Drug companies used to focus their marketing strategies exclusively on doctors. They spent millions on sales representatives who traveled the country chatting up physicians and handing out free samples. There was no such thing as direct-to-consumer (DTC) drug advertising. Now It seems as if every third commercial on television is for a medication. A physician from the 1980s would be astounded to see prescription drug ads to treat cancer, ulcerative colitis, rheumatoid arthritis or psoriasis.

The Spread of Prescription Drug Ads:

Prescription drug ads pay for a lot of your television viewing. If you have the impression that there are more such commercials on TV than there used to be, you are correct.

A study published in JAMA (Jan. 8, 2019) found that direct-to-consumer advertising went from $2.1 billion in 1997 to $9.6 billion in 2016. The proportion of marketing dollars spent on reaching consumers also increased during the last two decades. It went from 11.9% of total marketing dollars in 1997 to 32% of the total in 2016.

A Brief History of Prescription Drug Ads

In 1983 then FDA commissioner Arthur Hayes asked drug companies if they were planning to push for prescription drug ads directed at patients. According to an article by Dylan Scott (Stat, Dec. 11, 2016):

“Almost all of them said, ‘No, that would be a terrible idea.’”

In 1984 drug companies responded to Representative John Dingell from Michigan about DTC drug advertising:

R.T. Parfet, Chairman of the Board, Upjohn Company, (U.S. House of Representatives, 1984):

“The view of the Upjohn Company is that the direct advertising of prescription pharmaceuticals to consumers…would be detrimental to the pharmaceutical industry and, more importantly, a potentially disruptive element in our medical delivery system as a whole…Our view is that there is a vast difference between education and promotion…Product specific consumer ads could increase costs.”

Allan S. Kushen, Senior Vice President, Public Affairs, Schering-Plough (U.S. House of Representatives, 1984):

In 1997, for reasons that remain mysterious to us, the FDA decided to make it easier for drug companies to advertise prescription drugs directly to consumers. The companies conveniently forgot their concerns about such practices. The floodgates opened.

The special communication in JAMA (Jan. 8, 2019) by Drs. Schwartz and Woloshin noted the change from 1997 to 2016:

Can you believe it? In 2016 there were 663,000 TV commercials for prescription drug ads! We bet there were a lot more than that in 2018.

Names like Chantix (“I’m Ray and I quit smoking with Chantix”), Trelegy (“The Power of 1-2-3”), Trulicity (“I can do more to lower my A1C”) and Xeljanz (“the Unjection”) may sound familiar. They are good examples of television marketing of expensive prescription drugs.

There is little question that these commercials are effective. Drug companies would not spend billions of dollars if they weren’t getting a substantial return on their investment.

What they may not realize, however, is how much the American public dislikes these ads. Here is just a smattering of comments we have received.

“We have serious concerns about proposals to allow advertising directly to patients. We do not believe it is in the public health interest; indeed we believe that, in most cases, it cannot safely be accomplished.”

Edgar G. Davis, Vice President, Corporate Affairs, Eli Lilly and Company (U.S. House of Representatives, 1984):

“We do not believe that commercial advertising of prescription drugs is appropriate…prescription drugs embody a complex set of factors with potential human effects that can best be evaluated by the physician…Therefore, we believe that the need for the physician’s supervision of any prescription drug taken by the patient is paramount and that the potential pressures of public advertising of prescription drugs on the scientific decisions of the physician are both unwise and inappropriate.”

An About Face About Prescription Drug Ads

“DTC prescription drug advertising increased from $1.3 billion (79 000 ads) to $6 billion (4.6 million ads [including 663 000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies.”

Do DTC Prescription Drug Ads Work?

Chris in Florida wrote:

“The drug ads should actually show the TV actors experiencing the side effects of the advertised drug with an annoying soundtrack in the background. If one of the side effects is potential death, then show a funeral scene. I think that would make a funny SNL skit.

“They should also show a range in price per dose. That will not distract the audience. It would cause big pharma stocks to plummet, and only then will they pull their distracting ads.”

Jerry in North Carolina stated:

“Pharma ads should be banned for the simple reason that we are not qualified to make those decisions ourselves based on showing us happy people. Only our doctors are.

“A health care system such as ours makes as much profit from their product as they can. Showing happy faces is how they get us to ask our doctor for it. European countries do not allow prescription drug commercials to be aired.”

Patricia in California said:

“Everyone complains about ads, but no one does anything about them. I turn the channel off and don’t go back but invariably when I go to CNN, there they are again.

“I would like someone to explain to me why telling everyone they may commit suicide or have a heart attack or stroke is a good selling point. I wouldn’t take any of them. Also, this is the reason drugs are off-the-chart expensive.”

Keith in Massachusetts summed it up:

“All I have to say is AHHHH! I am going crazy listening to them. I am ready to break the TV. I run to mute it.”

One of the co-authors of the JAMA study, Dr. Steve Woloshin, told Kaiser Health News:

“Marketing drives more testing. It drives more treatments. It’s a big part of why health care is so expensive, because it’s the fancy, high-tech things that get marketed.”

We Have Complained to the FDA!

We are starting to sound like a cracked record when it comes to complaints about prescription drug ads. We are especially aggravated about the “formula” that drug companies have come up with to distract people from the part of the commercial that talks about nasty side effects. In virtually every ad you will see people smiling and having a good time when the announcer starts listing horrific drug side effects. Here is an article we wrote about this:

Do NOT Trust People Smiling During Drug Commercials

We complained about this practice to the FDA’s Office of Prescription Drug Promotion. Here’s what came back in response:

“Thank you for taking the time to alert us to potentially misleading promotion.  You and other healthcare providers are some of the most important resources we have in monitoring promotional activities in the prescription drug market.  Below is a detailed explanation of how we will use the information you have provided to help stop misleading promotion.

“If you provided contact information in your complaint, an Office of Prescription Drug Promotion (OPDP) representative may contact you to see if you would like to discuss your complaint.”

As far as we can tell there has been no follow-up. People are still smiling during the scary parts of the commercials. There is one other tactic. The latest Chantix “Cold Turkey” commercial has come up with other visual strategies to distract you. Here is a link so you can see for yourself.

Are you FED Up Yet?

If you have become fed up with prescription drug ads, why not let the Commissioner of the Food and Drug Administration know? You can contact

  • Dr. Scott Gottlieb, Commissioner of the FDA
  • 10903 New Hampshire Ave
  • Silver Spring, MD, 20993-0002.

Ultimately, though, this will likely require an act of Congress. You may want to express your thoughts to your Senator and Representative.

Share your feelings about prescription drug ads below in the comment section.

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