In 2005 drug companies' annual spending on direct-to-consumer advertising of prescription drugs reached $4.2 billion, according to the Government Accountability Office, and American television viewers see about 16 hours of advertisements for prescription drugs every year. But their content has received little scrutiny, until recently. Dominick L. Frosch and colleagues analyzed 38 television ads targeting conditions ranging from insomnia to hypertension. Their report concludes that direct-to-consumer advertising of prescription drugs "often attempts to persuade viewers on grounds other than rational consideration of medical costs and benefits."
In 1997 the Food and Drug Administration relaxed requirements for reporting adverse effects and precautions for prescription medications in direct-to-consumer broadcast advertisements, prompting a debate that continues today. Proponents say the ads educate the public on health conditions and treatments, while opponents contend that they encourage people to ask physicians for drugs they don't need or are more expensive than the alternatives.
Frosch and colleagues urge reconsideration of "the distinction between selling soap or other consumer products and selling prescription drugs." A consumer who chooses the wrong soap based on advertising isn't likely to suffer harm, they note, but pharmaceutical ads' "influence on drug preferences and the resultant importuning of physicians to prescribe cost-ineffective (or even inappropriate) drugs are a much more substantial concern."
Most of the ads suggested that the product would enable users to take part in activities negatively affected by the condition being treated. Most also gave some factual information about the condition. Nearly 60% claimed the product represented a breakthrough in treatment. Far fewer ads offered information about the risk factors for developing or prevalence of the condition or about the role of lifestyle in treating it.
Maryann Napoli, associate director of the Center for Medical Consumers, says that nurses can provide "an educational counterpoint" for patients. Nurses can also educate patients about the drug approval process, she says, by reminding them that "the drug being advertised did not have to be proven more effective than a competing drug, it just had to be proven better than nothing."
In a press release, Frosch says the ads "send the message that you need drugs [horizontal ellipsis] and that without medication your life will be less enjoyable, more painful, and maybe even out of control."
Mary Hager
Direct-to-Consumer Television Ads
Researchers analyzed 38 direct-to-consumer television advertisements of prescription drugs and found that
* 82% made factual claims.
* 26% explained risk factors.
* 95% appealed to the emotions.
* none discussed lifestyle changes as an alternative to drug therapy.
* 58% portrayed a prescription drug as a medical breakthrough.