Time to Ban Direct-to-Consumer Prescription Drug Marketing

It has been mentioned that the public is increasingly skeptical of the medical-industrial complex, and with good reason. Dr Hallgren recommended the lobbying bodies of AAFP, and AMA to campaign against DTC ads, and provide outlets of unbiased information. The public is eager for unbiased information about medications, and such information could be very beneficial to public health. Having an unbiased resource to refer patients to, and to proactively address the misconceptions generated by the DTC ads could save potentially long difficult discussions in many physicians’ offices that are not a productive use of precious time with the patient. The University of Iowa College of Pharmacy has produced the Iowa Drug Information Service Database for over 40 years. The Division of Drug Information Service in the College is staffed by drug information specialists who can provide a service via the internet to meet these needs. Funding a service of this type with a tiny fraction of the cost of the DTC ads would provide tremendous benefits for public health and be of great value to health professionals as well.

Competing interests:   I am the Director, Divsion of Drug Information Service, The University of Iowa College of Pharmacy.

Dr. Stange's points about the impact of DTC ads on patient care are well-taken, but I think his conclusion misses the point. Yes, it takes time out of an appointment to convince a person why they don't need the latest and greatest drug they saw on TV. Yes, DTC ads reinforce the already widely-held notion that many patients have about having a magic pill to solve medical problems rather than prevention or lifestyle changes. Yes, there is some research to support some of this.

Frankly, though, it's not someone else's [federal or state governments] job to combat this, it's ours, and we're the ones best qualified to do it. If all these malignant effects from DTC ads are real, our lobbying bodies (AAFP, AMA) should be campaigning against it and providing the outlets of unbiased information. Why not have our lobbyists work with Pharma in improving the ads? How about our private governing bodies provide material and media outlets for me to direct my patients to when they come around asking for the new magic bullet? Calling for the government (not explicitly stated in the article, but who else can do it?) to ban DTC ads is a bad idea. It invites more regulation into a profession which needs less and, in a larger sense, a continued erosion of free speech, even if that speech is powered by big money in search of bigger money. Finally, it simply goes against my belief in personal responsibility and dignity to suggest that patients and physicians are better off being shielded by regulation or law not just against the timing and content but the very existence of argumentative advertisements. I think we can do it just fine ourselves, thanks.

Competing interests:   My brother is an advertising executive and one of his clients is a pharmaceutical company.

I am worried that pharmaceutical companies might be motivated to place ads with TV, radio and media for drugs which might be in danger of being "pulled" from the market secondary to safety or other concerns. Furthermore, this creates a real conflict of interest for members of the press and media, as they might be tempted to not report certain damaging statements about a pharmaceutical product if it could lead to a loss of revenue. Conversely, media might be tempted to blackmail pharmaceutical companies in hopes that they might run more advertisements in an attempt to "bribe" the media into silence. This is is a real problem with a "for profit" news and media system which relies completely on advertisers to pay the bills. The fact that there is little or no oversight of this system creates multiple opportunities for abuse. Removing pharmaceutical ads from the media is an important forst step in correcting the system.

Competing interests:   None declared

Now is as good a time as any to advocate for something that has strong scientific support but faces obvious major obstacles. Americans seem to be increasingly skeptical of the medical-industrial complex so why not, as Stange advocates, take it on in a forum where it is most obvious - the pages of our newspapers and our TV screens. Any casual reader of national newspapers or any morning basement exerciser with the TV can observe for themselves the pervasiveness of direct-to-consumer ads that are drowning the american reader/viewer. The target populations are the aging boomers, teens with acne, men worried about "erectile dysfunction", and the usual cough/cold/stuffy nose crowd. But the ads are more clever, the medications more powerful and new "conditions or diseases" being invented every year.

Aside from the partial truths and hype involved with these ads, big Pharma and the equipment companies are needed by TV and newspapers to pay the bills. Any uneasiness about ethics seems to be overwhelmed by the finance departments of the media who also, like the public, have become drug (company) addicted.

The genius of advertising is to convince us that we need something we don't need and then offer a solution that we can't afford, but now are convinced we need. So it is with niche drugs and newly concocted "conditions". At least if we go back to the era of "tired blood" patients would take something like Geritol which, aside from being 24 proof alcohol, was less likely to do harm and much less likely to prompt a visit to the doctor for a newly medicalized condition, than coming to the doctor misinformed about the need for Erythropoetin.

Withdrawal, particularly economic withdrawal, is difficult. For the media to withdraw from dependency on Pharma ads for prescription meds means leaving the OTC market as the primary source of economic support for the media. It might mean thinner newspapers and fewer TV reruns.

Why not make DTC advertising bans a part of any presidential candidate's plan for universal health??

Competing interests:   None declared