Are TV Pharmaceutical Ads Damaging?

trivialscene asks: "ABC News is carrying an article about a recently published study in the medical research journal Annals of Family Medicine which examined prime time television ads run by pharmaceutical companies. The researchers concluded that the generally ambiguous ads, which appeal almost entirely to emotion rather than fact, tend to confuse viewers. They also suggest that the ads may be creating problems at the doctor's office, as some people might become convinced they need a particular medication and insist on getting it, rather than leaving the decision to trained medical professionals. What do you think about the presence of drug advertisements on television?"

Comments

not sure

[gEvil (beta)]

I dunno. I'm still trying to convince my doctor that Levitra helps you levitate.

Who cares?

[Captain Splendid]

All that matters is that there are pills that give me erections for hours on end. Balanced against that, who cares about the dumb viewing public?

Re:Who cares?

[gwayne]

All that matters is that there are pills that give me erections for hours on end.

You need pills for that? Sheesh, what's this country coming to?

marketing vs R&D

[lotsofgadgets]

I think the big wake up call should be the fact that Big Pharma is spending more on marketing their drugs than on developing them in the first place.

Re:marketing vs R&D

[Znork]

"That's actually not true at all."

Actually, it's entirely true. Take a look at the financials of your average pharmaceutical. They spend less than 20% of revenue on R&D, 40% is marketing and administration, and 40% cost of production and distribution. Some have profits that are twice what they spend on R&D.

That, of course, means we'd get five times the R&D for the same money we're paying today if we paid for it outright rather than granting monopolies. Or we'd get the same level of R&D at a fifth of the price.

Re:marketing vs R&D

[UncleTogie]

I used to run IT at a local medical practice, and we had pharm reps in all the time. Surprisingly, they use the same "Look at the monkey! Look at the monkey!" tricks the Sheeple get on TV, but in person.

First, riddle me this: When's the last time you saw an ugly rep? Most of those salesfolk we saw were women, cuties, 20s-30s. They brought the doctor and staff free lunch from the nearest Olive Garden or the like, and just sat around and shot the bull for the first half of lunch. Alway complimentary and agreeable, it was int'restin' that they all seemed to share any particular view that Doc would mention. So, the doctor gets a pretty young lady that hangs on his every word, brings him lunch, and is quick to agree with him.

The poor slob never stands a chance.

The second half of lunch is dedicated to the pitch. I've heard that most doctors will fall for the pretty-face routine darn near every time; you'll always see a Rx count bump up after these visits...

Re:marketing vs R&D

[chevelle496]

IAAD, and I think you have a very valid point. Most of the drugs advertised on television here in the US are high dollar moneymakers for the pharma companies. In my opinion, this is the biggest problem - the vast majority of the time, much cheaper generic medications which are equivalent (or sometimes superior) in efficacy are available. The ads are just marketing and serve to drive up the already astronomical price of healthcare in the US. Personally, I usually ignore requests and spend a few minutes talking with my patients and explaining to them why "Expensiva" is not the best choice based on side effects, costs, or available randomized controlled trials. Yes, this does take a bit more time, and others might just give in and prescribe, but one of a physician's most important skills is communication.

Re:marketing vs R&D

[bobcat7677]

The ads are also aimed less at the consumer and more at doctors; doctors are the ones that have to prescribe it, after all, so they have to learn about it before patients start asking about it. Otherwise the patients will think the doctor is uninformed.

Hate to break it to you, but the ads ARE in fact aimed at the consumers. They are telling YOU to ask your doctor. You the consumer. And lucky for them there are millions of mild hypocondriacts out there that go running to their doctor the first chance they get to get a script. And for the most part the doctors ARE uninformed about the drugs they are perscribing. Pharmacists are the ones that actually have to learn about the drugs and try to catch as many dangerous interactions the doctors may or may not know about as they can. There are a whole lot of doctors out there that happilly collect the office visit fee, write the script, and then wait to collect again when their patient comes back complaining about the side effects from the dangerous medication they are taking (and didn't really need in the first place). Its a vicious cycle that is the #1 biggest reason health care is so "expensive" in the US these days (followed by the #2 reason: rapent medical malpractice settlements, most of which are kept off the public records).

Viagra is a perfect example of a drug completely out of control. How "nessasary" is it for most of the millions who are taking it? How dangerous is it? How easilly can just about anybody email a less then completely ethical doctor somewhere and have a script mailed to them? Lets run down the possible side effects:
flushing, headache, nasal congestion, stomach discomfort following meals, abnormal vision including blurred vision, seeing shades of colors differently than before, or sensitivity to light, bladder pain, cloudy or bloody urine, dizziness, increased frequency of urination, pain on urination, diarrhea, bleeding of the eye, convulsions (seizures), decreased or double vision or other changes in vision, prolonged, painful, or inappropriate erection of penis, redness, burning, or swelling of the eye, anxiety

at least this one has relatively "mild" side effects compared to some other drugs. I have seen heartburn medication that had a possible side effect listed of "Death"...no joke. Guess they figure if you die you won't have that heartburn any more and it's a win for them.

If laws exist to keep cigarettes and alcohol from being advertized to minors, shouldn't stuff that has been shown to cause even more prompt death or permanent damage be more tightly regulated in who it's pushed on?

I was a pharmacist's assistant.

Re:marketing vs R&D

[AndersOSU]

Ugg, Normally I'm all for slamming big pharma - as a matter of fact let me do that now. I think that the fact that pharma spends more on advertising than R&D (which is true, in spite of GP's shilling comment) is shameful, and that neither consumers, doctors, legislators, nor shareholders should put up with it. And while this may seem like the perfect time to also take a dig at the patent structure - which is badly in need of reform - I don't think the monopoly meme is entirely appropriate here.

While it is true that each pharma company holds a monopoly on the drugs it invents, pharma is in no way a monopolized industry. If dumping money into R&D were so effective another pharma company with the same outrageous profits could do 5x more research, relying solely on academic journals to spread the word, and clean up with their vastly more and superior drugs. Unfortunately, pharma doesn't think (maybe rightly so) that an investment in R&D translates 1:1 into profit. Where, on the other hand, they seem to think (probably erroneously) that an investment in advertising translates more effectively into revenue.

Personally, I think that the solution involves regulating what, when, and how pharma can advertise, and severely regulating the way pharma's sales reps interact with doctors. But hey, as long as they can afford the good lobbiests, none of this will happen, so maybe we really ought to start with some decent lobbying reform.

Re:marketing vs R&D

[mrfunnypants]

This is not entirely true as well. The problem with pharmaceutical companies is when they report financials they have a category labeled as "Selling, Informational and administrative expenses." SG&A is the income statement item which combines salaries, commissions, and travel expenses for executives and salespeople, advertising costs, and payroll expenses.

For example looking under Pfizer's recent released financials you will see they spent 7,599 and 835 on R&D costs (clearly stated) while spending 15,589 on SG&A. Assuming SG&A all goes to marketing, which is incorrect, you would get a good 32% on marketing and 17% on R&D. However as stated SG&A is not just marketing. If you could figure out what percentage of SG&A is marketing then you would be correct.

If I recall correctly congress was going to pass a bill which would of required pharmaceutical companies to report the true percentage spent on marketing but due to lobbying it was shot down.

Re:marketing vs R&D

[slughead]

That, of course, means we'd get five times the R&D for the same money we're paying today if we paid for it outright rather than granting monopolies. Or we'd get the same level of R&D at a fifth of the price.

Oh of COURSE that's what it means.

Maybe they need that marketing to sell the drugs to pay for the R&D to make the drugs and the best way to do that is to pay for more advertisements.

You think companies like to advertise? They would rather give the money to R&D if the drugs actually sold themselves. Most drugs, however, do not sell themselves. Most of the medication sold in this country has little effect or could easily be replaced by an older drug which is 1/10 the cost and only 3 to 4% less effective.

Another problem is that if the patient dies, that '3 to 4%' figure is brought up in COURT in the form of a malpractice suit against the doctor that prescribed the alternative!

The niche medications which treat ailments that effect 1% of the population have a high price and the research in finding them is often NEVER PAID OFF. It's a tightly held secret that drug companies often pursue avenues that yield JACK SQUAT.

The worthless 'celebrex' and 'nexium' medications pay for those dead ends and niche drugs. And their marketing allows them to do that.

Drugs like Celebrex which show barely any improvement over placebo, and medications that take care of problems related to obesity (a relatively easily-cured disease) wouldn't be flying off the counters if it weren't for those commercials.

If the drug companies cut their marketing in half, freeing up 20% of their revenue according to your figures (which, btw, are wrong), they may end up having half the revenue to work with. So they'd have -50% less money and +20% more, for a net of -30%. Those are obviously arbitrary figures, but you can see the point: less marketing does not mean more money for R&D.

So, to sum up, the pharmaceutical system in the US is the best money could buy. If central planning were the answer, the US wouldn't be lapping the socialized world in pharmacological research. When government starts telling doctors what to prescribe and price fixing on drugs in America, we'll see a quick restructuring inside these companies in which R&D will fall through the floor.

Re:marketing vs R&D

[chevelle496]

You know it is funny (in a sad way), but during medical school we were taught that the average physician interrupts the patient within 30 seconds of the start of the conversation and starts asking yes/no questions. Unfortunately we (physicians), tend to miss many of the important bits of information because of that, and the average patient only talks for about 2 minutes if you just sit and listen. Miraculously, I have discovered that if you listen for that extra 1:30, you tend to save yourself a great deal of time ordering tests, drugs, etc. In my experience, patient visits tend to be handled much faster by listening for 2 minutes, asking a few open-ended questions to fill in the blanks, and parting ways with satisfaction rather than misunderstanding and unhappiness.

If I can explain something in 2 minutes rather than spend 5 minutes ordering a drug or test, everyone wins. Of course, this does not always happen, and sometimes the picture is less than clear when I leave a room...but a little extra time spent talking seems to save a lot of time in the end.

Take, for example, the common scenario of the vomiting child. Parents worried, me busy...now I can simply say, "yup, your child is vomiting, we'll give some *insert expensive anti-vomiting medication* and an IV," or I can spend a few minutes explaining the WHO process of giving small amounts (1 tsp or so) of fluid every few minutes so that the child will not vomit, explain how to limit the diet a bit for the next couple of days, and let the parents ask a few questions. In the end, the medication and IV takes an hour+ to accomplish, or the parents spend 1/2 hour giving small amounts of fluid that add up quickly. Either way (usually) the child's mild dehydration gets treated...and with a little more talking up front, I save 1/2 hour down the line.

I am the first to admit physicians get lulled into a "drug for every disease" pattern, but the truth is, a little time, reassurance and education will solve the majority of problems. The trick is knowing which problems that approach won't solve...but that's why I went to med school in the first place (and a topic for another day).

If not outright damaging, they don't help

[PDMongo]

Every time I see one of those ads I can't help but think that it isn't my job to try and convicen my doctor to prescribe some drug, it is the doctor's job to know what drugs are available and prescribe them to me.

If the drug companies want me to sell my doctor on their particlar product, I should get a commission every time they write me the prescription.

Re:If not outright damaging, they don't help

[yali]

it isn't my job to try and convicen my doctor to prescribe some drug, it is the doctor's job to know what drugs are available and prescribe them to me.

Actually, both of you have a job (though you're totally correct that yours isn't to act as a drug sales rep). What's insidious about this kind of advertising is that it exploits what should be a good trend. The old model of "doctor knows best, do whatever he tells you" isn't ideal. The best case scenario is when a patient becomes informed about his/her health and makes decisions in consultation with the doctor, drawing on the doctor's expertise.

When I was seriously ill a few years back, my doctors (who were outstanding btw) encouraged me to do research on my own. I scoured medical databases and brought that info to my doctors, who helped me sort through it. I think it elevated the quality of my care, and it made me feel like I retained some control over a scary illness.

Unfortunately, by feeding patients information that is biased or misleading and playing to emotion rather than providing useful information, these ads are probably eroding the kind of doctor-patient relationships that everyone should have.

YES

[zubernerd]

YES.

My mom's an MA (medical assistant) and my wife is a medical student (M2), and both tell me that those ads are a problem.

I hate hearing about people demanding drugs after seeming them on TV, thinking they know better than a professional with 4+ years of training. I watched my wife study for her pharm course, and all the interactions, contraindications, etc is enough to make her head spin a little bit (and mine a lot). Also, most of the time an off-patent generic drug that's been around for years is more beneficial than those new drugs being advertised.

It's the like the old joke about the old lady who wants that new arthritis drug: Viagra.

Yes

[ThePolkapunk]

Short answer: Yes. Long Answer: Your doctor is the one who should know about medicine. If he finds out about medication from advertisements on TV, it is time to choose a new doctor. If he finds out about medication from patients who saw advertisements on TV, it is time to choose a doctor. If he will prescribe medication to you based solely upon your request because you saw an advertisement on TV, it is time to choose a new doctor. His knowledge of medication should be completely restricted to facts, such as effects and clinical studies. Any time a doctor is being influenced by an advertisement, whether it be from television or the frequent free catered meals and trips with which pharmaceutical companies bribe doctors, your health is being put in jeapordy.

Not for me

[Quiet_Desperation]

I identified so much with the little unhappy blob thing on the Zoloft ads, that I finally sought treatment. I am finally free of 20+ years of clinical depression thanks to that ad.

Re:Not for me

[SuperficialRhyme]

Damn, I could have diagnosed you from your slashdot nick.

Bad Idea

[Enderandrew]

We're not doctors. We don't know what is wrong with us. We don't know what we need. We shouldn't be going in and requesting specific drugs. The bad thing is that doctors are only getting so much money to see us because of the HMO system, so they get us in and out as fast as possible. If I ask for a certain drug, more than likely I'm going to get it, regardless of whether or not it is beneficial or harmful to my health.

I also thing as a society we are treating symptoms by developing dependencies on medication rather than fixing problems.

If drug companies can afford every other Super Bowl commercial, and drug reps can throw money at every doctor and pharmacist in the country, maybe they can afford to sell drugs at reasonable prices to third world countries.

George W. Bush (love him or hate him, who am I kidding, everyone hates him) maybe did one thing right. He found American drug companies were charging five times as much for AIDS medications in Africa as they charged here. They openly profitted from people's deaths, and played upon their fears.

And yes, I believe their ads play upon emotions. I'd like to see a ban on drug ads on TV. They can spend the money in better places, like further drug research or third world countries.

Ask your doctor about modding parent up.

[Rob T Firefly]

A friend of mine is a GP, and he is pretty sick and tired of his patients asking him about whatever drug was last advertised while they were watching Oprah and therefore extra suggestible. His standard response is something like "If you want the professional medical opinion of your television, visit it instead of me. You're not buying dishwashing liquid here."

Re:Ask your doctor about modding parent up.

[Citizen of Earth]

"If you want the professional medical opinion of your television, visit it instead of me. You're not buying dishwashing liquid here."

You're seeing Dr. House?

Re:I hate ambiguous drug ads.

[gEvil (beta)]

An extra 5 seconds of ad time used to clarify what the drugs does doesn't sound like a waste of air time to me.

From this page:

"According to these FDA regulations, advertisers who name a prescription drug, and state its purpose and benefits, must also include full disclosure of its side effects, contraindications, and must follow specific labeling guidelines."

By stating the purpose of the drug, that "extra 5 seconds" suddenly turns into a full minute or two of small print being read to you. Not exactly what the advertisers want to be doing with their time/money.

They are banned in Britain

[Andy_R]

TV adverts for drugs are so lightly legislated over here that they are effectively banned (as are all drug adverts). The only one I can remember was a Pfizer advert that was so vague it only really seemed to be about Pele's inability to keep it (presumably a soccer ball) up.

Our medical system is based on the principle that if for have something wrong with you, you see a doctor, and the doctor prescribes the right drug for it if one exists. Therefore, drug companies market to doctors, not to patients, which seems the most sensible way to do it - after all a drug company's spend on advertising is spread a lot less thinly if they only advertise to doctors.

Re:I hate ambiguous drug ads.

[Pojut]

Well for one, if a drug is pending FDA approval they legally are not ALLOWED to state what the drug does. Ditto if the drug has not completed post-approval clinical trials as well.

And the second reason may seem shitty from a consumers point of view, but from the industrie's point of view it makes sense: it causes you to go online and check out what it does. In the meantime, you get to see what else the company manufactures, and therefore you have more names that are associated with that company and the marketers hope that because you remember another name from their company, if the need to use the treatment that drug provides you are (again, they hope) more likely to use THEIR drug since it's a name you recognize. (Apologies for the run on sentence)

And yes I work in the pharmaceutical industry.

The way I see it...

[djbckr]

I see these heartburn ads on TV and think to myself: These people on the screen are actors, in good health and probably don't get heartburn. The target audience gets heartburn because they eat too much and are overweight.

I know this because I am friends with a general practitioner (been an MD for about 15 years now) and he tells me that people in shape, like the actors in the commercials - in general - don't get heartburn.

I also know this because I was one of those people that got heartburn regularly. Once I started eating properly and getting back in shape, my heartburn disappeared.

Re:The way I see it...

[gEvil (beta)]

So how's the acting career coming along?

Re:The way I see it...

[tubapro12]

I know many people with sensitive stomachs and other digestive conditions who are not overweight and do not eat too much yet still frequent heartburn.

Re:The way I see it...

[SydShamino]

I'm generally in shape, and I eat moderately well. The problem has to do with what I eat well.

glass of red wine with dinner = heartburn
tomato sauce on pasta (or any tomato products) = heartburn
hamburger = heartburn
not eating at the correct times = sometimes heartburn (haven't figured this out)

If I eat enough milk fats with any of the above, I dont't get heartburn. Hence, I mix tomato sauce with a little Alfredo sauce, put cheese on the burger and have a glass of milk, and I don't have a problem.

Incidentally, this runs in the familiy. My father is on daily prescription medication and needs the valve at the top of his stomach replaced at some point. My older sister now takes daily over-the-counter medication and is still having problems. Both, like me, are generally in shape. My dad's suffered from it for most of his life, and I've been dealing with it since I was 20 or so.

Re:The way I see it...

[ShieldW0lf]

The researchers concluded that the generally ambiguous ads, which appeal almost entirely to emotion rather than fact, tend to confuse viewers.

This is what all ads do. And yes, ads are damaging. All of them.

Noticed in your sig you like Bill Hicks

[spun]

Me too. Here's my favorite Bill Hicks quote, very relevant to the issue at hand:

By the way if anyone here is in advertising or marketing... kill yourself.

No, no, no it's just a little thought. I'm just trying to plant seeds. Maybe one day, they'll take root - I don't know. You try, you do what you can. Kill yourself.

Seriously though, if you are, do.

Aaah, no really, there's no rationalisation for what you do and you are Satan's little helpers. Okay - kill yourself - seriously. You are the ruiner of all things good, seriously. No this is not a joke, you're going, "there's going to be a joke coming," there's no fucking joke coming. You are Satan's spawn filling the world with bile and garbage. You are fucked and you are fucking us. Kill yourself. It's the only way to save your fucking soul, kill yourself.

Planting seeds. I know all the marketing people are going, "he's doing a joke..." there's no joke here whatsoever. Suck a tail-pipe, fucking hang yourself, borrow a gun from a Yank friend - I don't care how you do it. Rid the world of your evil fucking makinations. Machi... Whatever, you know what I mean.

I know what all the marketing people are thinking right now too, "Oh, you know what Bill's doing, he's going for that anti-marketing dollar. That's a good market, he's very smart."

Oh man, I am not doing that. You fucking evil scumbags!

"Ooh, you know what Bill's doing now, he's going for the righteous indignation dollar. That's a big dollar. A lot of people are feeling that indignation. We've done research - huge market. He's doing a good thing."

Godammit, I'm not doing that, you scum-bags! Quit putting a godamm dollar sign on every fucking thing on this planet!

"Ooh, the anger dollar. Huge. Huge in times of recession. Giant market, Bill's very bright to do that."

God, I'm just caught in a fucking web.

"Ooh the trapped dollar, big dollar, huge dollar. Good market - look at our research. We see that many people feel trapped. If we play to that and then separate them into the trapped dollar..."

How do you live like that? And I bet you sleep like fucking babies at night, don't you?

"What didya do today honey?"

"Oh, we made ah, we made ah arsenic a childhood food now, goodnight." [snores] "Yeah we just said you know is your baby really too loud? You know?" [snores] "Yeah, you know the mums will love it." [snores]

Sleep like fucking children, don't ya, this is your world isn't it?

So, do you think that if doctors don't know the alternatives, we should advertise to the patients?

What exactly does a "pharmaceutical consulting group" do, anyway? Something good, like "Facilitate open communication between drug companies and doctors?" Or something bad like "Figure out how to push more drugs whether people need them or not?"

Used to work in this industry.

[SnowDog74]

I left pharmaceutical sales because, quite frankly, I was tired of being nothing more than an interruption in a doctor's day. In fact, I left sales entirely as a result of that experience.

The entire purpose of pharmaceutical sales at the doctor, clinic and hospital administration level is this: To abnormally influence the prescribing of drugs beyond what information is public by way of peer-reviewed scientific research. The drugs your doctors prescribe are sometimes influenced by how many pens, pads, lunches, dinners and other free crap are given to the physician and/or his staff. The drugs your insurance company covers are most influenced by what pharmaceutical company wines and dines the formulary administrators the most.

Physicians and administrators who participate in golf junkets, etc., are just as much to blame, but that doesn't remove the culpability of the pharmaceutical companies who know exactly what they're doing and are constantly pushing to be able to intrude even more in the treatment of a patient by way of these methods.

There are examples of egregious behavior at various levels of the pharmaceutical business ranging from minor nuisances to egregious breaches of ethics. One competing company's rep, while I was covering Mayo Clinic, got his company kicked out for six months by following a physician into his office WHILE the physician was seeing a patient... What was the rep's urgent matter? To deliver his canned sales pitch for his product. There have been pharmaceutical companies nailed for including large gifts in honorariums given to physicians for speaking on behalf of their products.

Mayo Clinic is one of the few institutions that has extremely strict rules... No pens, no pads, no papers, samples are signed in through a controlled process giving the rep very limited access to physicians. At the same time, they'll gladly throw up a banner for your product if you'll give them a huge research grant... While that's no guarantee that they'll bias the research in the pharma company's favor, human nature is such that money tends to drive a sense of obligation to the benefactor.

The advertisements have taken the Creationist approach to marketing... by appealing to the opinions and attitudes of the average, uninformed layperson. In doing so, they are still interfering in the process without really contributing anything of value that cannot be obtained by a physician who keeps up by reading the peer-reviewed journals on his or her own time... as a good physician will want to do. Physicians already have a motivation to do this research... it's called avoiding malpractice lawsuits.

Previously reputable pharmaceutical companies have stepped up and started direct advertising to consumers on television... It's getting worse and the cacophony of products being advertised by these companies creates a confusing atmosphere of insufficient information that does what exactly? The commercials don't begin by encouraging patients experiencing certain symptoms to go see their doctor and let them do their educated diagnoses. The ads begin by summarizing symptoms in a manner that creates a sort of confirmation bias, i.e. rattling off a barrage of symptoms, one of which might lead the viewer to suspect they need the drug... while ignoring the specific COMBINATION of symptoms that preclude a specific diagnosis. Then the ads encourage the patient who SUSPECTS they might have this problem not to go to the doctor and find out the proper course of treatment... but to "ask your doctor for".

They know what they're doing and even though I agree, simultaneously, in the principle of customer awareness... The ignorance of the average customer does not change the fact that it was the intention of the company to defraud and profit on the basis of that ignorance and therefore does not make the company any less responsible for doing so.

While I agree that medical science is a luxury and not a public utility, the health of a country's citizens does directly impact the nation's

It's worse than you think...

[Gordo_1]

This article points out that even doctors are susceptible to drug company advertising:

"...according to a review published in the Jan. 19, 2000, Journal of the American Medical Association. Ashley Wazana, M.D., of McGill University, analyzed 29 studies of relations between doctors and the pharmaceutical industry and found that the industry's marketing efforts clearly influence doctors' prescribing habits, although most doctors do not believe this to be true."

Mod Parent Up

[pkulak]

I have this discussion with people all the time who seem to think that pharma companies have razor-thin margins and spend all their money on R&D. The truth is that their margins are between 20% and 30% and they spend massive amounts of money on marketing. If you want a company with tiny margins and huge R&D expenses, look at AMD, not Phizer.