When one looks at television, a newspaper or a magazine it is impossible not to be inundated with ads for various prescription drug medications. This was not always the case. In fact, not until 1997, when the FDA issued its guidelines for direct to consumer advertising, did this massive pharmaceutical advertising expenditure begin.
It might interest some to know that only 2 countries in the world allow our brand of direct to consumer advertising of prescription drugs: the United State and New Zealand.
The amounts of money involved are staggering. A study done by the Kaiser Family Foundation in 2006 found that for every dollar a drug company spent on advertising, it earned $4 in additional sales. Doesn’t sound like much, does it?
But the real numbers put the impact in prospective. In 1999, just two years after the FDA permitted direct to consumer advertising in its current form, Pfizer spent 55 million advertising it’s cholesterol lowering drug, Lipitor. Sales of Lipitor jumped 56% that year to almost $2.6 billion.
As advertising spending went up, the amount of control exercised by the FDA fell. According to the New England Journal of Medicine, the FDA sent 142 violations letters to pharmaceutical companies in 1997. By 2006 the FDA sent only 21 violation letters.
As revenues from advertising grew, pharmaceutical companies found new ways to entice consumers to buy their brand. Celebrity advertising was born. Pfizer ran the now infamous commercials featuring Dr. Robert Jarvik promoting Lipitor “as a doctor and a father.” As it turned out, Dr. Jarvik was not a licensed medical doctor despite his being the inventor of the artificial heart. Dr. Jarvik did have a medical degree from the University of Utah but after earning a medical degree, physicians must complete a series of tests to earn certification to practice medicine.
Reps. John D. Dingell (D-MI), Chairman of the Committee on Energy and Commerce, and Bart Stupak, Chairman of the Subcommittee on Oversight and Investigations, launched an investigation into the misleading effect of the ads on consumers which had been approved by the FDA.
In February 2008 Pfizer agreed to withdraw the Lipitor advertising and promotions featuring Dr. Robert Jarvik. Rep. Dingell stated that “Pfizer’s decision was a wise one, and I am pleased our investigation prompted the removal of Lipitor ads featuring Dr. Jarvik. We trust that Pfizer is sincere in its commitment to ‘greater clarity’ in its advertising. My colleagues and I look forward to meeting with Pfizer’s management team to discuss their plans related to direct-to-consumer advertising.”
The FDA maintains that it continues to oversee direct to consumer advertising by drug companies to insure that ads are truthful balanced and accurate.
The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country’s leading pharmaceutical research and biotechnology companies. This trade and lobbying group takes the official position that the purpose of direct to consumer marketing is to raise patient awareness of diseases and treatments that might be available to treat them. Their studies show that direct to consumer advertising brings patients into their doctors’ offices and starts important doctor-patient conversations about health that might otherwise take place.
The drug industry is mounting major lobbying campaigns to have direct to consumer marketing allowed in Europe and Canada. The Health Action International (HAI-Europe), in December 2001 set forth their reasoning for continuing to ban direct advertising to consumers of prescription drugs. Given the current debate in the United States over health care reform some of their rationale is quite relevant.
The HAI-Europe gave 4 reasons for continuing the ban on direct to consumer advertising.
1.Direct to consumer advertising drives up prescription drugs costs, threatening the sustainability of national health care services and universal access to health care as a fundamental human right.
2. Direct to consumer advertising fails to inform. It does not provide the impartial, objective information consumers and patients need for informed health care decisions.
3. Direct to consumer advertising compromises public safety. It can lead to rapid widespread exposure to dangerous drugs before risks are fully recognized. Additionally, most new drugs are costlier than existing treatments, but few provide any therapeutic advantage.
4. Direct to consumer advertising promotes the medicalisation of normal life. The most heavily advertised drugs are for long-term use by large target audiences, often for mild conditions and ‘lifestyle’ problems that may not need drug therapy.
The debate will continue but do not look for a change in the advertising practices of U.S. drug companies anytime soon.