I so rarely disagree with anything Ed Silverman of Pharmalot has to say, I relish the opportunity to disagree with him for a change. When I read that the AMA had voted to call for a ban on Direct-to-Consumer [DTC] ads on TV [doctor power…], I felt almost giddy about my fellow physicians finally making that particular stand. Ed thinks it won’t work, thinks that it’s a dead end. I see it as the Phoenix now rising from the ashes!PharmalotBy Ed SilvermanDecember 8, 2015Open any magazine or flick on the television, and chances are you’ll see an advertisement for an arthritis treatment, an erectile dysfunction drug, an anticlotting agent, or some other medicine you don’t need. For years, doctors have complained these kinds of ads targeted directly to consumers can sway patients to ask for unnecessary, and potentially harmful, prescription drugs. The American Medical Association, the nation’s most influential physicians group, was long mum on the subject. But last month, the 168-year-old organization — which represents around 235,000 doctors — finally took a stand, calling for an outright ban on consumer ads for prescription drugs and medical devices. “Now is the time,” Dr. Patrice Harris, chair-elect of the AMA Board of Trustees and a psychiatrist in Atlanta, told STAT. “We hope to make this a reality.”
Whether this notion is realistic is debatable.
For a ban to go into effect, Congress would have to pass a new law. And given the slim chances for political change, the AMA might be better off reaching a compromise than setting up an antagonistic relationship with drug makers. The United States is the only country other than New Zealand that permits drug advertising directed at consumers. Last year, the pharmaceutical industry spent $4.8 billion pitching its products and messages to Americans, a 17 percent increase from 2013, according to the market research firm Kantar Media. That much money buys a lot of airtime — so it’s no wonder that physicians gripe that drug ads can create inappropriate expectations in consumers or make doctors feel pressured to write prescriptions out of concern their patients will go elsewhere.
But the AMA is now seizing on another reason for a ban. The organization argues that the ads largely feature the latest and priciest medicines that few can afford. “Most of the ads are often for newer drugs that are getting more expensive,” said John Mack, a marketing consultant to drug makers and publisher of Pharma Marketing News. “I think their concerns are valid.” By pointing to high prices, the AMA is making a smart move. The accelerating cost of medicines has galvanized Americans. About three-quarters of the public believes that prices for brand-name drugs are too high, according to a poll conducted last month by STAT and the Harvard T.H. Chan School of Public Health.
This tactic is more likely to resonate than the most commonly voiced arguments against drug ads — namely, that they misinform patients, overemphasize benefits, and encourage overuse. In another recent public opinion poll from the Kaiser Family Foundation, about half of the respondents said that prescription drug advertising is mostly a good thing and that the ads do a good job of describing potential benefits and side effects.
The fact is that a majority of Americans believe drug ads allow greater patient involvement in health care decisions — and the Pharmaceutical Research and Manufacturers of America agrees. “It’s not a bad thing for patients to bring questions to the doctor’s office,” said Dr. Michael Ybarra, an emergency physician and the trade group’s senior director of alliance development…
Ed doesn’t think physicians as a group can make a stand like this. I do and I hope it happens. As a group, we could do what I do. I don’t prescribe drugs when they first come out, even things like Prozac®. The FDA isn’t charged with telling us what to use – just with assessing safety and minimal efficacy [no snake oil]. We learn about drugs through use, not from ads. So I wait until I hear from colleagues and patients and then I’m willing to give it a try. That’s the way it has been since the beginning of my career. But I’ve added something new. I don’t prescribe drugs advertised on television at all. I doubt all specialties could do that. But I can, and do. Aren’t I depriving people of the up-to-the-minute-world’s-greatest-breakthroughs-ever? I can’t imagine what they would be. I can’t think of an example.
Media companies are so sensitive to the enormous amount of money they make from these ads that they won’t even take money to air a relatively mild spoof of them.
http://deadline.com/2012/04/three-stooges-drug-spoof-ad-cbs-rejects-ncaa-hoops-championship-broadcast-252124/
You’ll be able to hear crickets chirping with the amount of mainstream media coverage this AMA idea is going to get.
We as a community also have no moral leg to stand on when it comes to this. Don’t give “education” money to others, just to us and our own organizations.
http://www.policymed.com/2014/06/physician-payment-sunshine-act-ama-house-of-delegates-votes-to-increase-minimum-reporting-requirements-to-100-payments-and.html
That these “educational” materials (including reprints) are cash cows for these professional organizations has NOTHING to do with it.
Just as the close to $5 billion media companies are making from public education will have nothing to do with the limited coverage this will receive. Or, how much coverage the original legislation that allowed for DTC ads did receive.
Just as
“over my dead body”
http://www.cohealthcom.org/2015/11/16/rocky-political-road-ahead-for-pharma-industry/
And, this is the coalition that will convince people to be wary of pharma disseminated information? The coalition that will convince media corporations to turn away from pharma’ teat?
http://www.aafp.org/dam/AAFP/documents/advocacy/legal/sunshine/LT-Burgess-HR5339-10-24-14.pdf
What about all the drug ads in doctor’s offices? While waiting to see a doc one day, I started going through a Web MD magazine and counted about 8 of them half way through and got tired of counting.
In another office, I counted about 4 brochures for drugs to ask the doctor about. I didn’t bother to count the drug ads in the health magazines.
Unless doctors eliminate all the ads in their offices, I don’t think it really matters whether drug advertising is banned or not.
Absolutely right AA.
We have to go through the junk magazines and others that find their way into our offices. At least we can do that much.
If free market/free speech permits drug manufacturers to “sell” to consumers products that are NOT available to them (OTC), when are the illicit drug sellers and the military-grade armament manufacturers going to step up and exercise THEIR rights to speak freely? Can we anticipate “educational” information about the wonders of LSD and heroin that will have us running to who . . . the nearest street-corner vendor? Should we all be clamoring for our own personal Sherman Tank (I know–that dates me) . . . and ask who . . . the local National Guard key-keeper? Doctors as intermediaries/enablers ceded their authority, and like Mickey, I hope they rise from the ashes to take a collective, principled position that states: NO MORE.
Melody
It’s always amusing to see the practiced obfuscation of language in the DTC ads. The classic example is in the ads for Viagra and Cialis: “See your doctor right away if you experience sudden loss or decrease of vision or hearing.” They don’t want you to know you might go blind or deaf, but they are obliged to address that at least obliquely.
My resistance to a ban is that for all their faults, the ads do a better job on informed consent and side effects than most primary care doctors. Ask yourself, when is the last time you got a script and the prescriber covered 10-12 most likely adverse reactions? We could argue theoretically doctors should do a better job but that isn’t going to happen when they are distracted by pointless demands of EHR.
James,
That’s a good point. I’m going to think hard about it, but off the cuff, in my opinion, the risk benefit ratio of those @^#%C@%-ing ads is way on the risk side of center. I’m actually writing something about that as we speak.
My biggest problem with the PDE-5 inhibitor ads is that most people who are interested don’t really have a “medical” problem. The Axis 4 issue that shall always remain undiscussed and off limits is that their partner doesn’t look more like or is not as smiling and receptive as the women in the ads.
You make another strong point…
Yes I think that and twin bathtubs inexplicably placed outdoors in a 400 acre field atop an ocean bluff (who is the plumbing contractor?), and you’re probably good to go without any meds.
If you watch the evening news on network TV, you’ll be exposed to many drug ads.
They (along with car ads) are ubiquitous, pushing new drugs of dubious value (otherwise, they would not need to be advertised), hoping to make them blockbusters by influencing consumers to ask for them.
As the ads are on network TV, they’re aimed at a lower-educated segment of society that might well fall for the attractive images and not catch the rapidly spoken (and unintentionally funny) list of adverse effects, some quite gruesome, at the end of the lovingly crafted dramatic production.
Visitors from other countries are aghast at these baldfaced pharma manipulations.
Physician opposition to TV drug advertising is the only way this will be limited. If you’re a doctor, please do join the AMA in opposing drug ads on US TV.
(The magazine advertising is also pernicious, but not nearly as pervasive.)