Direct to Consumer Advertising of Pharmaceuticals

Television viewers and newspaper and magazine readers are bombarded by incessant commercials for drugs that are available only on a physician's order. Often these commercials are, unintentionally, humorous and bizarre. Typically, there is a person suffering from anxiety and depression, difficulty sleeping through the night or thingies in the blood that stick together. There is the direction that one consults a doctor and then comes the warning: Possible side effects include death; this is a cure for depression and anxiety? Certainly would make me more depressed!



What is the purpose of direct advertising of prescription drugs to the consumer-patient? It is make one rush to his or her doctor and "demand" that a specific prescription be written; the patient is already convinced that the malady is present and, I would assume, that enough doctors will accede to the patient's self-diagnosis and need for a specific advertised drug to make the advertising expense justified. Our primary care physician, who is a wise person, discussed his opinion against the ads and the pressure on doctors. He explained some doctors will lose patients if they refuse to prescribe drugs that their patients have seen on television, made a self-diagnosis and now demand a particular drug. Some physicians will sign prescription requests just to keep their patients happy and coming back, thereby becoming "rubber stamps" for patient requests.



[As a matter of full disclosure, my daughter and son-in-law are both physicians in Sarasota, Florida, and neither would write a prescription before examining the patient and making an independent educated decision as to the appropriate medicine to be prescribed, if any.]

Dr. Donna Sweet, a spokesperson from the American College of Physicians, testifying before Congress,


"[We are] opposed to -- DTC advertising, which often leaves our patients confused and misinformed about medications. It undermines the patient-physician relationship and impedes the practice of medicine by challenging the individual physician's medical judgment...

"[DCA creates] -- an adversarial element into the physician-patient relationship...

"Consider the toenail ad, my personal favorite. While I am trying to tell a senior that it is not life-threatening; that there really aren't little creatures with horns, legs, and arms under their toenails, living in sofas and chairs; that the drug is quite expensive; and that the risks of toxicity are significant and that it may not work, I lose valuable time that could have been directed at the underlying reason they have those toenails'"their diabetes, their vascular disease, their cholesterol, their overall health."



Advertising directly to consumers is generally prohibited worldwide; only the United States and New Zealand allow it. There are good and valid reasons for this general prohibition.



Prescription drug ads are not effectively reviewed to insure that they are not false or misleading. The FDA has been criticized by the Government Accountability Office for its inability to ensure that all ads are reviewed adequately primarily because of a general reduction of governmental regulation due to ideological and fiscal reasons, with an emphasis on the former.



Direct to consumer prescription drug ads harm public health by advocating drug use as a primary response to medical conditions that can often be remedied in other ways such as diet, exercise, stress reduction, and other preventative measures.



There are economic effects that fall upon the consumer, and to the extent that advertising costs are tax deductible by the drug company, upon all taxpayers. The expenditures by the drug companies are not insubstantial. According to industry statements and FDA estimates, drug companies spend upwards of $5 Billion annually on direct advertisements to consumers for each dollar spent, the retail price increases by $4.20!



All in all, drug advertising directed to consumers serves only the economic greed of the industry and ill-serves everyone else.