Cialis, Lyrica, Eliquis, Viagra, Humira, Celebrex, Abilify, Chantix. You’ve no doubt heard of these drugs. The companies that produce them have ads on every channel on TV throughout the day, in countless magazines, and are pervasive online[1]. These prescription drugs are just a few of the big money-makers for large pharmaceutical companies like Eli Lilly, Pfizer, or GlaxoSmithKlein. In 2013, Americans spent approximately $329,200,000,000 on prescription drugs[2]; a large portion of this revenue was generated as a result of direct to consumer (DTC) advertising of prescription drugs.
According to the American Medical Association, the United States is one of only two countries in the world that allow direct to consumer advertising of prescription drugs[3]. In 2015, spending on these ads cost pharmaceutical companies $6.09 billion dollars[4]. The business of prescription drugs is an extremely lucrative one for producers, and a costly one for patients. I submit that direct to consumer advertising should be banned in the United States.
DTC prescription drug advertising complicates the relationship patients have with doctors and may lead to harmful effects. Too often, an instruction to “ask your doctor about ____” puts a patient, hopeful of being cured of a disease they probably don’t have, in front of a doctor who is unable to persuade the patient they don’t have that disease or need that drug; this may lead to unnecessary cost for the patient and potentially harmful side effects[5]. In fact, 39% of doctors view DTC advertising as “damaging to the time efficiency of the visit”[6]; 40% of physicians think drug advertising, “compromises their position…with their patients”[7]. The doctor-patient relationship is one which requires a personal connectedness; the intrusion of pharmaceutical companies only serves to decrease the effectiveness of care.
At the same time, prescription drugs are complicated. While the cliché of a succinct thirty-second TV ad showing a man playing football with his friends, a coupling walking along the beach, or a elderly gentleman reminiscing about what he used to be able to do with his grandson (or some other cliché that comes to mind) may lend confidence about the drug’s efficacy and safety, the reality is anything but. Often, in early stages of drug approval, with little certainty about the safety of the medicine, companies cannot ensure absolute accuracy of their claims[8]. With so called first-in-class drugs, the potentially permanent side-effects and unknown interactions are just not known[9].
Experts say that not only do these advertisements create prescriptions that are unnecessary, but also those that are exceedingly expensive. It just doesn’t make economic sense for pharmaceutical companies to advertise their cheaper drugs, when they could make more selling the expensive drugs. The fact is, an expensive drug being advertised today may have only incremental improvements over a previous generation drug, but with an extreme markup in price[10].
Of course, from the point of the pharmaceutical company, drug advertising makes sense. If you invest billions of dollars creating a drug, getting it through clinical trials, and producing it, you’d want to be able to advertise to recoup your investment (also, what about the cost of drugs that don’t make it all the way to production?). Additionally, some concerns have been raised that banning DTC advertising limits the right to free speech of these companies.
While these are valid concerns, I maintain that at the end of the day, it is the physician who is charge of the care of the patient and signs his or her name on the prescription. As such, it is the physician who should be informed about the latest drug discoveries or miracle treatments, not the patient. While patient involvement in medical decision making is increasing and yielding positive results[11], I believe that laypeople should not seek a prescription for a certain drug. DTC advertising complicates medical practice and the relationship between doctor and patient, and as such, should be banned in the United States.
Sources:
[1] “The Top 10 Most-Advertised Prescription Drug Brands | FiercePharma,” accessed March 9, 2017, http://www.fiercepharma.com/special-report/top-10-most-advertised-prescription-drug-brands.
[2] “Big Pharmaceutical Companies Are Spending Far More on Marketing than Research,” Washington Post, accessed March 9, 2017, https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutical-companies-are-spending-far-more-on-marketing-than-research/.
[3] “AMA Calls for Ban on DTC Ads of Prescription Drugs and Medical Devices | American Medical Association,” accessed March 9, 2017, https://www.ama-assn.org/content/ama-calls-ban-direct-consumer-advertising-prescription-drugs-and-medical-devices.
[4] “Kantar - The Side Effects of Drug Ads,” accessed March 9, 2017, http://us.kantar.com/tech/tv/2016/ad-and-opinion-research-on-rx-drug-ads/.
[5] Dominick L. Frosch et al., “A Decade of Controversy: Balancing Policy with Evidence in the Regulation of Prescription Drug Advertising,” American Journal of Public Health 100, no. 1 (January 2010): 24–32, doi:10.2105/AJPH.2008.153767.
[6] Elizabeth Murray et al., “Direct-to-Consumer Advertising: Physicians’ Views of Its Effects on Quality of Care and the Doctor-Patient Relationship,” The Journal of the American Board of Family Practice 16, no. 6 (November 1, 2003): 513–24, doi:10.3122/jabfm.16.6.513.
[7] “Kantar - The Side Effects of Drug Ads.”
[8] Miriam Shuchman, “Drug Risks and Free Speech — Can Congress Ban Consumer Drug Ads?,” New England Journal of Medicine 356, no. 22 (May 31, 2007): 2236–39, doi:10.1056/NEJMp078080.
[9] Ibid.
[10] Innovation and Marketing in the Pharmaceutical Industry - Emerging | Min Ding | Springer, accessed March 19, 2017, http://www.springer.com/us/book/9781461478003.
[11] Shaghayegh Vahdat et al., “Patient Involvement in Health Care Decision Making: A Review,” Iranian Red Crescent Medical Journal 16, no. 1 (January 2014), doi:10.5812/ircmj.12454.