You don’t often hear, “I wish we had more prescription drug ads.”
Because of a sensible Food and Drug Administration regulation, any drug ad that mentions the drug brand name is flanked by the required “fair-balanced” disclosure about side effects. You’d think this requirement to talk about vaginal discomfort or bloody diarrhea or, God forbid, cancer, would be a deal killer for airing an ad on television. But not in America. No ma’am.
Drug companies are also protected by the First Amendment, albeit regulated heavily by the FDA on what they can or need to say when promoting their products. Apparently these ads work, or someone thinks they do. Otherwise drug companies wouldn’t be spending so much money – $4.5 billion in 2014, according to marketing research – to produce and air them.
But the Question Is, Couldn’t We Do Better?
During years of meeting patients in cities and towns across the country, I haven’t found a person who even kindalikes these commercials. A recent Pew study found that at least half of patients polled do not like drug ads in their current form. Depending on where you fall on the patient-caregiver continuum – whether you were just diagnosed, have been unsuccessfully battling a disease for years with other advertised drugs, suffered a near-fatal side effect or have a loved one who has – drug ads can conjure up a serious case of post-traumatic stress, anguish or at a minimum, low-grade disgust if they don’t work for you.
Industry, including the media and agencies that support it, counters that the primary benefit of drug ads is that they prompt a dialogue between the patient and doctor. This reminds me of a story that Dr. Howard Schertzinger, a prominent Ohio-based sports medicine internist, would often share while on the road with us. Dr. Schertzinger once had a patient who came to him with a shoulder injury, and he noticed the patient brought a sticky note with the word “Levitra” on it. The patient said, “Doc, what about this drug?” “Why do you ask?” he replied. “Because I saw an ad during Monday Night Football for it, and there was a guy who couldn’t throw a football through a tire. Then he took the drug and he was able to do it.” When Dr. Schertzinger informed him that the ad was for a drug to treat erectile dysfunction, the patient sheepishly retreated.
Money Well Spent, Right?
Many patients believe that the money spent on advertising increases the cost of drugs. They are angry when the drug offers the promise of a better life but doesn’t work for them. They are disappointed when their insurance company won’t cover the drug. They are scared when they are presented with the long list of side effects, some of which could kill them.
The side-effect issue is important and hypocritical. Shouldn’t car manufacturers be required to disclose the dangers of texting while driving, or drinking and driving, or driving under the age of 25 or over the age of 80?
More importantly, shouldn’t we have side-effect information that tells us not that we could die, but what the chances of death are? Dr. Jeff Curtis, a noted rheumatologist and principal investigator with me onArthritis Power, a patient registry designed to track patient-reported health outcomes and to estimate the benefits and risks of arthritis treatments, agrees. Two different side effects might be equally important to a patient, but with a very different likelihood of occurring. Severity versus the probability of occurring isn’t weighed when a voice-over reads side effects during a commercial, or they’re listed on page 2 or 3 of the fine print in that magazine ad. Patients deserve to have quantitative information about the expected risks and benefits of their treatments, ideally based on evidence derived from the experience of people like them. Drug ads don’t tell them this.
I think Americans want improved communication about matters which affect our health between patients, caregivers and the drug companies who have the information – not one-way directives dispensed through our TVs, magazines, newspapers, radio and the Internet. This means throwing out everything except, “Talk to your doctor” from direct-to-consumer drug ads.
But what about changing the format altogether? Patient education and support receives a tiny fraction of the resources drug ads get. I know because I co-founded the non-profit Global Healthy Living Foundation, which is committed to the long-term goal to repurpose money from drug advertising into patient education, support and research. This issue has become a topic in the presidential debates. We will continue to work with industry, government, patients and physicians in an effort to achieve this sensible objective.
It’s time we, and other dedicated groups and institutions, prove that we could do more with $4.5 billion a year – and with a lot fewer side effects.