Do You Promise To Run Honest TV Ads?
16 CommentsBy Ed Silverman // May 20th, 2008 // 5:03 pm
That’s what two Congressmen are asking the ceo’s at Pfizer, Schering-Plough, Merck and Johnson & Johnson. John Dingell and Bart Stupak, Michigan Democrats who run the House Energy and Commerce Committee, also sent a letter to PhRMA’s Billy Tauzin asking if the trade group will update its guidelines.
The move comes less than two weeks after the House Oversight and Investigations Subcommittee held a hearing on DTC advertising, which focused specifically on the infamous Lipitor ads featuring Robert Jarvik, as well as ads for Vytorin and J&J’s Procrit.
During the hearing, execs from the drugmakers failed to promise Dingell they would implement changes to their advertising practices, citing a lack of authority. But they did invoke PhRMA guidelines, although Dingell and Stupak worry that PhRMA guidelines may not prevent misleading or deceptive ads.
“Consumers should not have to rely on the oversight function of Congress to make sure drug companies tell the truth in their ad campaigns,” Stupak says in a statement. “Pharmaceutical companies should consider it a privilege to air DTC ads and, as with all privileges, there comes responsibility. We intend to make certain that drug companies market their products properly in order to protect American consumers from manipulative commercials designed to mislead and deceive for profit.”
Former BP
Three words - Will never happen.
Paul
Not sure what they’re asking. Isn’t this already in the PhRMA guidance on DTC that companies agreed to? I thought that it was just a matter of teh FDA to get enough staff and resources to review the deluge of ads that would come in for review.
This is like Congress sending me a letter to make sure I stop at red lights.
I must be missing something.
MD 1
Unfortunately, the Congressmen are spitting in the ocean. Big pharma will not change until they are forced to change. I say ban the ads and give the practice of medicine back to the physicians. Don’t let the companies take their promotional activities directly to the public! It’s not needed. if they are allowed to do anything, it should only be true patient education efforts without product mention, just like in Europe and most of the rest of the world.
M Helm, MD
I sometimes get questions about medications advertised on television from patient families. My standard response is that the best medications don’t need to be advertised to consumers. I want to treat my patients with the best medications possible and I work very hard to know what those are. If the products advertised were the best treatment choices available, the companies would not have to pay millions to advertise them to consumers.
When the discussion is framed this way, most patients seem to understand that they are being played. I very rarely prescribe a medication that is advertised on television. Of course, I very rarely also give samples. If physicians and others who write prescriptions would determine to communicate to the patients that what is advertised is not necessarily better, there would be less advertising.
DTC advertising continues because it is effective (or believed to be effective) in generating higher sales. Since the only way this is possible is with complicity of phsycians (or other prescribers), who is to blame for the continuation of the practice?
Dan
Published on http://www.brainblogger.com:
Your Television as you doctor?
Often, usually on television, one viewing will often at times see an advertisement for some type of medication- usually one involved in a large market disease state and the commercial is sponsored usually by a big pharmaceutical company for a particular network. This is called direct to consumer advertising, and doctors would prefer they did not exist.
Since 1997, when the FDA relaxed regulations regarding this form of advertising, the popularity of the creation of such commercials has greatly increased. The pharmaceutical industry spends around 5 billion annually on this media source now. Normally, the creation of such a commercial becomes visible to the consumer within a year of the drug’s approval, which raises safety concerns. And involves money spent that could be applied to greater uses, according t many, but we are dealing with a corporation here.
The purpose of DTC ads is not education, in my opinion, as others have claimed. Any advertising of any type shares the same objective, which is to increase sales and grow their market and, in this case, for a particular perceived medical condition or disease state. The intent of DTC advertising is to generate an emotional response from the viewer, such as fear or concern, believing upon research that the viewer will then question as to whether they need to seek treatment for what may be an unconfirmed medical condition. Furthermore, the FDA has admitted that they are ignorant as far as the content of such DTC ads, in relation to their accuracy and clarity, as well as their effect on the health care system.
DTC advertising is also a catalyst for and similar to disease mongering.
Disease mongering is the creation of what some believe to be medical flaws, and illustrated by the creators through exaggeration and embellishments through media sources as an avenue for suc propaganda, as is often seen with DTC advertising. Yet the flaws may not be medical, but corporate creations of these questionable human ailments that do not require treatment, possibly, and may be an attempt to develop a particular medical condition to acquire profit. One of my favorite DTCs is the new indication for the use of an anti-depressant for a social disorder. This used to be called introversion, a term created by Dr. Carl Yung. And it is a personality trait, not a medical disease. There are other questionable medical conditions claimed in the contents of DTC commercials, as the creators wish to grow the market for a particular, and possibly fictional, disease state. Then there is baldness treatments advertised, as another example. Lifestyle meds are not treatment meds for illnesses, and should not be portrayed as such.
Also, DTC ads discuss only one treatment option normally, so it seems, when likely several treatment options exist for authentic medical disorders. This should be left to the discretion of the doctor, as they assess your health, not your television or another media source. That’s why most of the world does not conduct DTC advertising, with the exception of our country and New Zealand.
Finally, DTC advertising and its ability to influence viewers to make their own assessment instead of a medical professional remains largely unregulated, yet apparently effective for the DTC creators. People are prone to believe what they see and hear, regardless of whether or not it is actually true. Many, after viewing a DTC ad, seek out a doctor visit and request whatever product that was advertised, which makes things cumbersome for the doctor chosen for such a visit. So the doctor and patient relationship is altered in a negative way, because most DTC ads require a prescription.
Medical information and claims of suggested health ailments should come from those in the medical field instead of the corporate world. Perhaps this will save some over-prescribing, which will benefit everyone in the long term. And the Health Care System can regain control of their purpose, which is far from financial prosperity.
“Men of ill judgment oft ignore the good that lies within their hands till they have lost it”
Sophocles
Dan Abshear
Laurie
“My standard response is that the best medications don’t need to be advertised to consumers”
Exactly!
Paul
My standard response is that an informed patient makes for a better patient. Doctors do not have the time, the incentive, nor the skill to have a rich conversation with patients.
So…patients are left alone in trying to find out information for themselves. DTC is definitely biased and too glossy to be useful. However, is the rest of the crap (sorry Ed) in the internet any better?
There’s got to be a more comprehensive solution than only regulating DTC ads; that will help some, but won’t make much of a dent.
Jack2
You can think that M Helm MD….
But if I scan the WHO list of 100 essential meds, I can find meds that in my lifetime I remember seeing DTC ads for. On top of that, DTCs a relatively new thing, and it’s basically impossible for a brand name med to get on that list, so I think at least some meds that you see ads for today will make the list in the future after the patent expires.
We can debate whether or not DTC makes sense for a lot of reasonse. But I don’t think the quality of the med determines whether DTC makes sense. Currently, the therapeutic area really determines whether or not you will see DTC - almost regardless of whether the meds one of the “best” meds - whatever that means.
Bingo
Jack2,
If you look at the WHO list of essential meds, you’ll notice that almost all of the many antiretrovirals are NOT off patent and are not available as generics in the U.S. You’ll also note that these products are not, as far as I know, the subject of DTC ads. Clearly, companies engage in DTC when the believe it will help boost patient demand, regardless of the therapeutic benefit of the product. I think the absence of products with DTC ads from the list of essential medicines underscores the point that they are not necessarily the best therapeutic option. Certainly if they were so vastly superior to other treatment options, they’d be on the list.
Jack2
Explain why simvastatin is on the list, and atorvastatin is not - besides cost?
Bingo
Jack2,
That’s exactly the point. In many cases there is no therapeutic need for the more expensive option, although DTC advertising can suggest otherwise to patients. That isn’t to say that the more expensive option isn’t appropriate in some cases, just that higher cost (or the existence of DTC ads) doesn’t necessarily mean a superior option for the patient.
Jack2
I see your point, fair enough Bingo.
I personally think that there’s a difference between those two drugs, but is the difference big enough to justify spending for a brand-name med in a 3rd world country?
Would you at least admit that the WHO list is biased towards first-in-class medications, and well-established meds? I think some drugs (or drug classes) with current DTC campaigns (or past DTC campaigns) will crack that list.
Bingo
Jack2,
From the WHO website:
“Essential medicines are those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.”
So the list doesn’t consider efficacy alone, but rather within the context of several other factors.
re: atorvastatin vs. simvastatin I agree they’re different, but “superiority” isn’t always obvious. Sometimes “good enough” is, in fact, the best choice.
I just think that DTC can get in the way of reasoned decision making in the choice of medications by unduly influencing patients who do not have adequate understanding of the variables to make a truly informed choice. Drugs are sold by prescription only in large part to ensure the choice of medication is appropriate to the individual case.
Jack2
Thanks Bingo.
My views on DTC are mixed.
Again, I just don’t think you can claim an advertised drug is a bad drug. With no data (historical or otherwise - since DTCs relatively new), I predict drugs advertised today will make that list when they go off patent.
I’ve seen Tylenol commercials, and Tylenols on the list. There used to be Zocor DTC as well.
In 1996 Merck spent 40 million on Zocor DTC. Was simvastatin on the WHO’s list in 96? I don’t know, but I suspect it was not.
Bingo
Jack2,
I agree that you can’t assume a drug is bad simply because it’s the subject of a DTC ad. More importantly, I don’t think consumers should assume a drug is *good* just because it’s the subject of a DTC ad. I think that’s the real problem because patients ask for drugs they know only through the ads. I wouldn’t be surprised if some currently advertised products end up on the WHO list, but I would be somewhat surprised to find one on the list while it is still being advertised.
James
The best results come from an educated patient who talks w/ their doctor. DTC ads can help inform those decisions.
My own example–I struggle w/ allergies. Bad ones. Dr. suggested a switch to a different type. I’m willing to try, as I knew about them through both the ads and a friend’s experiences, but I asked if he could prescribe one that would be on a a cheaper tier of my insurance. He prescribed one that is on generic. And he gave me a sample of the branded one to boot.
So, DTC ads, sales reps, my doctor, my insurance and I all worked together to get me a drug that isn’t advertised and isn’t represented by a salesperson. I didn’t need a gov’t counter-detailer, and I didn’t need a DTC ban. In fact, I would have been less prepared to make that decision were it not for the ads.