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Healthy Skepticism Library item: 16945

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: news

Hogstrom E
The side effects
The Telegraph Herald 2009 Dec 20


Relaxed rules allow drug companies to advertise directly to consumers. Is it a cure for ignorance or a prescription for trouble?

Full text:

A dozen years ago, the Food and Drug Administration relaxed restrictions and allowed direct-to-consumer advertising of prescription drugs on television.
Promotional spending by the pharmaceutical companies soared, from $11.4 billion in 1996 to
$29.9 billion in 2005, and now the typical American television viewer can expect to spend 16 hours per year watching direct-to-consumer drug advertisements.
Critics complain such advertising encouraged inappropriate medication usage and increased health-care costs. Drug companies contend the advertisements provide accurate information about diseases and treatment options that makes patients and doctors better partners in care.
Do direct-to-consumer advertisements of pharmaceuticals benefit consumers?
YES Ken Johnson, a senior vice president for Pharmaceutical Research and Manufacturers of America, a trade group representing America’s pharmaceutical research and biotechnology companies, said direct-to-consumer
advertising serves a vital health-care role by increasing people’s awareness of diseases and available treatments.
“At a time when policy-makers at the federal and state levels view disease prevention as a top priority, it is critical to have an honest and open dialogue about the health benefits of direct-to-consumer advertising,” Johnson said.
Johnson believes such advertising benefits the American health-care system by encouraging patients to seek medical attention that could help manage conditions and avoid the need for more costly hospitalization or surgery.
The advertisements increase awareness of all drugs, Johnson contends, not just the brand-name medications marketed by manufacturers on television.
Nine of the 10 most frequently prescribed drugs in the United States are lower-cost generic medications.
Manufacturers say this statistic demonstrates that pharmaceutical marketing to consumers does not determine the number and type of medicines that patients use.
The advertisements do more than increase awareness, Johnson said. The television spots send people to doctor’s offices for potentially life-saving conversations.
“A national survey by Prevention Magazine found that 29 million patients talked to their doctor for the first time about a health condition after seeing a direct-to-consumer ad,” Johnson said. “In those conversations, according to the survey, most patients discuss behavioral and lifestyle changes, and more than half received a recommendation for nonprescription or generic drugs.”
The result, Johnson contends, is a reduction in the undiagnosed incidence of such serious conditions as diabetes, hypertension and depression.
Without direct-to-consumer advertising, Johnson fears a large share of patients who should be using medications would go untreated, creating a treatment gap that would lead to poor patient outcomes and higher health costs.
“Such advertising informs patients potentially suffering from an undiagnosed condition and raises awareness of treatment options,” he said.
No The proliferation of direct-to-consumer advertising concerns Jim Miller, who oversees local Mercy Family Pharmacy stores as director of Retail Pharmacy Services for Mercy Medical Center.
“My concern is that when you treat people’s health, it is a holistic approach,” Miller said. “We don’t just treat your blood pressure (with a medication), there are other factors.”
Health-care professionals will advocate for increased exercise to help control blood pressure and target diet to solve other problems.
“You need to stop eating pizza at 9 o’clock at night, that’s what is causing your heartburn,” Miller said.
Suggesting advertised drugs solve problems themselves, Miller said, represents a disservice to patients.
“In our culture, there’s a perception that there is a fix for everything,” he said. “It’s unrealistic. You build up this perception that if I get this particular product my quality of life is going to go back up.”
Drug companies contend the advertisements help foster increased patient-physician communication.
“Most physicians would agree patients are more knowledgeable,” Miller said, “but physicians have trained themselves about how to talk to patients. I don’t think it has to do with how much advertising there is on television.”
The health-care provider’s role, Miller said, is to develop the most effective — and most cost-effective — treatments for patients. Direct-to-consumer advertisements shift the focus away from this traditional role, he fears.
“We miss that part by having people focus on a brand-name product as the only one that’s going to work for them,” he said.
Advertisements for low-cost, generic versions of drugs don’t routinely appear on television.
“Yet, in the top 20 drug products that are advertised, for every one there is a generic, therapeutic alternative,” Miller said.
Pharmacists often explain to patients the benefits of taking the least-expensive product at the lowest possible dose.
“The lowest dose we can have you on, the least likely you are to develop any threatening side effects,” Miller said. “You can’t get that (discussion) in a 30-second sound bite.”
Despite his criticisms of direct-to-consumer advertising, Miller believes such promotional tactics are here to stay.
“I don’t see it changing,” he said. “Once you let the horse out of the barn, I don’t see you putting it back in.”

by the numbers

216 million Dollar amount the drug company Astra-Zeneca spent promoting the cholesterol drug Crestor in 2004. By comparison, Pepsi spent $212 million in promotion that year.

88 Percentage of patients who asked for a prescription drug by brand name because of an advertisement, who actually had the condition the drug treats.

16 The number of hours per year a typical American television viewer can expect to spend watching direct-to-consumer drug advertisements.

12 Estimated percentage increase in drug sales generated by direct-to-consumer advertising in 2000.

4.20 Dollar amount of the additional sales generated by every $1 spent on drug advertising.

3 The three highest drug categories in terms of advertising spending on pharmaceuticals in 2005 were heartburn medications, insomnia medications and cholesterol medications. Erectile dysfunction ranked No. 7.

Sources: The Nielsen Company, The Kaiser Family Foundation and the U.S. Government Accountability Office

Have you been paying attention?
Take our quiz matching the drug advertisement to the brand.

Here are descriptions of the six drug advertisements that viewers could recall the best during the 2008-09 television season.
See if you can name the drug based on the description of the advertisement.
The advertisements
A. Men at a baseball game frequent the bathroom as a baseball announcer lists the male urinary symptoms caused by a condition called BPH.
B. Various couples are shown in bathtubs, on a beach and sitting on a couch and on stairs while an announcer says “what are you waiting for?”
C. Moms are shown with their daughters surfing, shopping, sewing, swimming and talking.
D. A woman with a wind-up doll says she has to “wind herself up” just to get out of bed.
E. A hospital gurney follows a man through a museum.
F. A woman in a blue sweater asks if you’re treating rheumatoid arthritis but still having trouble with everyday things.
The answers
A. Flomax, a medicine used to treat benign prostatic hyperplasia and manufactured by Boehringer-Ingelheim.
B. Ciallis, an erectile dysfunction medication manufactured by Eli Lilly.
C. Gardasil, a vaccine to prevent cervical cancer manufactured by Merck.
D. Pristiq, an antidepressant manufactured by Wyeth.
E. Plavix, an antiplatelet agent used to inhibit blood clots manufactured by Bristol-Meyers Squibb and Sanofi-Aventis.
F. Orencia, a rheumatoid arthritis medication manufactured by Bristol-Meyers Squibb.
Source: The Nielsen Company


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There is no sin in being wrong. The sin is in our unwillingness to examine our own beliefs, and in believing that our authorities cannot be wrong. Far from creating cynics, such a story is likely to foster a healthy and creative skepticism, which is something quite different from cynicism.”
- Neil Postman in The End of Education