cites research showing that prices for both brand name and generic drugs have risen steadily — along with advertising dollars. Drug ads, the AMA argues, make patients ask for the most expensive treatments, when often the less pricy options are just as good.
Americans are definitely concerned about high drug prices. About three-quarters of the public (70 percent of Republicans and 80 percent of Democrats) believes that prices for brand-name drugs are too high, according to a 2015 poll cosponsored by the Harvard T.H. Chan School of Public Health. About 20 percent said that paying for drugs was a major problem in their own lives or for family members. In another poll around the same time from the Kaiser Family Foundation, a majority of Democrats, Republicans, and independent voters all favored “government action to lower prescription drug prices.”
But unlike the AMA, we are divided about drug ads. In the Kaiser survey, half of the American public said they think that the ads are mostly a good thing. One reason is that ads may remind people to take care of a problem they’ve put on their back-burner. Has an ad ever helped motivate you to seek help? Has an ad ever made you question your doctor’s advice to use an older or generic drug? In the same Kaiser study, about 3 in 10 people said they had talked to a doctor about a particular drug after seeing an ad for it.
Around the world, consumers don’t see ads for drugs. The United States and New Zealand are the only two countries that permit direct-to-consumer advertising of medications and medical devices.
Critics of consumer drug advertising point out that there is no evidence that it helps people get the care they need or improves health, but instead promotes “drugs over healthy alternatives.” For example, only 19 percent of drug ads in a 2005 study mentioned lifestyle changes that could address the problem and 78 percent tied using the drug to winning social approval.
As an example, Kurt Stange, MD, a Cleveland family physician, epidemiologist, and editor of the medical journal Annals of Family Medicine, describes how a multimedia ad campaign for “a drug with potentially life-threatening side effects” suggested it as a solution for painful feelings in the abdomen.
“Viewers are encouraged to tell their doctor about their symptoms and to expect their doctor to suggest fiber and laxatives. (Diet changes, physical activity, and other non-magic-bullet solutions are not mentioned.) The subtle implication is that by suggesting fiber or laxatives, the doctor is not taking the patient seriously. The ad goes on to suggest that if the patient persists, the doctor will prescribe this drug.” The problem is that most people don’t need it, Stange points out.
If Congress passed a law limiting drug advertising, observers say it probably wouldn’t be an all-purpose ban that could be challenged as too big an infringement on free speech. The rationale would be to protect the public. New drugs often turn out to have unexpected side effects, so the most likely restriction would be to ban ads for their first two years after a new drug hits the market. Although the U.S. Food and Drug Administration regulates drug ads to make sure they are true and not misleading, it can’t ban advertising altogether. It can, however, negotiate with manufacturers seeking approval of a new drug. In 2015, the maker of the female libido treatment flibanserin (Addyi) agreed with the FDA to wait for up to 18 months before promoting it on television and radio to help ensure that doctors prescribed it only to appropriate patients. The company can still promote it on social media, or through events and interviews with the press. Women haven’t had this kind of option to treat low desire before, so it will take a while before many hear the news. But sildenafil citrate (Viagra), which was also the first drug of its kind when it appeared in 1998, has become one of the best known and most heavily advertised drugs. It’s also often abused.
Alongside its call for a ban, the AMA plans to launch a campaign to push for more affordable drugs, in part by making it harder for drug companies to prevent competition from generic versions of brand names.
February 17, 2016
Janet O’Dell, RN