Are TV Pharmaceutical Ads Damaging?

trivialscene asks: "ABC News is carrying an article about a recently published study in the medical research journal Annals of Family Medicine which examined prime time television ads run by pharmaceutical companies. The researchers concluded that the generally ambiguous ads, which appeal almost entirely to emotion rather than fact, tend to confuse viewers. They also suggest that the ads may be creating problems at the doctor's office, as some people might become convinced they need a particular medication and insist on getting it, rather than leaving the decision to trained medical professionals. What do you think about the presence of drug advertisements on television?"

YES

[zubernerd]

YES.

My mom's an MA (medical assistant) and my wife is a medical student (M2), and both tell me that those ads are a problem.

I hate hearing about people demanding drugs after seeming them on TV, thinking they know better than a professional with 4+ years of training. I watched my wife study for her pharm course, and all the interactions, contraindications, etc is enough to make her head spin a little bit (and mine a lot). Also, most of the time an off-patent generic drug that's been around for years is more beneficial than those new drugs being advertised.

It's the like the old joke about the old lady who wants that new arthritis drug: Viagra.

Re:I hate ambiguous drug ads.

[gEvil (beta)]

An extra 5 seconds of ad time used to clarify what the drugs does doesn't sound like a waste of air time to me.

From this page: [amsa.org]

"According to these FDA regulations, advertisers who name a prescription drug, and state its purpose and benefits, must also include full disclosure of its side effects, contraindications, and must follow specific labeling guidelines."

By stating the purpose of the drug, that "extra 5 seconds" suddenly turns into a full minute or two of small print being read to you. Not exactly what the advertisers want to be doing with their time/money.

Re:I hate ambiguous drug ads.

[Pojut]

Well for one, if a drug is pending FDA approval they legally are not ALLOWED to state what the drug does. Ditto if the drug has not completed post-approval clinical trials as well.

And the second reason may seem shitty from a consumers point of view, but from the industrie's point of view it makes sense: it causes you to go online and check out what it does. In the meantime, you get to see what else the company manufactures, and therefore you have more names that are associated with that company and the marketers hope that because you remember another name from their company, if the need to use the treatment that drug provides you are (again, they hope) more likely to use THEIR drug since it's a name you recognize. (Apologies for the run on sentence)

And yes I work in the pharmaceutical industry.

Re:marketing vs R&D

[Znork]

"That's actually not true at all."

Actually, it's entirely true. Take a look at the financials of your average pharmaceutical. They spend less than 20% of revenue on R&D, 40% is marketing and administration, and 40% cost of production and distribution. Some have profits that are twice what they spend on R&D.

That, of course, means we'd get five times the R&D for the same money we're paying today if we paid for it outright rather than granting monopolies. Or we'd get the same level of R&D at a fifth of the price.

It's worse than you think...

[Gordo_1]

This article [findarticles.com] points out that even doctors are susceptible to drug company advertising:

"...according to a review published in the Jan. 19, 2000, Journal of the American Medical Association. Ashley Wazana, M.D., of McGill University, analyzed 29 studies of relations between doctors and the pharmaceutical industry and found that the industry's marketing efforts clearly influence doctors' prescribing habits, although most doctors do not believe this to be true."

Re:YES

[Anonymous Coward]

"I hate hearing about people demanding drugs after seeming them on TV,"

Which drugs do you have in mind? I don't know of one. Crestor is better for some and advertised pretty clearly. Levitra and Viagra were never around before and had no prior similar drugs that did what they do. I've never seen a TV ad for an antibiotic, yet those are pumped the most by salespersons to doctors.

So, name ONE drug that you think is pumped on TV that's out of line. You know restless leg syndrome? Most people were never informed by their doc about it. Know most Herpes patients didn't know antivirals were available to them. Merck has been promoting their cervical cancer vaccine, and you know what? Most women didn't even known it was available and that particular vaccine even got a lot of press when it came out.

So why do you "hate" this? Most doctors know less than an informed patient. An informed patient will often know about his condition than his doctor; he lives with it, knows the signs, has been getting treatment, etc. A doctor maybe spends 15-20 minutes per patient on average.

Cases in point--My family physicians (I see a group, so at least 2) didn't understand iodine had squat to do with my particular thyroid condition. Another didn't identify. There is a whole generation of doctors who STILL can't identify the warning signs of a heart attack in women, or the general average age heart attacks occur in women or a good way to calculate risk based on menopause. Even with HIV/AIDS treatment, the patient often knows more than their treating physician.

I'll tell you why--because you realize that your family's occupation is really sham, that they are simple overpaid health technicians, and that the insurance companies and pharmaceutical companies have forwarded medicine far far more than the practioners as a discipline.

"thinking they know better than a professional with 4+ years of training."

They often do. The patient depends on signs and symptoms, and they live through it. Often it's the doctor who does not listen who is creating the problem, not some overanxious, worrisome patient.

btw, you don't know squat either. An OD or MD who comes out of medical school knows shit about the actual practice of medicine except in the roughest sense. They've only been trained, what, 4-5 weeks per general discipline and have not undergone residency.

"I watched my wife study for her pharm course, and all the interactions, contraindications, etc is enough to make her head spin a little bit (and mine a lot)."

That's because that course is nearly sheer memorization; there are common mechanisms, but pharm is one course that brute force memorization comes in handy. It's a course that flies in the face of anatomy, biochem, and the like, where the understanding the underlying mechansism leads to understanding the material; pharm is extension probably most of biochem, but it's really just raw rote.

Also, pharm is the basics. 90% of those drugs aren't used regularly anyways by the typical physician. Residency will wipe out most of those charts and flash cards med students memorize anyways; you nearly relearn the standards of treatment.

"Also, most of the time an off-patent generic drug that's been around for years is more beneficial than those new drugs being advertised."

See how easy that was? Here you are, not having anywhere close to your own standard of 4 years of medical education, commenting from what you heard from your wife, who isn't even a medical professional yet and barely knows the damn basics. What, you think HER eduction rubs off on you? Sorry to tell you, it doesn't work that way.

Not to mention, none of your blood relations you mentioned even meet the 4+ year standard you put forward, at least when it applies to rigorous and continuous training. Your mother has experience. Your wife when she graduates won't even have 4 full years of education (med school summers are off except for perhaps after year 2).

Can you even

Re:marketing vs R&D

[dedalus2000]

Don't forget about the government funded R&D that big pharmaceutical companies often get exclusive rights to.

Re:marketing vs R&D

[bobcat7677]

The ads are also aimed less at the consumer and more at doctors; doctors are the ones that have to prescribe it, after all, so they have to learn about it before patients start asking about it. Otherwise the patients will think the doctor is uninformed.

Hate to break it to you, but the ads ARE in fact aimed at the consumers. They are telling YOU to ask your doctor. You the consumer. And lucky for them there are millions of mild hypocondriacts out there that go running to their doctor the first chance they get to get a script. And for the most part the doctors ARE uninformed about the drugs they are perscribing. Pharmacists are the ones that actually have to learn about the drugs and try to catch as many dangerous interactions the doctors may or may not know about as they can. There are a whole lot of doctors out there that happilly collect the office visit fee, write the script, and then wait to collect again when their patient comes back complaining about the side effects from the dangerous medication they are taking (and didn't really need in the first place). Its a vicious cycle that is the #1 biggest reason health care is so "expensive" in the US these days (followed by the #2 reason: rapent medical malpractice settlements, most of which are kept off the public records).

Viagra is a perfect example of a drug completely out of control. How "nessasary" is it for most of the millions who are taking it? How dangerous is it? How easilly can just about anybody email a less then completely ethical doctor somewhere and have a script mailed to them? Lets run down the possible side effects:
flushing, headache, nasal congestion, stomach discomfort following meals, abnormal vision including blurred vision, seeing shades of colors differently than before, or sensitivity to light, bladder pain, cloudy or bloody urine, dizziness, increased frequency of urination, pain on urination, diarrhea, bleeding of the eye, convulsions (seizures), decreased or double vision or other changes in vision, prolonged, painful, or inappropriate erection of penis, redness, burning, or swelling of the eye, anxiety

at least this one has relatively "mild" side effects compared to some other drugs. I have seen heartburn medication that had a possible side effect listed of "Death"...no joke. Guess they figure if you die you won't have that heartburn any more and it's a win for them.

If laws exist to keep cigarettes and alcohol from being advertized to minors, shouldn't stuff that has been shown to cause even more prompt death or permanent damage be more tightly regulated in who it's pushed on?

I was a pharmacist's assistant.

Re:marketing vs R&D

[mrfunnypants]

This is not entirely true as well. The problem with pharmaceutical companies is when they report financials they have a category labeled as "Selling, Informational and administrative expenses." SG&A is the income statement item which combines salaries, commissions, and travel expenses for executives and salespeople, advertising costs, and payroll expenses.

For example looking under Pfizer's recent released financials you will see they spent 7,599 and 835 on R&D costs (clearly stated) while spending 15,589 on SG&A. Assuming SG&A all goes to marketing, which is incorrect, you would get a good 32% on marketing and 17% on R&D. However as stated SG&A is not just marketing. If you could figure out what percentage of SG&A is marketing then you would be correct.

If I recall correctly congress was going to pass a bill which would of required pharmaceutical companies to report the true percentage spent on marketing but due to lobbying it was shot down.

Re:marketing vs R&D

[yali]

First, riddle me this: When's the last time you saw an ugly rep? Most of those salesfolk we saw were women, cuties, 20s-30s.

That's because drug companies actively recruit cheerleaders [nytimes.com] to work as reps.

WRONG==you. You're missing the point, troll.

[KWTm]

Your troll post might sound genuine enough to the casual reader that I'm going to respond anyway. Your post, though sprinkled with truths, is fundamentally wrong. Here's why:

One, new drugs come out ALL of the time. It is impossible for a doctor to know every new drug out there, even with continuing education. These commercials, along with the "pharmaceutical companies bribes" and "pharm babes"(cute drug reps), serve a purpose in educating doctors as well as consumers.

1. New drugs do indeed come out all the time, more than what a doctor can absorb. But most of these drugs are not relevant; they are "me too" drugs that aren't necessary. The classic example is sildenafil (Viagra), which was eventually followed by vardenafil (Levitra) and tadalafil (Cialis). I'm annoyed that I had to study two new drugs that essentially did nothing but make money for their respective manufacturers but were basically the same[1] as sildenafil. If my patients specifically request one or the other, that's what I prescribe; otherwise, I simply use the one that's been around the longest and has the most safety data behind it. So if it weren't for TV ads pushing consumer demand, why is it important for me to learn about Levitra and Cialis? That's like saying that a skilled C++/Java programmer is no good because he doesn't know Visual Smalltalk and Object-Oriented COBOL.

2. Do you seriously consider the TV ads as "educational opportunities [qfever.com]"? Perhaps you can learn First Aid and CPR from TV shows? Get a law degree from Law & Order episodes? Enough said about this ridiculous suggestion.

Just for the record: no, drug company dinner presentations are not unbiased. In case you couldn't tell.

Two, doctors don't know all of the existing drugs before they graduated from medical school, did their residency, etc. They don't have full knowledge of the thousands of drugs that were out there, they were too busy studying where things are in the body, and accepted ways to fix them.

Same criticism as before: no, MD's don't know all the drugs, nor do they need to. Do they know all of the *relevant* drugs? Yes, the good doctors do. How could they possibly keep up? They get mandatory Continuing Medical Education (CME) required by the licensing bodies, and attend a certain number of conferences per year where experts discuss peer-reviewed, evidence-based developments in new drugss, new treatments, even new research showing that we no longer need to use certain drugs because they're not found to be of benefit.

Classic recent example: women are no longer prescribed hormone replacement pills [wikipedia.org](Premarin) when they reach menopause[2]. You think the makers of Premarin were going to tell us that? Perhaps wined and dined by "pharm babes"? Give me a break.

Three, NEVER count on a M.D. for drug information. They have VERY little pharmacology training, and almost no knowledge on drug interactions. That is what pharmacists are for. Doctors prescribe drugs to keep you alive, pharmacists stop them from killing you.

Since you're speaking in absolutes and hyperbole, it's no surprise that you're wrong. Never count on an MD for drug info? So if the doctor says, "This drug can harm your liver," you shouldn't believe him? MD's know the relevant information for drugs they prescribe, and have a better grasp than pharmacists about which side effects to be worried about.

For example, celecoxib (Celebrex, used for arthritis) can cause GI upset. They also cause headache in 15% of people. But guess what? Placebo caused headache in 20% of people. You gonna look up side effects of celecoxib? The list includes things like suicide, overwhelming infection, and perforation of the esophagus. Are you suggesting that your doctor is remiss for not telling you that one patient who committed sui