Pro & Con Quotes: Should Prescription Drugs Be Advertised Directly to Consumers?
Crystal Adams, PhD, Assistant Professor of Sociology at the University of Miami, in a Nov. 2016 article for Journal of the American Medical Association (JAMA) Oncology titled “Direct-to-Consumer Advertising of Prescription Drugs Can Inform the Public and Improve Health,” wrote:
“Prescription drug advertisements spread valuable educational information about the promoted product and conditions associated with the drug. Better-educated patients can make well-informed decisions regarding their own health care…
DTCA [direct-to-consumer advertisements] can motivate patients to bring to physicians’ attention the information they receive about diseases and products in advertisements… Constraints on physicians’ time make it vital for patients to be educated outside of the physician’s office so that they can use the time with their physicians as effectively as possible… DTCA also motivates patients to disclose difficult to discuss issues, particularly for highly stigmatized diseases such as depression and attention-deficit/hyperactivity disorder.
The positive effects of DTCA on patients are grounded in evidence. These effects include greater involvement in medical decision-making, increased compliance with prescription medication intake, and improved patient-physician communication, which may lead to the diagnosis of previously undiagnosed medical conditions.”Nov. 2016 - Crystal Adams, PhD, MPH
Pfizer, an American pharmaceutical company, in a Mar. 2016 fact sheet titled “Direct-to-Consumer Communications,” available from pfizer.com, wrote:
“Consumers benefit from information about diseases and medical treatment options received through direct-to-consumer (DTC) communications, including advertising. DTC communication raises the awareness of medical conditions, informs consumers about the benefits and risks of medicines, and motivates people to discuss prevention, diagnosis, treatment and wellness information with their health care professional…
Pfizer believes that providing information to consumers about medical conditions and available treatments helps patients make educated choices about their health….
Pfizer supports the continued ability of companies to provide information to consumers about pharmaceutical products and medical conditions through ethical and responsible DTC communication that meets all regulatory requirements and industry standards.”Mar. 2016 - Pfizer
Adam Scott Roberts, Senior Vice President and Group Media Director at Communications Media, Inc., in a Nov. 15, 2013 article, “DTC Ads Should Do More than Raise Eyebrows,” available at mmm-online.com, stated:
“Consumers are informed by what they see online and on television from content and advertising. Consumers are actively bringing physicians information, asking about treatment options and even challenging decisions in an effort to manage their own health. Searching online across the healthcare continuum can shape an understanding for symptoms, treatment options and alternatives and even provide solutions on how to access and pay for therapies or medications…
It’s a pretty simple formula: information + education = participation—by being a participant in the management of a health journey, the voice of the consumer will be heard and the physician will help guide… Advertising done responsibly can participate and help provide value and utility without selling.”Nov. 15, 2013 - Adam Scott Roberts
The Pharmaceutical Research and Manufacturers of America (PhRMA), a pharmaceutical industry trade organization, stated the following in its Dec. 2008 “PhRMA Guiding Principles: Direct to Consumer Advertisements about Prescription Medicines,” available at phrma.org:
“An important benefit of direct to consumer (DTC) advertising is that it fosters an informed conversation about health, disease and treatments between patients and their health care practitioners.
A strong empirical record demonstrates that DTC communications about prescription medicines serve the public health by:
Increasing awareness about diseases;
Educating patients about treatment options;
Motivating patients to contact their physicians and engage in a dialogue about health concerns;
Increasing the likelihood that patients will receive appropriate care for conditions that are frequently under-diagnosed and under-treated; and
Encouraging compliance with prescription drug treatment regimens…
PhRMA members want patients and consumers to talk to their physicians about the medicines that may help them and to fully understand the known risks regarding these medicines. We know that DTC communications, particularly DTC television advertising, can be a powerful tool for reaching and educating millions of people.”Dec. 2008 - Pharmaceutical Research and Manufacturers of America (PhRMA)
The American Advertising Federation, a national advertising trade association, stated the following in its Sep. 2008 position statement “DTC Prescription Drug Advertising,” available at aaf.org:
“The AAF supports the right of pharmaceutical companies to advertise prescription drugs directly to consumers, provided all claims are substantiated and appropriate disclosures are included in the advertising. Proposed moratoriums on pharmaceutical advertising would violate the First Amendment protection for commercial speech. Barring information from advertising will cause more harm to consumers who are not encouraged by an ad to see a doctor about an illness. Surveys show that these ads prompted more than 39 million to ask their doctor about a particular health condition. Advertising is an important source of information about pharmaceuticals.”Sep. 2008 - American Advertising Federation
Daniel J. Carlat, MD, psychiatrist, stated the following in his Oct. 29, 2007 blog post “What’s Wrong with DTC Ads?,” available at the Carlat Psychiatry blog:
“I have certainly received an excessive dose of DTC ads… And, yes, I get that DTC’s encourage consumers to ask their doctors to prescribe the newest and most expensive meds.
But banning them doesn’t make sense. Why? For one, it’s one of the only arenas where drug companies advertise their products with full disclosure. Everybody knows it’s an expensive ad paid for by the company. There’s no pseudo-legitimate journal or medical education company pretending to be a scientific article, when in reality it’s a paid advertisement.
Second, they do serve an educational function for consumers, if biased. There are a lot of guys out there urinating very frequently who would not consider this a potentially treatable issue if they hadn’t seen those irksome Flomax commercials, the ones featuring the sports-crazed baby boomers who get to hang out in their kayaks longer without having to run into the woods–all because they’re taking their Flomax. Sure, viewers are going to run to their doctors and ask for Flomax my name, but it’s up to the docs to decide which drug is best. And meanwhile, some men will find out they have early prostate cancer (rather than benign prostatic hyperplasia) and might get their lives saved in the bargain.
I say let the companies have their DTC ads.”Oct. 29, 2007 - Daniel J. Carlat, MD
AstraZeneca, a pharmaceutical company, in an Oct. 1, 2013 blog post written by Rod Wooten, Commercial Brand Leader for Crestor, titled “AstraZeneca Takes a New Advertising Approach to Engage & Educate Consumers,” available at the AstraZeneca Health Connections website, stated:
“AstraZeneca believes responsible direct-to-consumer (DTC) advertising is integral to raising disease awareness, fostering patient education, enhancing the patient/physician dialogue and encouraging medication adherence. And we also recognize that consumers today need to be engaged differently. Ads need to be both informative and compelling to make a lasting impression and to effectively raise awareness of an issue or a treatment.”Oct. 1, 2013 - AstraZeneca
Richard E. Ralston, MA, Executive Director of Americans for Free Choice in Medicine, stated the following in his June 2005 article “Prescription Drug Advertising Is Good for All of Us,” available at capmag.com:
“Effective advertising of new drugs provides obvious benefits. Most importantly, it informs those with medical conditions about new treatments (including those who may have given up on getting relief). It may motivate them to discuss the condition with a physician for the first time, creating an opportunity for the physician to undertake testing and make a correct diagnosis. The physician may prescribe another medication better suited to the patient’s needs. Or, the physician’s knowledge of the condition’s serious consequences may alter the treatment course instead of just addressing the symptoms reported by the patient.”June 2005 - Richard E. Ralston, MA
Bob Ehrlich, MBA, Chief Executive Officer of DTC Perspectives, Inc., stated the following in his Feb. 19, 2010 article “A World Without DTC?,” available at the DTC Perspectives website:
“The best solution is to let information flow for DTC and other items with viable alternatives. There are plenty of sources of information on drugs, many of which are critical of branded drugs and offer alternatives. Government is free to publish clinical results that can refute claims of brands. Managed care can play one branded drug against another to get a great price. Doctors can decide if the branded drug really is better for their patients. Patients can check the Internet or ask friends if the drug works well. Putting the DTC information genie back in the bottle seems a bad alternative after 13 years of mass DTC availability.”Feb. 19, 2010 - Bob Ehrlich, MBA
Alan F. Holmer, JD, Director of Inspire Pharmaceuticals Inc., stated the following in his 1999 article “Direct to Consumer Prescription Drug Advertising Builds Bridges Between Patients and Physicians,” published in the Journal of the American Medical Association:
“Direct-to-consumer (DTC) advertising is an excellent way to meet the growing demand for medical information, empowering consumers by educating them about health conditions and possible treatments. By so doing, it can play an important role in improving public health…
Direct-to-consumer advertising that encourages millions of Americans to consult their physicians can help to improve public health because a number of leading diseases are under diagnosed and under-treated…
Direct-to-consumer advertising is a highly effective way to communicate the availability of treatments to the public. In 1992, the first DTC consumer television advertisement for a nicotine patch aired during the Super Bowl. According to the American Association of Advertising Agencies (AAAA), the public response was so great that, within weeks, demand for the patches exceeded the supply. The product had been available for months, but people who might have been interested in quitting smoking were simply not aware of it.
Advertising promoted widespread awareness overnight, prompted patient-physician conversations, and may have helped many people to stop smoking.
Pharmaceutical companies have both a right and a responsibility to inform people about their products under the supervision of the FDA, which regulates prescription drug advertising. Companies are committed to responsible advertising that enhances the patient-physician relationship and encourages the appropriate use of prescription drugs under a physician’s supervision. While such advertising prompts more people to seek professional help, it does not dictate the outcome of the physician visit or the kind of help patients eventually receive.
Direct-to-consumer advertising merely motivates patients to learn more about medical conditions and treatment options and to consult their physicians.”1999 - Alan F. Holmer, JD
The Coalition for Healthcare Communication, a health care industry trade organization, stated the following in their Nov. 24, 2009 statement “Coalition Speaks Out on New DTC Research Analysis,” available at cohealth.org:
“DTC plays a critical role in informing patients about their treatment choices, and as the starting point in a dialogue between physician and patient in defining a treatment path. The Coalition supports responsible, effective communication on treatment benefits and risks that improve physician-patient dialogue and foster better care. Limiting FDA-vetted healthcare information impedes access to fair-balance information and stunts two-way dialogue between a patient and their doctor critical to improving medical treatment and quality-of-life.”Nov. 24, 2009 - Coalition for Healthcare Communication
Uwe Reinhardt, PhD, Professor of Political Economy, Economics and Public Affairs at Princeton University, in an Oct. 9, 2002 interview with Frontline, available at pbs.org, stated:
“I may be the odd person out, but I always felt advertising to consumers is a reasonable thing for the industry to do. A) There is the First Amendment. You make new products. Why can’t you tell people about it? Why should that industry be forbidden to do it, when the auto industry can advertise SUVs? Right? You can ask yourself.
Secondly, we’ve found in research that quite a few patients don’t actually get the drugs. There were these studies on beta blockers that said only about half the patients in America got beta blockers after a heart attack. Well, you could ask, ‘Wouldn’t it have been good if on television they had seen, ‘If your loved one has a heart attack, be sure to ask that he gets beta blockers?” So I think I’m on the industry side on that.
The money isn’t that overwhelming. I think it’s something like $8 billion, maybe $10 [billion], that they’re spending on it. Doctors and HMO executives are vexed by this, because you have patients coming to the doctor and say, ‘ want Vioxx,’ or ‘I want this drug or that drug.’ My feeling is, that’s why we have doctors. A good doctor should say, ‘Yes, it’s a drug,’ or say, ‘Actually, let me show you. I have a study here. That drug, for the money, isn’t worth it.’ That is the doctor’s job. So I don’t understand why you would take away freedom of speech to an industry, when it’s so easy to counter it.”Oct. 9, 2002 - Uwe Reinhardt, PhD
Durhane Wong-Rieger, PhD, Assistant President and CEO of the Institute for Optimizing Health Outcomes, in a Feb. 2009 Canadian Family Physician article, “Should Canada Allow Direct-to-Consumer Advertising of Prescription Drugs? YES,” available at the National Center for Biotechnology Information website, wrote:
“Drug or disease advertisements contribute to public health by increasing appropriate consultation for undiagnosed or untreated health conditions.
As prescription medications require approval of a learned intermediary, advertisements do not lead to patients getting inappropriate medications.
Patient surveys suggest that direct-to-consumer information about pharmaceutical products serves an unmet patient need.
Direct-to-consumer drug information that is balanced, screened, and monitored can promote the appropriate use of drugs.”Feb. 2009 - Durhane Wong-Rieger, PhD
Merck, a pharmaceutical company, in its June 2008 “Public Policy Statement: Direct-to-Consumer Broadcast Advertising in the United States,” available at merck.com, stated:
“Merck believes that Direct-to-Consumer (DTC) advertising can be an important and helpful way to inform patients about diseases that may be relevant to them and therapeutic options they may want to discuss with their physician. Credible data demonstrate that DTC can have a positive impact on patient health in terms of diagnosis, treatment and adherence to prescribed therapies. We recognize that DTC is one channel amongst many to help educate patients. Print materials, telephone, websites and other channels are also utilized to provide more in-depth information to patients. The ultimate decision to prescribe a product for any specific patient remains with the physician following discussion with their patient. Merck adheres to a set of forward-looking principles on DTC advertising.”June 2008 - Merck
Pfizer, a pharmaceutical company, in its “Practicing Ethical Sales and Marketing” policy adopted in 2005, available at pfizer.com, stated:
“Responsible consumer advertising has proven value in helping patients engage in more informed conversations with their healthcare providers, leading to better health outcomes. In all of our consumer advertising, we adhere to applicable FDA regulations and guidance. We also abide by the PhRMA Guiding Principles on Direct-to-Consumer (DTC) Advertising About Prescription Medicines. We follow strict internal standards that have been developed to ensure the information we share with consumers is: (1) scientifically sound; (2) balanced; (3) easy to understand; and (4) helpful in encouraging people to consult with a health care professional.”2005 - Pfizer
Eli Lilly, via Sidney Taurel, Chairman, President, and CEO, in a Nov. 20, 2002 interview with Frontline, available at pbs.org, stated:
“As to direct-to-to-consumer advertising, first of all, I’d like to put things in perspective. I think there has been a criticism of the industry that we are spending more on DTC than we do on the rest of marketing, or more importantly, on R&D. In fact, in 2001, the total expenses for direct-to-consumer advertising was $2.4 billion for the whole industry, versus $30 billion on R&D.
I think direct-to-consumer advertising has some very important public health benefits. One is, you can see for the majority of the products which are advertised, that they deal with conditions which, according to medical experts and the data available, are under-treated — diseases such as depression, such as diabetes, such as hypertension, such as high cholesterol. All of these areas are today under-treated, and direct-to-consumer advertising helps educate patients and bring them to the doctor’s office. The most expensive disease is the one which is not diagnosed or treated.
The other benefit of direct-to-consumer advertising, from a public health standpoint, is that, according to surveys of both physicians and patients, one out of five, approximately, says that to see the advertisement helps that patient remember to take his or her medication. Non-compliance is a very, very serious issue.”Nov. 20, 2002 - Eli Lilly
The Royal New Zealand College of General Practitioners, in a Mar. 2017 position statement titled “Prohibition of Direct-to-Consumer Advertising of Prescription Medications,” available from its website, wrote:
“Direct-to-consumer advertising (DTCA) of prescription medications causes considerable public harm through misinformation and the stimulation of demand for unsuitable or unnecessary, costly treatment, leading to inappropriate prescribing… DTCA of prescription medications should be prohibited…
Those in support of the DTCA of prescription medications – primarily the pharmaceutical industry – claim that they are a source of information for consumers about conditions and new medications. However, the information provided is often misleading and of variable quality, with many advertisements citing inappropriate publications to support their promotional claims. The misuse of scientific evidence erodes trust in true, evidence-based advice and contributes to public confusion…
DTCA increases the likelihood of the consumer requesting the advertised product and/or believing they have a condition, resulting in increased prescribing. This can cause harm to the patient, damage the doctor–patient relationship and create unnecessary costs to the patient and health system.”Mar. 2017 - Royal New Zealand College of General Practitioners (RNZCGP)
The American Society of Health-System Pharmacists (ASHP), in a 2016 policy position (number 1624), detailed in its report titled “ASHP Policy Positions 1982-2016,” available from ashp.org, wrote:
“[Policy Number] 1624…
To advocate that Congress ban direct-to-consumer advertising [DCTA] for prescription drugs and medication-containing devices…
ASHP recognizes that banning a constitutionally protected right to free speech, even commercial speech, must be reinforced by evidence that indicates the banned speech negatively impacts society. In the case of DCTA, those negative impacts, including intrusion on the patient-prescriber relationship and increased healthcare costs, are evident and overwhelming. Given the outsized role prescription drug products have as a cost driver to the healthcare system, the detrimental effects of DCTA, and the limited potential benefits, ASHP has concluded that a ban on DTCA of prescription drugs and drug-containing implantable medical devices is warranted.”2016 - American Society of Health-System Pharmacists (ASHP)
The American Medical Association (AMA) in a Nov. 17, 2015 press release titled “AMA Calls for Ban on DTC Ads of Prescription Drugs and Medical Devices,” available from their website, wrote:
“Today’s vote in support of an [direct-to-consumer] advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices… Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”Nov. 17, 2015 - American Medical Association (AMA)
Martha Rosenberg, author and health reporter, in a Feb. 13, 2014 blog post, “Following Success of DTC Drug Advertising, DTC Radiation Advertising? What?,” available at the Center for Health Journalism website, stated:
“Seventeen years after direct-to-consumer (DTC) drug advertising was instituted in the US, 70 percent of adults and 25 percent of children are on at least one prescription drug. Topping the adult pill category is–surprise!–antidepressants which are used by an astounding one in four women between 50 and 64. Topping the child pill category is–another surprise!–ADHD meds, though kids increasingly take blood pressure, diabetes and insomnia meds too. (Babies are actually given GERD medicine for spitting up.) Twenty percent of the population is now on five or more prescription medications. Ka-ching.
DTC advertising has done two pernicious things. It has created a nation of hypochondriacs with depression, bipolar disorder, GERD, Restless Legs, insomnia, seasonal allergies and assorted pain, mood and ‘risk’ conditions and it has reduced doctors to order takers and gate keepers. Thanks to TV drug ads, patients tell doctors what is wrong with them and what pill they need, coupon in hand. Drug company-funded web sites even give patients talking points to use when they see the doctor, lest they don’t ring up a sale.
Selling prescription drugs like soap makes a mockery of a medical school education.”Feb. 13, 2014 - Martha Rosenberg
The American College of Physicians (ACP), a national membership organization of physicians, provided the following testimony, in a statement delivered by Donna Sweet, MD, during the Sep. 29, 2005 US Senate Special Committee on Aging titled “The Impact of Direct to Consumer Drug Advertising on Senior’s Health and Health Care Costs,” available at the Senate Special Committee on Aging website:
“Since 1998, ACP has been opposed to the practice of DTC advertising, which often leaves our patients confused and misinformed about medications. It undermines the patient-physician relationship and impedes the practice of medicine by challenging the individual physician’s medical judgment…
Consider the toenail ad, my personal favorite. While I am trying to tell a senior that it is not life-threatening; that there really aren’t little creatures with horns, legs, and arms under their toenails, living in sofas and chairs; that the drug is quite expensive; and that the risks of toxicity are significant and that it may not work, I lose valuable time that could have been directed at the underlying reason they have those toenails—their diabetes, their vascular disease, their cholesterol, their overall health…
ACP would prefer to see Congress ban DTC advertising because it does not constitute appropriate patient education.”Sep. 29, 2005 - American College of Physicians
Robert M. Centor, MD, Director of the Division of General Internal Medicine at the University of Alabama at Birmingham, stated the following in his June 12, 2005 editorial “Take Drug Ads off the Air,” published in USA Today:
“Direct-to-consumer drug advertising works very well – for pharmaceutical company profits, but not for the public health…
Some argue that the First Amendment protects direct-to-consumer drug advertising. However, restrictions on commercial speech exist when the outcome of the speech can be harmful to the public. The Federal Communications Commission no longer allows tobacco ads to appear on TV. Following the same logic, prescription-drug ads should be taken off the air.
Drug advertising results in more costly prescriptions. Few inexpensive drugs are advertised on TV. The commercials don’t educate patients. Rather, they create a demand for a product based on an effective commercial rather than the patient’s medical need…
Direct-to-consumer ads should be banned. Doctors and patients have much to gain. Only the pharmaceutical industry has anything to lose.”June 12, 2005 - Robert M. Centor, MD
Kurt C. Stange, MD, PhD, Professor of Family Medicine, Epidemiology & Biostatistics, Oncology, and Sociology at Case Western Reserve University, stated the following in his 2007 editorial “Time to Ban Direct-to-Consumer Prescription Drug Marketing,” available at anfammed.org:
“It is time to ban direct-to-consumer (DTC) advertising of prescription drugs. The current US system of pharmaceutical company self-monitoring and Food and Drug Administration oversight is not working. Moreover, it cannot realistically be expected to work. A ban is needed to protect the public’s health and the quality of healthcare…
DTC ads manipulate the patient’s agenda and steal precious time away from an evidence-based primary care clinician agenda that is attempting to promote healthy behavior, screen for early-stage treatable disease, and address mental health.
…Discussing why the advertised drug is not the best option for a particular patient may mean that a mammogram is not ordered, an important health behavior is not discussed, a family matter is not brought up… The clinician is put in the role of gatekeeper for the advertised commodity rather than a gateway for prioritizing health care based on the concerns of patients and the science-based recommendations for preventative, chronic disease, mental health, and family care…
Only a ban will work. The impossibility of regulating complex overt and covert multichannel messages with both rational and emotional appeals, the power imbalance between the public good and the commercial imperative, the difficulty of anticipating ads’ unintended consequences, and the availability of less-biased sources of information and motivation all argue for totally proscribing DTC ads.”2007 - Kurt C. Stange, MD, PhD
Jerry Avorn, MD, Professor of Medicine at Harvard Medical School, stated the following in his comment to the Aug. 4, 2009 article “Should Prescription Drugs Ads Be Reined In?” published in the New York Times:
“Just as every other industrialized nation has figured out how to provide health care to all their citizens and how to get drug makers to negotiate the prices of their products, each of those countries (with the exception of New Zealand) also bans direct-to-consumer advertising for prescription drugs…
All those other countries have it right, and we don’t. Doctors spend precious minutes of ever-shorter office visits explaining to patients why their cholesterol drug is every bit as good as the one they saw on television, or why feeling sad at the death of a loved one doesn’t require an antidepressant. Hawking medications to the public encourages rapid adoption of new products that may be no better — or even worse — than older, unadvertised generic drugs.
[T]his advertising promotes only the most expensive products, it drives prescription costs up and also encourages the ‘medicalization’ of American life — the sense that pills are needed for most everyday problems that people notice, and many that they don’t.”Aug. 4, 2009 - Jerry Avorn, MD
Gary Ruskin, MPP, Executive Director and Co-Founder of Commercial Alert, authored the following statement, endorsed by 226 US medical school professors, and delivered it at the Nov. 2, 2005 “US Food and Drug Administration Hearings on Direct-to-Consumer Prescription Drug Advertising,” available at the Commercial Alert website:
“Direct-to-consumer marketing of prescription drugs should be prohibited…
Pharmaceutical advertising does not promote public health. It increases the cost of drugs and the number of unnecessary prescriptions, which is expensive to taxpayers, and can be harmful or deadly to patients…
Prescription drug advertising pressures health professionals to prescribe particular medications, and often the ones that may be less effective and more expensive and dangerous. This intrudes in the relationship between medical professionals and patients, and disrupts the therapeutic process. It takes up valuable time to explain to patients why they may have been misled by the drug advertisements they have seen. Prescription drug advertising is not educational. It is inherently misleading because it features emotive imagery and omits crucial information about drugs and their proper use, as well as about side effects and contraindications that can be found on the full FDA-approved label. Drug companies have an inherent and irredeemable financial conflict-of-interest which drives them to exaggerate the positive and minimize the negative qualities of their own products.”Nov. 2, 2005 - Gary Ruskin, MPP
Andrew Weil, MD, Founder and Director of the Arizona Center for Integrative Medicine, stated the following in his Aug. 1, 2009 article “Should You Get Your Drug Information from an Actor?,” available at the Huffington Post website::
“I worry about DTC ads for three reasons:
1. Drug ads strengthen our belief in pharmaceutical drugs as the cures for all of our problems. In fact, the consequences of poor lifestyle choices cannot be undone with pills.
2. Many advertised drugs are not only ineffective, but have serious side effects that are frequently played down (and occasionally concealed) by manufacturers. Because heavily advertised drugs have such vast profit potential, political and financial interests collude to speed them to market before they have received sufficient scientific scrutiny.
3. Ads circumvent better sources of information and make people believe that they are being proactive about their health when they request an advertised drug. Thirty-second TV spots that trade on emotion and celebrity contribute little or nothing of value to patient education.
The free market works well in many ways, but it has failed us here. Whether it is done independently or as part of an omnibus health care reform initiative, we need to make the same decision that the rest of the developed world has made: that is, ban direct-to-consumer advertising of prescription pharmaceutical products.”Aug. 1, 2009 - Andrew Weil, MD
Peter Lurie, MD, MPH, former Deputy Director of the Health Research Group at Public Citizen, provided the following testimony during the Sep. 29, 2005 US Senate Special Committee on Aging titled “The Impact of Direct to Consumer Drug Advertising on Seniors’ Health and Health Care Costs,” available at the Senate Special Committee on Aging website:
“[W]e believe that the clearly demonstrated adverse effects of DTC advertising outweigh the still undemonstrated effects that might be beneficial. Where there is any hint of a beneficial effect, we find that there are better ways of accomplishing it…
First, direct-to-consumer advertisements bear little relationship to public health needs. New and expensive drugs, those for diseases that are bothersome and incurable, are the ones that we see advertised.
[M]any DTC advertisements are misleading or dangerous…
Point three, consumers are being mislead. Sixty percent of people surveyed by the FDA thought that the advertisements provide insufficient information about drug risks, and 44 percent felt similarly about the benefits.
[D]octors are being coerced. [There] is a clear increasing of prescribing when it is probably not justified…
Point five, the price of health care is being driven up. Patients are being induced to request new, more expensive medications…
FDA enforcement is lackadaisical.
[W]e believe that the benefits have not been demonstrated, and to the extent that there are any [benefits] they can be secured through other less dangerous routes, but the dangers are quite clear.”Sep. 29, 2005 - Peter Lurie, MD, MPH
Marcia Angell, MD, former Editor in Chief of the New England Journal of Medicine, in a Nov. 26, 2002 interview with Frontline, available at pbs.org, stated:
“There is this kind of marketing that is designed to convince people that they need pills. It’s designed to convince them that they need particular pills that happen to be more expensive, or just going on patent rather than coming off. Then, armed with this feeling, the consumer goes to the physician, who often just prescribes the pills. It’s a buyer’s market here. Doctors don’t want to lose patients. They don’t want to say no to patients. They’re, in some sense, too busy to say no to patients. They are forced to see more and more patients more and more rapidly. It’s faster to write out a prescription than it is to try to talk with patient and convince the patient that he or she may have been manipulated by these ads.
In addition, the doctors themselves are manipulated by the same ads, and also by what amounts to bribery from the drug companies. The drug companies turn up. They have $8 billion worth of free samples that they give to doctors. The doctors hand out the free samples to patients. It makes the doctor look good. The patient has free samples. But both the doctor and the patient, from that point on, are hooked on that particular drug. And believe me, it’s not going to be a generic, and it’s not going to be a drug that’s just going off patent. It is going to be a new, newly patented, high-price drug. So in a sense, both the doctors and the consumers are sucked into a sort of ‘bait and switch,’ because sooner or later they will have to pay for [that drug.]”Nov. 26, 2002 - Marcia Angell, MD
Barbara Mintzes, PhD, Assistant Professor of Anesthesiology, Pharmacology, and Therapeutics at the University of British Columbia, in a Feb. 2009 Canadian Family Physician article, “Should Canada Allow Direct-to-Consumer Advertising of Prescription Drugs? NO,” available at cfp.ca, wrote:
“Direct-to-consumer prescription drug advertising can cause damage by instigating rapid, widespread stimulation of use of new drugs before harmful effects are fully known.
Advertisements exaggerate treatment benefits and use emotive messages to target people with milder health problems, many of whom are unlikely to benefit from the drugs advertised.
Advertising leads to higher drug costs and overall health care costs through substitution of new, expensive drugs without treatment advantages.”Feb. 2009 - Barbara Mintzes, PhD
The World Health Organization (WHO), in their 2000 publication, “Guidelines for the Regulatory Assessment of Medicinal Products for Use in Self-Medication,” available at who.int, stated:
“Advertisements to the general public should help people to make rational decisions on the use of drugs determined to be legally available without a prescription. While they should take account of people’s legitimate desire for information regarding their health, they should not take undue advantage of people’s concern for their health. They should not generally be permitted for prescription drugs or to promote drugs for certain serious conditions that can be treated only by qualified health practitioners, for which certain countries have established lists. To fight drug addiction and dependency, scheduled narcotic and psychotropic drugs should not be advertised to the general public. While health education aimed at children is highly desirable, drug advertisements should not be directed at children. Advertisements may claim that a drug can cure, prevent, or relieve an ailment only if this can be substantiated. They should also indicate, where applicable, appropriate limitations to the use of the drug.”2000 - World Health Organization
Upjohn Company (now part of Pfizer), via R.T. Parfet, then Chairman of the Board, in a 1984 letter to then Energy and Commerce Committee Chairman John Dingell (D-CO), reprinted in “A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection” by Julie Donohue, available at facultynh.syr.edu, stated:
“The view of the Upjohn Company is that the direct advertising of prescription pharmaceuticals to consumers… would be detrimental to the pharmaceutical industry and, more importantly, a potentially disruptive element in our medical delivery system as a whole… Our view is that there is a vast difference between education and promotion… Product specific consumer ads could increase costs.”1984 - Pfizer
Eli Lilly and Company, via Edgar G. Davis, Vice President of Corporate Affairs at the time, in a 1984 letter to then Energy and Commerce Committee Chairman John Dingell (D-CO), reprinted in “A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection” by Julie Donohue, available at facultynh.syr.edu, stated:
“We do not believe that commercial product advertising of prescription drugs is appropriate… prescription drugs embody a complex set of factors with potential human effects that can best be evaluated by the physician… Therefore, we believe that the need for the physician’s supervision of any prescription drug taken by the patient is paramount and that the potential pressures of public advertising of prescription drugs on the scientific decisions of the physician are both unwise and inappropriate.”1984 - Eli Lilly
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