Drug ads to be banned? Keep dreaming

As those following the healthcare debate are aware, President Obama has backed off his campaign promises to legalize drug reimportation and require drug companies to negotiate drug prices with Medicare. Apparently deciding that healthcare reform would be defeated if he had to fight both Big Insurance and Big Pharma, he has decided to let Big Pharma off the hook.

Now, “healthcare reform” has become “health insurance reform” in the president’s speeches.

Millions of Americans, as well as many in Congress, are frustrated by this decision. And perhaps this frustration is behind current efforts in Congress to ban pharma ads directed at consumers.

Let me play prognosticator for a moment: It’s not going to happen.

Believe me, I would like to see it happen. Drug ads have been directly responsible for a dramatic increase in prescription drug use since they were legalized in the 1990s. Only the United States and New Zealand allow such ads to be shown to the public. The rest of the world knows better.

But in a short time, pharmaceutical advertising has emerged as a $4.5 billion-per-year boon to the media and advertising industries. That advertising, in turn, has led to exploding profits for Big Pharma, and trickle-down benefits for everyone in the supply chain, right down to Wal-Mart and its $4 generics.

Once a cow like that has been let out of the barn, there’s no way you’re getting in back in.

Nonetheless, the New York Times asked its readers what they thought of pharma ads, and the overwhelming majority of respondents said they wanted to see the ads altered or banned. I thought you’d be interested in seeing a few of the responses:

From pharmacists –

As a pharmacist I have seen first hand what these ads do, and there is no question that they work dramatically. For this we are paying a tremendous price. The patients demand these drugs in some instances and too many physicians give in to the requests. All drugs have side effects and some of these newer drugs not only are proven later on to have side effects not seen in clinical trials but they are costly and have no benefit over older drugs that are time tested and may be available as generics.

As a pharmacist, I see how damaging direct to consumer marketing is. The reality is that there is a large segment of the populace that will see a commercial, and then want that item. Whether it is a new car, a new phone, Ipod or drug. The sexiness of the marketing just increases the appeal of that consumer good. Frequently patients demand the prescriptions from their physicians. They make up symptoms, pester the doctor, go to many extremes to get what they want. And that doesn’t even include the free coupons available on-line and in magazines that further the demand by the patients.

From physicians –

As a physician who has to deal with the pharmaceutical industry on a daily basis, I can tell you that the information they provide me is very biased. They like putting a positive spin on non-relevant data to entice me to prescribe their products. The fact is generic drugs are often as effective as the branded products advertised on television.

I’m a family doc in Colorado, in practice for 32 years now. I find it ridiculous that I can no longer accept a ballpoint pen from a drug company because that might influence me to prescribe their product, but companies are allowed to spend millions and millions on TV and print ads aimed at patients who have no idea that they “need” such medications. Why do the same meds cost more here than in Canada? Try cutting these advertising budgets and I bet you’ll see prices come down!

As a physician, I can not recall a patient ever coming to me with information from an advertisement that helped them, or me. The ads are designed to sell drugs, not educate. Patients are convinced by the ads that they should “ask their doctor” about them, but we already know about these products from the medical literature (and the ads aimed at physicians!). When patients ask about a drug they saw an ad for, it generally takes a lot of time to convince them that what they are on already is doing well for them, or that they don’t have that condition, or the medicine is more of a risk than they need to take. I allow 30 minutes for a follow-up visit and would rather spend that time examining them and talking about what we should really be doing, than talking about an inappropriate medicine.

From consumers –

What upsets me is that ads for Viagra and similar products are aired at all hours and on all kinds of programming. When I’m watching an afternoon baseball game with my 7-year-old son, we’re inundated with these ads and their ridiculous warnings. My son and daughter have seen so many of these ads that they go around the house singing the Viva Viagra jingle. There must be some limits on these ads — at least as to when they air.

We are raising kids with the idea that taking a pill can solve almost any problem — even the simple discomfort of being shy at parties. Is social anxiety disorder a valid illness? Yes. Is mass advertising the most effective way to reach and help those people? No. But it’s a great way to convince the rest of us that we need that pill.

I agree with all these points. Who knows — maybe most thoughtful Americans do as well. But it doesn’t matter. Prescription drug advertising is here to stay.