When visitors from another country turn on the TV in the U.S., they are often shocked to see commercials for prescription drugs. The only other place in the world where this is permitted is New Zealand, and efforts are underway to prohibit the practice there.
Since the FDA opened the floodgates several years ago, prescription drug ads have proliferated. It’s hard to watch the evening news without seeing a commercial for drugs to lower cholesterol or relieve arthritis pain.
Heavy TV advertising helped make Vioxx so successful. Hundreds of millions were spent suggesting that this arthritis drug could make life more enjoyable.
In early commercials, Olympic figure skater Dorothy Hamill was featured gliding over the ice in a picture-perfect mountain setting. The message: “Ask your doctor about Vioxx, a prescription medicine from Merck. And find out if Vioxx is right for you.”
With 20/20 hindsight, experts are complaining that the direct-to-consumer advertising for Vioxx created unjustified enthusiasm. People badgered their doctors for a prescription for the drug instead of relying on over-the-counter pain relievers such as ibuprofen (Advil, Motrin, etc) or naproxen (Aleve). It turns out these inexpensive products may have been about as effective as Vioxx and a lot safer.
Since prescription drug commercials must include information on side effects, it’s surprising they work so well. In most ads, an authoritative voice describes a litany of side effects. While you watch people having a wonderful time, you hear about potentially serious reactions like headache, blurred vision, kidney failure, heart attack, liver disease and pneumonia. Why would anyone beg a doctor for something that can cause so much misery?
The reason appears to be that people disregard the warnings. The time devoted to side effects in TV commercials can be measured in a few seconds. In addition, commercials often diminish the seriousness of such warnings with exciting, uplifting images that distract the TV viewer from the voice-over describing disease and death. An appealing visual image trumps scary words every time.
Repetition is also a key to success. The pharmaceutical industry spends almost $4 billion on these ads so that the television audience will get a lot of exposure. With that kind of promotion, it’s hardly any wonder that products like Lipitor, Levitra, Zoloft and Viagra have become household names.
Occasionally the FDA cracks down on a TV ad. In one Viagra commercial, a man and woman are strolling along a street. A lingerie display in a store window catches his eye, and part of the Viagra logo becomes glowing devil horns on his head.
The FDA found this ad objectionable because it does not inform consumers what the product is for or what the side effects might be. Pfizer was told to take the commercial off the air because of a lack of information about risks. So the Viagra devil has disappeared from the screen, although print ads still feature him.
Proponents of TV ads for prescription drugs claim they serve a valuable educational function. But in the wake of the Vioxx fiasco, the FDA should reconsider its rules on such commercials to make sure the public really learns about the risks.
The People's Perspective on Medicine