Should prescription drugs be advertised on TV?

It usually goes a little something like this:

[A young attractive lady in black sits on a park bench looking depressed, then a pretty animated butterfly comes around and perches on her nose, immediately perking up the depressed lady. Her outfit is suddenly transformed to a pretty pink color, signalling the end of her drab emotional state]

Then comes the long list of possible side effects/warnings of said anti-depressant drug delivered in a quickfire speed, in a manner that rivals your favorite rap artiste. 

Sound familiar? Of course it does; it is the typical format of a prescription drug TV commercial.

There is an ongoing debate going on about whether prescription drugs should be directly marketed to consumers. Up until the mid-1980s, information about prescription drugs were given only to doctors and pharmacists, who then relayed that information to their patients if appropriate. Nowadays, drug companies give the general public more direct access to this information through Direct To Consumer (DTC) ads. These marketing ads are overseen by the FDA  using a number of federal laws, including the Federal Food, Drug, and Cosmetic Act, which requires that advertisements for prescription drugs be truthful, balanced, accurately described and not misleading.

However, there is still no denying the convincing power of advertising. As pharmaceutical company marketing budgets are increasing, so are the number of prescriptions being issued. But what are your thoughts? Do you think prescription drugs should be advertised directly to consumers? In order to remain objective, I will present both sides of the argument:

FOR DTC advertising

“AstraZeneca believes responsible direct-to-consumer (DTC) advertising is integral to raising disease awareness, fostering patient education, enhancing the patient/physician dialogue and encouraging medication adherence. And we also recognize that consumers today need to be engaged differently. Ads need to be both informative and compelling to make a lasting impression and to effectively raise awareness of an issue or a treatment.”

DTC advertising, when done responsibly, has been said to foster informed conversations about health, disease and treatments between patients and their health care practitioners. By being a participant in the management of their own health journey, the patient’s voice can be heard, even though it is still the physician that makes the ultimate decision.

Another argument for DTC advertising is that it can be good for under-treated conditions. It encourages millions of Americans to consult their physicians on a number of leading diseases that are either under diagnosed, under treated or both. Take the example of someone who suffers from a unique diagnosis such as restless leg syndrome – he/she was probably suffering in anonymity before seeing a solution on TV. 

Uwe Reinhardt, PhD,a Professor at Princeton University also points out that “there is the First Amendment, you make new products, [so] why can’t you tell people about it? Why should that industry be forbidden to do it? The auto industry can advertise SUVs? Right?”

AGAINST DTC advertising

“Seventeen years after direct-to-consumer (DTC) drug advertising was instituted in the US, 70 percent of adults and 25 percent of children are on at least one prescription drug. Topping the adult pill category is–surprise!–antidepressants which are used by an astounding one in four women between 50 and 64. Topping the child pill category is–another surprise!–ADHD meds, though kids increasingly take blood pressure, diabetes and insomnia meds too. (Babies are actually given GERD medicine for spitting up.) Twenty percent of the population is now on five or more prescription medications. Ka-ching!DTC advertising has done two pernicious things. It has created a nation of hypochondriacs with depression, bipolar disorder, GERD, Restless Legs, insomnia, seasonal allergies and assorted pain, mood and ‘risk’ conditions and it has reduced doctors to order takers and gate keepers. 

The most popular criticism of TV advertising of pharmaceuticals was perhaps in 2004 when Merck recalled the very heavily advertised painkiller Vioxx after studies showed it increased the risk of heart attacks and strokes. According to Tom Abrams, a FDA representative, there is no guarantee of a balanced presentation of facts regarding claims of drug effectiveness and description of side effects. The FDA apparently sends about 100 letters annually to drug companies asking them to change ads and promotional promotions due to their misleading information. Some companies are even said to be repeat offenders.

In addition, doctors have complained that TV commercials simply drive consumers to the latest (and usually more expensive drugs), which in turn puts pressure on them to prescribe said drug. According to Dr Bradford Pontz, ” the TV ads have convinced them that this medicine will cure them forever and they are reluctant to listen to [any] other advice”. The American College of Physicians also states that DTC advertising often leaves patients confused and misinformed about medications, undermining the patient-physician relationship and impeding the practice of medicine. 

Currently, the U.S. and New Zealand are the only two countries in the world to that allow Direct-to-consumer pharmaceutical advertising. 

FDA recommendations

Regardless of what side you’re on, the FDA proposes a few questions to think about when you see an ad for a prescription drug on TV. Also, think about asking these questions when you talk to your doctor or pharmacist about a drug.

• What condition does this drug treat?
• Why do I think that I might have this condition?
• If I have the condition, am I part of the population the drug is approved to treat?
• Should I take this drug if I have a certain condition?
• Should I take this drug if I am taking certain other drugs?
• Which of the drug’s possible side effects am I concerned about?
• How will this drug affect other drugs I am taking?
• Will foods, beverages (alcoholic or non-alcoholic), vitamins, or other supplements affect how this drug works?
• Are there other drugs that treat my condition?
• Is there a less costly drug I could use to treat my condition?
• What else can I do to help deal with my condition? For example, should I exercise or change my diet?
• Do other drugs for my condition have different side effects?
• How can I learn more about this condition and this drug?

Once again what are your thoughts? Do you think there are any societal benefits of advertising something that can only be taken if medically necessary?

For laughs: see this Saturday Night Live parody on a mythical drug called Annuale….it states at the end: “Do not take Annuale if you plan to ever become pregnant, as it may turn your baby into a fire-monster. … In the days around your period, you may develop a leathery tail.”