Drug companies used to employ armies of sales representatives who traveled the country to convince doctors to prescribe lucrative prescription medications. In the past decade, though, most firms have been laying off drug reps to save money. Many doctors are too busy to spend time listening to the sales pitch.
Instead, the pharmaceutical industry has turned to television. Since the 1990s, prescription-drug advertising has become widespread. You can’t watch the evening news without seeing commercials for drugs to treat arthritis, erectile dysfunction, atrial fibrillation (A-fib), diabetic nerve pain, psoriasis, heartburn, COPD and low-T (testosterone).
Everyone assumes that these ads are aimed at patients. That’s why they are called “direct to consumer” (DTC) commercials. But a drug-industry insider confided to us that shortly after airing a new commercial, prescription sales for that medicine skyrocket. This happens too quickly for many patients to make an appointment to see the doctor and request the medication.
The assumption this executive made was that the commercials are having an important impact on prescribers. Even though such commercials are incredibly expensive, they may be more cost-effective than a large pharmaceutical sales force.
Although they may respond to these messages by writing prescriptions, doctors are ambivalent about DTC advertising. A Food and Drug Administration survey of physicians conducted last year found that nearly two-thirds of them believe DTC ads misinform patients and three-fourths think that the commercials overemphasize the benefits and downplay the risks of the featured products. At the same time, almost two-thirds agreed that the televised messages could prompt patients to seek medical advice.
Most viewers really dislike these commercials, though. Here is just one comment:
“The 24/7 bombardment with prescription-drug ads on television makes me want to haul the TV to the landfill. The motive behind these ads has nothing to do with human well-being. It has everything to do with ca$h in the pockets of the prescription-drug overlords. I think scare tactics and fear-mongering to sell medicine is bad policy.
“They often say, ‘Ask your doctor.’ Can’t people think for themselves anymore? Or must they run to the doctor daily to be told what to think and what to do? I take no prescription drugs, and scary ads don’t worry me.”
Actually, the side effects of many drugs that are advertised should worry people. The FDA requires the manufacturers to list serious adverse reactions. It’s not unusual for a voice-over to include disability or death in the long list of side effects.
Take the compelling Celebrex commercial, for example. A woman watching her friends in the water swims out to them and plays with a lovely dog while the announcer intones that the drug “may increase the chance of heart attack or stroke, which can lead to death.” The litany of serious skin reactions, bleeding and life-threatening ulcers is recited against an idyllic background.
DTC advertising is often defended as a way of informing the public about medical conditions and effective treatments. As compelling as the ads may be, however, they are not the best way to learn about the benefits and risks of potential therapies.