Direct-to-consumer drug advertising on TV a growth industry

The Pfizer flag flies in front of world headquarters in New York. (AP Photo/Mark Lennihan

The Pfizer flag flies in front of world headquarters in New York. (AP Photo/Mark Lennihan

The pharmaceutical industry spends more than $2 billion a year advertising direct-to-consumer drugs on TV, an increase of 30 percent over the past two years. Only the United States and New Zealand permit these ads.

Dr. Marcia Angell, former editor in chief of the New England Journal of Medicine, and author of “The Truth about Drug Companies,” believes that if the drug industry can convince essentially normal people that minor complaints require long-term drugs to treat them, its market will grow. So-called disease mongering convinces people that their usually mild ailment urgently requires drug intervention.

And Dr. Arthur Caplan, professor of bioethics at NYU, says that a human condition such as attention deficit disorder, something that affects children and which they eventually outgrow, is increasingly being marketed as an adult condition. Caplan maintains that such routine human conditions as unhappiness, bone thinning, and stomach aches are increasingly being redefined as depression, osteoporosis, and gastritis. Other conditions cited as examples of disease mongering include restless leg syndrome, testosterone deficiency, and erectile dysfunction.

Of course, it’s not healthy to expose adults and children to an average of 9 drug advertisements per day on TV telling healthy people they’re sick. In fact, those ads might well induce ill health themselves. But if, as with political ads during election campaigns, we become so inured to their message we respond to the ones touting drugs for sleeplessness. But beware: Possible side effects, the manufacturer warns, include memory loss, anxiety, severe allergic reactions, swelling of the tongue or throat, trouble breathing, nausea and vomiting, confusion, agitation, hallucinations, drowsiness, dizziness, symptoms of the common cold and unpleasant taste in the mouth. Oh, and suicidal thoughts or actions.  Wouldn’t you rather just suffer occasional sleepless night?

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Among the biggest advertisers is Pfizer, which spends some $230 million advertising Viagra alone.

So, not that long ago, one would be hard-pressed to find more than a handful of men who would own up to erectile dysfunction. Now, it’s a growth industry. The Merck Manual claims that about 20 million American men suffer from ED and that 50% of men between 40 and 70 have occasional experience of ED. And the treatments are not without side effects. A long-term study of Viagra in rats showed some decline in their fertility without expressing any opinion as to whether the rodents felt it was worth the experiment. And among the warnings about using ED treatments are that they might cause visual or hearing problems.  (And who wants to have sex without actually hearing or seeing what’s going on?)

One often finds these ads on TV during the news hour – the over-60 set actually still watches the news. Thus, interspersed among stories of worldwide death and destruction, are such “come to bed” enticements as Cialis’ vignette showing a couple, if not exactly in flagrante delicto then pretty close to it as they head breathlessly to hotel room bliss.

And what about the ads’ admonition to “tell your doctor about an erection lasting more than four hours.” Such extraordinary priapism would surely merit a doctor’s earnest research paper, to say nothing of its owner’s startled disbelief. And anyway, doctors simply don’t have the time to deal with all these “outside the exam room” queries. And these drugs are certainly not cheap. With one little pill costing upwards of $40, that’s a pretty expensive way to keep up with the Joneses, or anyone else.

But the ads are being closely monitored. A Connecticut lawmaker, Rosa DeLauro, is trying to put curbs on direct-to-consumer advertising by pharmaceutical companies — a practice that came under fire on the presidential campaign trail and from the American Medical Association, whose board of directors condemned them in 2014. The fact that the ads are still there is testament to the drug companies’ clout in Washington where they spend a whopping $229 million a year on lobbying. Hillary Clinton has said she would strip pharmaceutical companies of their ability to deduct their direct-to-consumer advertising costs.

With Big Pharma spending more on advertising than on research, is it time to ban these ads altogether? When tobacco ads were outlawed, consumption decreased; perhaps a similar proscription on ED drugs might lead, if not to their demise, at least to more flaccid sales.

David Woods, Ph.D., is a Philadelphia-based medical writer and editor. A former editor in chief of the Canadian Medical Association Journal, he is the author of four books and more than 200 articles, editorials, and reviews in peer-reviewed health care publications.


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