Healthy Skepticism Library item: 12982

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Appleby J.
Analyzing the side effects of drug ads
USA Today 2008 Feb 29
http://www.usatoday.com/news/health/2008-02-29-drugs-inside_N.htm

Full text:

A few times every week, patients ask Jim King about drugs they’ve seen advertised.
“They’ll say, ‘I saw this ad on TV, and I think I have this medical problem,’ “ says King, a family physician in Selmer, Tenn., who says he’s not bothered by the requests. “It gives me an opportunity to talk with the patient. It’s amazing how many don’t have the problem” or need the drug they saw advertised.

Billy Tauzin, president of Pharmaceutical Research and Manufacturers of America, the industry’s lobbying group, says the ads educate patients about diseases such as depression or diabetes and encourage them to see a doctor.

Doctors and health care analysts say those visits also prompt patients to seek the latest and often most expensive drug, helping to drive up spending on health care and raising questions about whether patients need those particular new medications.

The Food and Drug Administration has allowed drug advertising since 1997. After safety concerns led drugmaker Merck to pull its heavily advertised painkiller Vioxx off the market in October 2004, Congress and consumer groups such as Public Citizen escalated their criticism of drug ads.

The industry responded with guidelines it said would improve consumer information. Ads are “less offensive than they were a few years ago, more educational, and they balance a discussion of benefits and risk,” Tauzin says.

Prescription-drug advertising is big business. The pharmaceutical industry in 2006 spent $4.8 billion on consumer ads, according to IMS Health, a private firm that tracks sales and marketing. The industry spent $7.2 billion more marketing products to doctors.

Consumer advertising has “contributed to overall increases in spending on both the advertised drug itself and on other drugs that treat the same conditions,” says a Government Accountability Office report from 2006. It cites another study of 64 drugs that found for every $1 spent on advertising, sales increased by a median of $2.20.

Endocrinologist John Buse sometimes urges his patients to wait until a drug has been on the market for a while to see whether side effects undetected in earlier studies emerge. “There are a lot of unmet needs in medicine,” says Buse, who is president of medicine and science at the American Diabetes Association. “Does that mean these new drugs meet those needs? Not always. Sometimes it’s just new, and you’re trading” side effects.

New drugs vs. generics

Visits prompted by advertising can propel patients to take more expensive, newer drugs, when lower-cost generics would work just as well, says Jerry Avorn, a professor at Harvard Medical School and author of Powerful Medicines.

If education were the true goal of advertisements, he says, public service spots would fill that need without encouraging people “to spend so many dollars on the most expensive drugs.”

Even so, slightly more than half, 53%, of those surveyed by USA TODAY, the Kaiser Family Foundation and the Harvard School of Public Health say drug advertising is mostly a good thing, and two-thirds say it helps educate people. Two-thirds say there are too many ads, but only 27% say they are bothered a lot by advertising. The survey of 1,695 adults was taken in January and has a margin of error of +/-3 percentage points.

“Advertising has been a good thing,” says Belle Woods, 55, of Bluffs, Ill. “If I hear of a medication I think could help someone, I share that information. Also, I hear all the possible side effects (of a drug) and think, ‘Hmm, maybe I’m not going to try it.’ “

Gloria Henderson, 59, of Madisonville, Tenn., says some of the money spent on ads would be better used by drug companies to lower prices, perhaps setting prices based on people’s incomes. She wants to see TV drug ads banned.

Matt Carr, 64, of Manassas, Va., says drugmakers have a right to market their products. He once asked his doctor about an asthma drug he saw advertised. “He gave me a reason why the one I was already taking was preferable.”

Market’s high pressure

Advertising is just one factor in rising drug prices.

Overall prices grew about 3.5% in 2006, government data show, spurred not only by ads but also by new drugs on the market and an aging population. In 2006, insurers, consumers and government spent $216 billion on prescription medications, about 10% of the total spent on health care in the USA.

The average price increase masks some sharper jumps in certain types of drugs. Sleep aids – a heavily advertised product – rose 13.8% in price from 2005 to 2006, according to data from Express Scripts, a private firm hired by employers and insurers to handle drug benefits. The data cover people with insurance; the uninsured may have seen steeper increases.

Cholesterol drugs, also heavily advertised, went up an average 5.5% – the average price of a prescription of Lipitor hit $85.68 for a month’s supply, according to the Express Scripts data.

King, who is president of the American Academy of Family Physicians, says the three types of drugs he most commonly hears patients request are treatments for impotence, indigestion and restless legs, a condition that causes strange sensations in the legs and an uncontrollable urge to move. All three are heavily advertised.

When patients do need medication, King says, he talks with them about the drugs and their costs. “If I can use a less expensive medicine or a generic, I will,” he says.