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Are drugs ads hazardous to your health?

Pharmaceutical manufacturers spend $5 billion dollars a year to market prescription drugs directly to American consumers. It's the "other" American drug problem, says one doctor.

If you watched TV, read a newspaper, or flipped through a magazine this week, there’s a very good chance you saw a few advertisements for prescription drugs. They’re hard to miss. It’s not uncommon for a 30-minute network newscast to have four or five drug commercials.

Pharmaceutical manufacturers spend $5 billion dollars a year to market prescription drugs directly to American consumers.

According to the Pharmaceutical Research and Manufacturers of America (PhRMA), the goal of these ads is to make patients and doctors better partners by giving them “accurate information about disease and treatment options.” PhRMA says this brings patients into their doctor’s offices “and starts important doctor-patient conversations about health that might otherwise not have happened.”

That may be. But these ads also move product. According to a November 2006 GAO report, direct-to-consumer advertising “has contributed to increased drug spending and utilization.” The report cites a study of 64 drugs that found a median increase in sales of $2.20 for every dollar spent on ads targeted at consumers.

This is a big concern to many in the medical community. One doctor I spoke to referred to this as “America’s other drug problem.”

“Why we would trust a for-profit industry to have the public health at heart is really beyond me,” says Peter Lurie, deputy director of the Health Research Group at Public Citizen. “It’s an attempt to turn the patient into an advertising representative for the drug company and to force the doctor to prescribe a drug that he or she would otherwise not prescribe.”

The TV ads are clever and often emotionally charged. Unlike real life, they always have a happy ending. Yes there are possible side effects, but after taking the medicine the person in the ad always feels better and looks happier. The clear implication is this could be you if you “just ask your doctor” about that drug.

“The way it’s presented in the ads, this drug will transform your life,” says Dr. Peter McGough, a family physician with the University of Washington’s School of Medicine. “Patients will literally come in with ads and say, ‘I want this drug.’ ”

According to a recently released survey conducted by the Kaiser Family Foundation, Harvard Medical School and USA Today, a third of the adults responding said they talked to their doctor about a drug they had seen advertised. Of this group, 44 percent said they got a prescription for that drug, 88 percent got a prescription for some type of drug.

This is what worries consumer groups – patients asking for drugs that are sometimes inappropriate for them or not the best choice for their condition.

“Sometimes the ads can serve a useful purpose in educating people about treatments they might not have known about, says Gail Shearer, Director of Consumer Reports Best Buy Drugs. “But overall, this is harmful in terms of patient safety and information.” Shearer says many people pay very high prices for highly-promoted medications when there are alternatives “that are equally effective, equally safe, and are much more affordable.”

The medical bill in this country is staggering – around $7,500 per person – more than any other country on the planet. There are many reasons for this, but prescription drug costs are a significant contributor. “These ads drive up costs dramatically," says Peter Lurie of the Health Research Group.

“We appreciate the fact that there’s a discussion about important issues like depression and diabetes in these ads,” says Dr. McGough. “But recommending specific drugs, especially those that have limited evidence of safety and effectiveness is not in the public’s best interest.”

That’s exactly what happened with Vioxx. The new arthritis drug was backed by a $100 million a year advertising campaign that resulted in 20-million Americans taking it. But Vioxx was no better than similar drugs already available. In 2004, when studies showed it doubled a person’s risk of heart attack and stroke, Vioxx was taken off the market.

Doctor-patient relationship
Dr. Jerry Avorn, a professor of medicine at Harvard and author of the book “Powerful Medicines,” would like to see prescription drug ads go away. “It introduces more noise than information,” he says. “Patients get the impression that they need to be given a drug when they may not need it.” Plus, he says, they don’t understand the potential risks.

A visit with the doctor these days isn’t very long. Dr. Avorn says a lot of that precious time is now spent explaining to patients why they don’t need the drug they want based on an ad they saw. “Doctors and patients don’t have enough time together to be able to waste it on silly things like that.”

My two cents
My father was a pharmacist, so I know and respect the benefit of prescription medications. I also know the power of advertising and how it can cause us to make irrational decisions. Maybe that’s why every country in the world, other than the U.S. and New Zealand, prohibit direct-to-consumer prescription drug advertising.

It wasn’t always like this. Before 1997 drug companies could not pitch prescription drugs to consumers. But the Food and Drug Administration let the advertising genie out of the bottle and there’s no going back – there’s simply too much money at stake.

I have no problem with drug companies making a profit. But medical costs are out of control and something needs to be done. I believe drug ads need to be restricted and doctors need to resist pressure to prescribe.

Consumer groups want the government to prohibit pharmaceutical companies from running consumer ads until a prescription drug has been on the market for two years. That’s a good idea. It would provide time to discover unexpected problems before millions of people are on the medicine.

The bottom line: be skeptical of all prescription drug ads. Get your medical advice from your doctor or some other trusted source. , such as online at Medline Plus run by the National Institutes of Health and Consumer Reports Best Buy Drugs.

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