Last night I dreamed there was a day without a drug commercial….
When I woke up, reality stared me in the face. It couldn’t be true. Not right now. Not without revolutionary changes in the drug industry.
Here are some numbers that may surprise you. Or maybe not.
Six out of ten adults in the U.S. take a prescription medication. That’s up from five out of ten a decade ago. (These numbers appeared in a recent study published in the Journal of the American Medical Association.)
Further, nine out of ten people over 65 take at least one drug, and four out of ten take five or more—nearly twice as many as a decade ago.
One more statistic: insured adults under 65 are twice as likely to take medication as the uninsured.
Are you surprised by any of these numbers? I’m not.
Until the 1990s, drug companies largely relied on physicians to promote their prescription drugs. But in 1997, the Food and Drug Administration revised its earlier rules on direct-to-consumer (DTC) advertising, putting fewer restrictions on the advertising of pharmaceuticals on TV and radio, as well as in print and other media. We’re one of only two countries–New Zealand is the other one–that permit this kind of advertising.
The Food and Drug Administration is responsible for regulating it and is supposed to take into account ethical and other concerns to prevent the undue influence of DTC advertising on consumer demand. The fear was that advertising would lead to a demand for medically unnecessary prescription meds.
It’s pretty clear to me that it has. Do you agree?
Just look at the statistics. The number of people taking prescription drugs increases every year. In my view, advertising has encouraged them to seek drugs that may be medically unnecessary.
Of course, many meds are essential to preserve a patient’s life and health. But have you heard the TV commercials? Some of them highlight obscure illnesses that affect a small number of TV viewers. But whether we suffer from these ailments or not, we’re all constantly assaulted by these ads. And think about it: If you feel a little under the weather one day, or a bit down in the dumps because of something that happened at work, or just feeling stressed because the neighbor’s dog keeps barking every night, might those ads induce you to call your doc and demand a new drug to deal with it?
The drug commercials appear to target those who watch daytime TV—mostly older folks and the unemployed. Because I work at home, I sometimes watch TV news while I munch on my peanut butter sandwich. But if I don’t hit the mute button fast enough, I’m bombarded by annoying ads describing all sorts of horrible diseases. And the side effects of the drugs? Hearing them recited (as rapidly as possible) is enough to make me lose my appetite. One commercial stated some possible side effects: suicidal thoughts or actions; new or worsening depression; blurry vision; swelling of face, mouth, hands or feet; and trouble breathing. Good grief! The side effects sounded worse than the disease.
I’m not the only one annoyed by drug commercials. In November 2015, the American Medical Association called for a ban on DTC ads of prescription drugs. Physicians cited genuine concerns that a growing proliferation of ads was driving the demand for expensive treatments despite the effectiveness of less costly alternatives. They also cited concerns that marketing costs were fueling escalating drug prices, noting that advertising dollars spent by drug makers had increased by 30 percent in the previous two years, totaling $4.5 billion.
The World Health Organization has also concluded that DTC ads promote expensive brand-name drugs. WHO has recommended against allowing DTC ads, noting surveys in the US and New Zealand showing that when patients ask for a specific drug by name, they receive it more often than not.
Senator Bernie Sanders has repeatedly stated that Americans pay the highest prices in the world for prescription drugs. He and other Senators introduced a bill in 2015 aimed at skyrocketing drug prices, and Sanders went on to rail against them during his 2016 presidential campaign.
Another member of Congress, Representative Rosa DeLauro (D-Conn.), has introduced a bill specifically focused on DTC ads. Calling for a three-year moratorium on advertising new prescription drugs directly to consumers, the bill would freeze these ads, with the aim of holding down health-care costs.
DeLauro has argued, much like the AMA, that DTC ads can inflate health-care costs if they prompt consumers to seek newer, higher-priced meds. The Responsibility in Drug Advertising Act would amend the current Food, Drug, and Cosmetic Act and is the latest effort to squelch DTC advertising of prescription meds.
The fact that insured adults under 65 are twice as likely to take prescription meds as those who are not insured highlights a couple of things: That these ads are pretty much about making more and more money for the drug manufacturers. And that most of the people who can afford them are either insured or in an over-65 program covering many of their medical expenses. So it’s easy to see that manufacturers can charge inflated prices because these consumers are reimbursed by their insurance companies. No wonder health insurance costs so much! And those who are uninsured must struggle to pay the escalating prices or go without the drugs they genuinely need.
Not surprisingly, the drug industry trade group, the Pharmaceutical Research and Manufacturers of America, has disputed the argument that DTC ads play “a direct role in the cost of new medicines.” It claims that most people find these ads useful because they “tell people about new treatments.” It’s probably true that a few ads may have a public-health benefit. But I doubt that very many fall into that category.
Hey, Big Pharma: If I need to learn about a new treatment for a health problem, I’ll consult my physician. I certainly don’t plan to rely on your irritating TV ads.
But…I fear that less skeptical TV viewers may do just that.
So please, take those ads off the air. Now.
If you do, you know what? There just might be a day without a drug commercial….
[The Wellness Letter published by the University of California, Berkeley, provided the statistics noted at the beginning of this post.]