This is a guest article by Silvio Aladjem MD
OK, so that everybody knows upfront, I am biased. I think advertising directly to the public every new and/or old drug, is not a good idea and has nothing to do with improving health. It has to do exclusively with improving the bottom line of drug companies. Why else would they spend billions of dollars every year in advertising? It is estimated that for each dollar spent in drug advertising there is a four dollars or so return (http://bit.ly/1cGXwkp). Not too bad!
Used to be that you went to the doctor and he/she would prescribe a remedy depending on what your ailment was. It was unheard of for the patient going to the doctor and ask for a given drug he/she was told would be good for him or her. May be you would ask for a cough medicine, and the doctor presumably knew which was the best for you and wrote a prescription.
The Food and Drug Administration (FDA) regulated drug companies advertising in 1997 by mandating that side-effects should be listed in the commercial. Changes have been made to that strict ruling and now only the most significant adverse effects are listed in plain language that the average person can understand.
I am amazed at the amount of drug advertising available today. The advertising targets mostly the older people but younger ones are not spared. Invariably you will see the golf course, the family, the golden retriever dog and everything that is needed to suggest peace, quietness and happiness. Against this background you are told that you should tell your doctor about all the medications you are taking, to be aware that the particular drug may lead to depression and should you feel like committing suicide to call your doctor (really?). Or that the drug may produce heart attacks, or stroke, or some other terrible complication, in which case you should discontinue the drug and seek care immediately. They fail to tell you if you should discontinue the medication before or after the stroke! Of course the final message is to ask your doctor if the drug is good for you.
It is presumed that such advertising alerts the patient regarding various treatment options. This is a fallacy. Patients have no way to know what their treatment options may be before seeing their physician.
It is not unusual that the new drug is a “me too” drug. What that means is that the “new drug” does the same as some other “old drug”. As a patient you may think or be lured into believing that a new drug “must be better”, which is not always necessary the case. In fact because it is new, physicians have not enough experience and side effects may not have yet surfaced, as opposed to the old drug, which has been around “forever”. As one of my old Professor used to say: “if it works, don’t interfere”.
An interesting side effect of this trend is that advertising by lawyers soliciting clients that may have been hurt by the “new drugs” has increased, as you probably have noted. “You may be entitled to compensation” is the lawyer’s slogan.
One aspect of drug advertising is that the benevolent doctor that in the add prescribes the new drug, shakes your hand and accompanies you to the elevator when you leave (tell me who that doctor might be), most likely is not a doctor at all but an actor. Does it matter? I think it does because subliminally you are inclined to believe it is a doctor and reinforces your confidence. Frankly when that happens I believe it is deception. Truth in advertising, however, does not seem to apply, and it should. Other times, and these are documented cases, someone misrepresents itself as a notable physician without being one.
In the Bulletin of the World Health Organization (WHO) Gary Humphrey reports on Dr. Robert Jarvik who was introduced as the inventor of the artificial heart in an advertising of the drug Lipitor. It turned out that he was not a doctor, nor the inventor of the artificial heart (http://bit.ly/1Gfzj0L). I understand that this was an extreme case and I am not suggesting it is the norm, but it happens.
For each “advantage” for advertising drugs to the consumer there is a “disadvantage” depending on your point of view. Drug advertising is not a universally accepted commercial method. It used to be that only the USA and New Zealand were the only countries which allowed drug advertising directly to the public. Canada restricts advertising which have to conform to strict regulations. The last I knew, the European Union forbids such advertising but efforts are being made to change that.
The issue of advertising drugs directly to the patient is a complex one. It probably has as many supporters as there are detractors. Nowhere is the dictum of “buyer beware” more appropriate than in this area. In this era of instant overwhelming information, one must be aware of the misinformation that comes with it. I am biased again, but your doctor should be your best source of the right information for you!
SILVIO ALADJEM MD, an obstetrician/gynecologist and Maternal Fetal Medicine (high risk obstetrics) specialist, is Professor Emeritus in obstetrics and gynecology at Michigan State University, College of Human Medicine, in Lansing, MI. He is the author of “10,000 babies: my life in the delivery room” now available on Amazon, Barnes and Noble and other book stores. Dr. Aladjem published extensively in Scientific Medical Journals and wrote several textbooks in the specialty. Should you wish to contact him, you may do so by email at: firstname.lastname@example.org