“Are you experiencing crushing chest pain with shortness of breath? Are you sweating profusely? You could be having a heart attack! Ask your doctor whether Zycrox is right for you.”
Would an ad like that sound preposterous? We have to admit that Zycrox is a figment of our imaginations. But the idea of advertising a medication for a serious condition like a heart attack is not so farfetched.
Plavix is advertised to consumers even though this heavy-duty drug is prescribed to prevent life-threatening blood clots that could cause a heart attack or a stroke. Sales have soared since people started watching Plavix commercials on TV.
TV commercials have touted everything from drug-coated stents for clogged coronary arteries to potent anemia drugs like Procrit for cancer patients on chemotherapy. Before prescription drug advertising came to dominate prime time television, TV drug ads featured over-the-counter products. If you asked a physician from that era whether he could imagine a patient asking for a prescription drug seen on a TV commercial, he would have laughed in your face.
Doctors spend years in medical school learning about the benefits and risks of medications and devices such as drug-coated stents. The notion that a patient could request a powerful prescription medicine based on a 30-second TV spot would have seemed ludicrous. Today, of course, it is commonplace. You can’t watch the evening news without seeing several prescription drug ads.
Most people tell us they hate TV drug ads. They especially hate ads for prescription drugs to treat erectile dysfunction or overactive bladder. But they also dislike commercials for drugs that lower cholesterol, control blood sugar or ease arthritis pain. Many ask us why the FDA permits such ads at all, even though few realize that only one other industrialized country allows direct-to-consumer prescription drug advertising.
FDA’s authority to regulate drug ads goes back to a 1962 act of Congress. Drug advertising must not be false and misleading, and it must offer a “fair balance” of benefit and risk information.
Until the 1980s, drug companies assumed they couldn’t use television to advertise prescription drugs: 30-second ads are too short to allow the listing of all the possible negative effects of a drug. Then the FDA decided that broadcast ads could cover only the “major risk information.” In practice TV ads cover many fewer side effects than print ads (New England Journal of Medicine, May 22, 2008).
The pharmaceutical industry likes to frame prescription drug ads as educating the consumer, but in fact they generate big bucks. Ten of the top 12 brand-name drugs advertised to consumers rake in more than $1 billion a year.
The industry’s other argument is that commercials are protected as free speech. We wonder if that is what John Adams, Thomas Jefferson, James Madison and the other founding fathers had in mind.
The only way consumers could have an effect on such television commercials would be to contact their Congressional representatives. A Congressional hearing in May investigated misleading ads about prescription drugs. Unless Congress changes the law, the FDA has no power to make the industry change its ways.