They’re everywhere, on billboards, television screens, in magazines, and on the Internet. And of course in pharmacies. Advertisements for prescription drugs are nothing new, but they are becoming more prevalent. ”It’s incredible how much it’s grown,” said Dr. David Katzen of Cranston-based Allergy & Asthma Associates.
In the past, where drug companies would gear advertisements to the doctors prescribing the medicine, they now go directly for the consumers, in what is called, “direct to consumer advertising.”
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”It’s been increasing for the last three or four years,” said Steve DeToy, director of government and public affairs for the Rhode Island Medical Society.
”I think it’s because drug companies realize that if they go direct to consumers,” said DeToy, “they can sell more product than if they rely on doctors’ recommendations.”
The problem with this sort of advertising is that the consumer does not know as much about drugs.
”We want patients to be informed about the choices in the marketplace,” said DeToy, “But far too often patients will come into a doctor’s office and say, ‘I want drug x’, and it may not be for them.”
DeToy said pharmaceutical companies are trying to build brand loyalty. But when you’re talking about drugs, he said, it should be a matter of what is best for the patient, not which ads are best.
This issue is so problematic that last year the Food and Drug Administration revised the Code of Federal Regulations for prescription drug advertising.
Prior to the revision, the Code indicated that most drug companies did not advertise directly to the consumer.
”Whereas the advertising of drugs sold ‘over the counter’ is regulated by the Federal Trade Commission, the advertising of drugs sold by prescription is regulated by FDA,” according to the March, 1998 Report, “Generally, such advertising is directed to the medical profession.”
Later that year, the National Consumers League Direct-to-Consumer Promotion of Prescription Drugs Roundtable made several statements about what product-specific, direct-to-consumer promotion of prescription drugs should encompass and how it should be regulated.
Some of the suggestions made by the National Consumers League include:
For print ads, there was agreement that the brief summary, presented in its entirety, frequently written in small type and technical language, does not communicate useful information to consumers.
[On television commercials], visual images are often at odds with audio text. Some participants believed the audio and visual risk information should be presented concurrently
Direct-to-consumer promotion cannot provide consumers with sufficient background information to fully understand the spectrum of risks, safety, and potential effectiveness of drugs.
It doesn’t appear that the companies are paying much attention. A televised commercial for Astra Rhinocort nasal inhaler shows a visual collage which includes a child flopping onto a couch, presumably in celebration of his decongested nose, while the voiceover describes possible side-effects of the drug such as nosebleeds, dry nose, or cough. A Claritan ad rattles off the harmful side effects that can happen to a user while the visual suggest tranquility in a woman walking through a field. And advertisements for drugs in magazines continue to use the entire backside of the page for technical explanations of the drugs effects.
In a study released at the beginning of this summer, IMS HEALTH, a provider of information solutions to the pharmaceutical and health care industries, reported that some pharmaceutical companies had as much as a 32 percent increase in promotional spending. The company that spent the most on promotional advertising between July, 1999 and June 2000 was Pfizer, spending $523,861,000. Merck and Co., which spent 28 percent more on advertising than in the previous year, spent $364,671,000.
One of the other complications of direct-to-consumer advertising of prescription drugs is that certain insurance companies do not feature certain drugs on their formularies [lists of medicines, etc.]. This means that a patient might not be able to obtain the drugs that he or she sees advertised for a good price, because insurance companies only cover certain brands.
“A lot of times, it’s not the way you want to practice medicine,” said Dr. Katzen, “You hate to look at a patient and say, ‘they’ve got United [insurance], I have to write this brand for them.'”
It’s a very complicated issue,” said DeToy, “Say a company advertises its brand, and it’s not on the formulary, and the patient wants it, it ends up costing more. The physician should be the one making the decision with the patient.”
DeToy also said that insurance companies and drug companies sometimes act in cahoots with one another, and cut deals to have their product on the insurance companies’ formularies.
DeToy said that because of this sort of underhanded networking, people aren’t able to afford the drugs that they need, and then they get sicker and have to go to the hospital.
It all comes together to cause high drug prices,” he said, “when drug prices get high, people don’t get the medications they need, and it ends up costing health care more.”
Everyone wants the newest and best,” said Dr. Katzen, “and the newest is not necessarily the best.”
