On Prescription Drug Advertising

At exactly 6:48 PM EST during the NBC Nightly News every evening, a Cialis commercial airs.  It’s not late-night television, or even primetime, but please TV announcer, get those older men prepared.  That way, when they are asked “when the moment is right, will you be ready?” the next time, they will be ready.  The people watching the news are probably just finishing dinner: a perfect time to send a message about erectile dysfunction and maintaining libido to families, children, and other viewers on a daily basis.  They will really appreciate the information.

Prescription drug advertisements are wasting Americans’ time and senses.  Half of the time or space of every commercial tells us what side effects a medicine has that we need to watch out for and why we shouldn’t take the drug in the first place.  Spending all this energy to inform consumers just how terrible that drug really is, though, is intentional: the FDA requires each ad to “present the benefits and risks of a prescription drug in a balanced fashion.”  However, if all those risks are true (and how could they be false if they’re presented on TV?), then why tell us about the drug in the first place?  We can’t prescribe our own medicines, nor can we diagnose our own illnesses—we leave those jobs to doctors (for now, at least).  So, maybe these ads have a place in health-professions-only journals and television channels, but certainly not in our living rooms, during our dinners, or in our newspapers with our morning coffee.

Only recently did it become easier for pharmaceutical companies to advertise such prescription drugs to American consumers.  The FDA relaxed its rules restricting such direct-to-consumer advertisement of prescription drugs in 1997, making requirements for the information about side effects and contraindications less strict, and a new era began.  Big Pharma increased their spending on these television commercials astronomically ($4.9 billion was spent in 2007), and Americans have been increasingly bombarded with disease and drug information since. 

This increased advertising has led to an increase in hypochondriac-like behavior in the United States.  By being constantly slapped in the face with information about rheumatoid arthritis, depression, and most recently atrial fibrillation (AFib, as the commercial calls it), it’s not unlikely for television viewers to start questioning their own health.  One classic Zoloft commercial, with the sad face stuck under a rain cloud that can’t even smile when a cute blue bird comes by to be his friend, describes symptoms of depression in an undertone voice, making you, the viewer, feel depressed just watching and listening!  Halfway through the commercial, a jazzy clarinet tune has begun, the sad face is happy and can bounce around the screen and has made friends with the blue bird (he’s not lonely any more).  During this joy-filled segment of the commercial, the narrator describes the risks associated with taking the medicine, the possible side effects (enough to make anyone not want to take Zoloft), and instructs the listener to talk to their doctor.  The narrator is happier during this description, or at least more upbeat than when he described the depression symptoms earlier, making you think that if you take Zoloft, you’ll instantly be restored from a depressive, mopey, and lonely blob into a happy, carefree, spirited soul, despite being sick from the side effects.  The final scene of the commercial confidently states the drug’s slogan that is actually applicable, describing Big Pharma’s goal in their drug marketing plans: “When you know more about what’s wrong, you can help make it right.” 

That is the goal, of course: educate consumers about the combination of symptoms related to a disease or disorder that can be treated with one of Company X’s fabulous drugs.  However, there’s a difference between educating consumers about their health and giving them the agency to choose health care and treatments that are right for them versus instructing patients to demand specific prescriptions from their doctors and, if denied that medicine for whatever reason, finding another doctor who will give them that drug.  One study found that direct-to-consumer advertising of drugs treating high cholesterol is “effective in generating new patient visits” (Liu and Gupta, 2011).  So, people see such drug advertisements and decide they need to go to a doctor, as they have that disease or health problem described and need relief that only the drug they saw can provide.  That doesn’t mean that all people who see these commercials and decide they need that drug actually know they will be diagnosed with that particular problem or disease that the drug treats.  Some people see commercials for anti-depressants and start thinking they are depressed and need that drug so they can be happy, when really they are just having a bad day: when they wake up tomorrow or next week, they will feel better.  There’s a reason that doctors spend eight years in school after high school and three to seven more years on top of that training in their specialty, and that reason is not to train them to give patients whatever they want simply because they saw it on television.  People whose legs wiggle around when they are idly sitting do not all necessarily have restless leg syndrome, they may just have developed the motion out of habit.  In the same grain, prescription drug advertising is not an effective way to educate Americans about health and disease.

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(Cited article can be found here)