollar spent on DTC ads, the company earns back more than four dollars. Most patients who go to their doctor demanding a drug they saw advertised will get that drug. If one doctor denies the request for a prescription, many patients will find another doctor who will give it. The United States makes up 5% of the world’s population but accounts for 42% of global prescription drug spending. The U.S. and New Zealand are the only two countries who allow DTC advertising.

Legal Considerations

Prescription drugs are promoted by DTC ads before long-term safety information is known. Vioxx is a familiar example. It was advertised and prescribed from 1999 to 2004 for treating arthritis pain. In 2004, it was pulled off the market once it was connected to thousands of deaths from strokes and heart attacks. The manufacturer Merck agreed to pay nearly $5 billion to settle subsequent lawsuits.

Stay Tuned

Many of these DTC advertised prescription drugs are not necessary, not necessarily effective, and quite likely not even safe. These ads overstate the benefits of the drugs and understate their risks. The AMA called for a ban on DTCs in 2015. Stay tuned to see how that plays out.

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