Money Through Lies – Direct-to-Consumer Drug Advertising

Making You Want Something You Didn’t Know You Needed

I despise drug ads. No one should be interrupted from watching the season finale of Survivor only to have a picture of a highly unkempt woman on a couch quickly to be turned into vital young dream girl thanks to the latest wonder-pill. That is absolute poppycock.

But drug companies spent $4.2 billion in 2005 on direct-to-consumer advertising in the US.

Types of Direct-to-Consumer Drug Marketing

Marketing directly to the public is known as direct-to-consumer advertising (DTCA) and only two developed countries allow DTCA of drugs: the United States and New Zealand.

There are three types of DTCA:

1. Product claim advertising – includes both the product name and the therapeutic claim
2. Reminder advertisements – names the product without citing the use
3. Help-seeking advertisements – informs the consumer about new, but unspecified, treatment options for diseases

All three types of direct-to-consumer advertising of drugs are permitted in the US. Land of the free, home of the brave? Doesn’t strike me as free or brave.

How it is the US government can allow DTCA, particularly the product claim type, for prescription drugs is beyond me. People point to a pharmaceutical conspiracy. Well, I see no reason the US government can’t stand up to the pharmaceutical industry like every other country does. (Save New Zealand. I Don’t know what’s up there.)

Direct-to-Consumer Advertising in Canada

All three types appear to contravene the Food and Drugs Act in Canada but loopholes have been exploited since 1996 for help-seeking advertisements and since 2000 for reminder advertisements. Plus, there is the issue of US cable and radio feeds containing drug ads coming into Canada. Health Canada and the Canadian Radio-television and Telecommunications Commission (CRTC) are responsible for enforcement of the laws but appear to do so haphazardly.

A disturbing note: Because drug advertisers are exploiting a loophole in the Canadian system, rather than actually obeying specific regulation, drug companies can do reminder advertising in Canada for products with a black box warning – something they cannot do the US.

Direct-to-Consumer Drug Ads Cost You Money

Actually, drug ads don’t just cost you money, they cost you a lot of money.

From 1995 – 2006 US companies spent $38 BILLION in drug advertising in the US. (This is compared to $191 million in Canada.) On average, drug companies spend 24 times the amount advertising in the US than in Canada.

(FYI, Canada has about 1/10 the people of the US, so you would expect spending to be 10 times higher.)

So, do you wonder why you have to pay 10 times more for drugs in the US than in Canada? Ask marketers.*

Reasons Why Direct-to-Consumer Advertising is Good

It isn’t. Only the drug company wins.

That’s if you ask me. Others say direct-to-consumer advertising is good because:

• Drug/disease advertisements contribute to public health by increasing appropriate consultation for undiagnosed or untreated health conditions.
• As prescription medications require approval of a doctor, advertisements do not lead to patients getting inappropriate medications.
• Patient surveys suggest 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.

I say all that stuff is crap. The diagnosis of an illness should always be made by a doctor, not a commercial. Treatment should always be decided by the doctor and patient, not a commercial. I think drug advertising is nonsense. It does not serve as an education and there is no evidence it improves health outcomes at all.

Drug Advertising Works – You Buy the Drug You’re Told to Buy

The problem is drug advertising works. While there was an idiotic study done that suggests drug ads are not as effective as previously thought (there are methodological issues with that study), drug ads do make people buy drugs just like car ads make people buy cars.

Patients, over and over, walk into doctor’s offices and say, “I want drugX. I saw it on TV last night.”

And if you ask doctors, they will tell you that even trying to get the person to try a more appropriate drug of the same class, the patient won’t do it. Because the branding and the advertising is that strong. And as I’ve mentioned before, new drugs are always riskier than old drugs because not enough people have taken them yet for us to see potentially rare and dangerous side effects. Many patients would be better served by an older, well-known drug. But that’s not what patients want.^

Drug Advertising Is a Lie

I have ex-marketer friends who say their job as marketers was to make you want something you didn’t know you needed. And it doesn’t matter if that thing is a drug, or a car, or a carbonated beverage – they advertise it, you want it.

I know people think they are above drug advertising, but that just isn’t true. The only way to be above drug advertising is to avoid it. Like the plague.

A Little Bit More

* It’s more complicated actually. Canada regulates drug prices, which creates less profit, which in turn reduces the drug company’s motivation to spend as much advertising money in Canada.

^ This is not to suggest that sometimes a new drug isn’t appropriate, sometimes it is, but walking off the street and demanding it isn’t generally one of those cases.

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This Week on Breaking Bipolar

This week on Breaking Bipolar I’m going to talk about other drug branding and advertising issues.

• Drugs 101: What’s in a (Brand) Name? – on how drugs are named
• Are Brand Name Drugs Better Than Generics? Drugs are not Cornflakes
• Please, Don’t Say Prozac – on why doctors shouldn’t refer to drugs by their brand name