Healthy Skepticism Library item: 1353

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

MacDonald J.
Impact Of Drug Ads Studied: Doctors Tell Committee They Feel Pressured By Patients Seeking A Quick Fix
The Harford Courant 2003 Jul 23
http://articles.courant.com/2003-07-23/news/0307230471_1_tv-ads-spending-on-prescription-drugs-doctors

Full text:

WASHINGTON — Many doctors feel pressured to write prescriptions for drugs because patients are “seeking instant gratification” and have seen a product advertised on television, a top official of the American Medical Association said Tuesday.

Decrying the trend, Dr. Nancy H. Nielsen of Buffalo, N.Y., said, “If the medication is not necessary or appropriate, the physician is put in the uncomfortable and awkward position of defending why this is the case.”

The comments by Nielsen, speaker of the AMA’s House of Delegates, came as Congress is struggling to write legislation adding a prescription drug benefit to Medicare and make other changes in the federal health care program for the elderly. The lawmakers’ task is more difficult because spending on drugs has soared at double-digit rates for each of the past three years.

Chairman Larry E. Craig, R-Idaho, said the Senate Special Committee on Aging, which held a hearing on the subject Tuesday, wants to find out whether advertising contributes to rising spending on pharmaceuticals and whether the ads provide any useful information.

A recent study found that television advertising accounted for about 12 percent of the growth in spending on prescription drugs in 2000. Whatever the amount, doctors Tuesday questioned the value of the ads.

Nielsen said that since the Food and Drug Administration relaxed its rules on broadcast ads in 1997, an increasing number of doctors have had patients come to their offices and demand a drug they saw advertised on television.

“We live in a society that prefers instant gratification, and taking a pill can seem much easier than changing one’s lifestyle,” Nielsen said. “There is a danger that [televised ads] may cultivate a belief among the public that there is a pill for every ill and lead to an overmedicated society.”

Marjorie E. Powell, assistant general counsel of the Pharmaceutical Research and Manufacturers of America, reiterated drug company arguments that the TV ads help educate patients about treatments available to them and promote a better dialogue with doctors.

Siding with Nielsen, Dr. Arnold S. Relman, professor emeritus at Harvard Medical School and a former editor of the New England Journal of Medicine, said he saw no evidence to support the companies’ claims. Most TV ads are 30 seconds or 60 seconds, Relman said, adding: “There simply isn’t time to provide any useful information about the side effects. To call this education strains the meaning of the word.”

Dr. Janet Woodcock, director of the FDA unit that oversees drug advertising, said a survey last year of 500 doctors showed that 75 percent believed televised ads caused their patients to think a drug worked better that it really did. And about 25 percent felt pressure to prescribe a drug a patient had seen advertised on television.

Most physicians suggested other courses of action, Woodcock said. But Relman said the ads still had a “significant effect” on drug spending.

Meredith B. Rosenthal, a Harvard University expert, said a study she published last month showed that drug companies’ promotional spending has increased an average of 16 percent a year since 1996. That spending, which is approaching $3 billion a year, is concentrated on a relatively few new drugs that have experienced significant sales growth, she said. Each additional $1 spent on television advertising produced $4.20 in new pharmaceutical sales in 2000, Rosenthal said.

In her study, Rosenthal said that while drug spending growth has slowed recently, it is still expected to average 9 percent to 12 percent for most of the next decade. “Given this continuing rapid growth, the debate over the costs and benefits of [television advertising] are likely to continue,” Rosenthal wrote.

During its recent debate over Medicare, the Senate rejected proposals to curb prescription drug advertising. Craig showed no interest in reviving the issue, but he agreed the issue will be around for years. “The public has noticed the dramatic increase in broadcast advertising over the last few years,” he said, “and many tell us that they are concerned about it.”