In an editorial from the journal New Scientist, one of the best arguments against allowing pharmaceutical companies to continue to advertise to the general public. I have been a supporter of a ban of drug ads for years. There is no purpose and I believe it causes illicit drug use to go up. As long as the image is that drugs will solve all of your health problems, instead of talking about leading a healthy lifestyle, we are going to be a sick society with way too expensive of a health system.
Here is the editorial.
BACK in 2001, a series of poster advertisements appeared in US cities depicting athletic young men climbing mountains and sailing boats. The sun was always shining and everything seemed right with the world, though the men all had HIV. The clear implication of the ads, which came from pharmaceutical companies, was that thanks to a new generation of drugs, HIV-positive men could now live life to the full.
As marketing campaigns go, it was something of a failure. Gay activists complained that the ads did not reflect the reality of life on anti-retroviral medication. Eventually the Food and Drug Administration told the companies to stop using such unrealistic images, but by then the damage had been done: a survey by health officials indicated that by playing down the consequences of becoming infected with HIV the posters were encouraging unsafe sex.
This may be an extreme example of the dangers of “direct-to-consumer” drug advertising (DTCA), but the lesson has not been learned. Drug companies now spend more than $3 billion annually on DTCA, twice what they spent in 2001, despite the fact that the ads have repeatedly been shown to result in unnecessary or potentially harmful prescriptions. So it is worrying that US policy-makers are backing away from moves to restrict DTCA, and that in Europe, where such advertising is banned, drug companies are trying to bring it in by the back door.
Lobbyists for the industry argue that DTCA is a win-win business: the public gets access to information about new medicines at no cost to the taxpayer, and people who would benefit from them are prompted to visit their doctor to discuss treatments. None of these claims stands up. DTCA does encourage people to see their doctor, but it doesn’t follow that they get the right treatment. Very often their enthusiasm for a drug they have seen advertised persuades the doctor to prescribe it inappropriately. This was illustrated by a 2005 study in which actors claiming to be suffering from “adjustment disorder” – a strong emotional reaction to a stressful event – visited doctors and asked for an antidepressant they said they had seen in a television advert. It is unusual to prescribe such drugs for this condition, since it normally goes away of its own accord, yet more than half the doctors agreed. Many physicians admit it can be hard to resist pressure from patients, something drug companies are well aware of.
Part of the problem is that adverts rarely tell the whole story. Patients are often framed by the setting sun or pictured freewheeling down leafy avenues. The subtext is: here is a pill that can end your pain. What most adverts fail to mention is that many diseases can be tackled or prevented with lifestyle changes, such as diet or exercise. Little wonder that most doctors find DTCA unhelpful.
What everyone agrees on is that the adverts work. In New Zealand, the only other country that permits DTCA, a 1998 marketing campaign resulted in 16,000 asthma sufferers persuading their doctors to switch them to a new brand of inhaler. The adverts angered many doctors, who felt the new inhaler offered little or no extra benefit, and since it was more expensive the switch is estimated to have cost taxpayers over $2.5 million.
That kind of tale should be enough to kill off DTCA everywhere. Some US policy-makers want the government to be able to ban TV commercials for a new drug for up to three years if it thinks the drug poses unknown risks, but last week a House of Representatives subcommittee stripped the proposal from a bill making its way through Congress. Politicians in Europe are likely to face a similar battle as the pharmaceutical industry tries to introduce DTCA under the guise of providing health information to patients.
There is nothing wrong with giving consumers access to information – generally the more the better. The problem with DTCA is that the information is at best incomplete, at worst biased. There is a better way to provide people with data about medicines: the US Consumers Union, for example, produces free drugs guides in partnership with independent researchers who have no financial interest in the drugs they may recommend. It seems the US Congress has thrown away the chance to follow this enlightened approach. The European Commission should embrace it.