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Learn More Prescription drug marketing harms the doctor-patient relationship Prescription drug advertising pressures health professionals to prescribe particular medications, and often the ones that may be less effective and more expensive and dangerous. This intrudes in the relationship between medical professionals and patients, and disrupts the therapeutic process. It takes up valuable time to explain to patients why they may have been misled by the drug advertisements they have seen. So far, 211 professors from U.S. medical schools have endorsed our statement calling for an end to direct-to-consumer prescription drug advertising. Endorsers include prominent medical school professors from Harvard, Johns Hopkins, University of Pennsylvania, Columbia, Stanford, Yale, Duke, University of California, San Francisco and other top medical schools, along with two former editors-in-chief of the New England Journal of Medicine. Send us an email if you are a health care professional and you want to endorse this statement. Thirty-nine organizations have endorsed the Public Health Protection Act, which would stop direct-to-consumer prescription drug advertising. Send us an email if your organization wants to endorse this legislation. Drug ads leads to the over-prescription of drugs. The purpose of drug advertising is to increase the sale of a particular drug. But many people who see drug ads could be harmed or even killed if they took the advertised drug. The results can be tragic. For example, Merck & Co. deployed one of the largest DTC ad campaigns ever on behalf of Vioxx. Some of Merck’s ads made extremely broad appeals, such the tagline “for everyday victories,” for arthritis sufferers who wanted to overcome their disabilities.1 In 2000 and 2001, Merck spent $160.8 and $135.4 million on Vioxx ads, the most for any drug during those years, and Advertising Age named it one of its “Top 100 MegaBrands” for 2000. According to a recent study in The Lancet, one of the most respected medical journals in the world, as many as 140,000 serious cardiovascular events in the United States resulted from the use of Vioxx.3 Pharmaceutical companies have conflicts-of-interest that keep them from presenting unbiased information about their products. Pharmaceutical companies exist to make a profit. That is their duty under the law – to yield a maximum return for their shareholders. In order to do that they have to sell drugs. The more drugs they sell, the better their shareholders will do. Every piece of information that the company sends out must be geared to this end. This is why pharmaceutical companies are not a good source of information about their own prescription medicines. Their financial interests directly conflict with any intention to provide unbiased information about their products. Because of their financial conflicts-of-interest, pharmaceutical companies are perhaps the least trustworthy sources for information about their own drugs. By their very nature, drug companies hype the benefits – or alleged benefits – of their drugs and downplay the negatives. They encourage people to see their problems as diseases that require medication. The result is a public that is increasingly pathologized and drugged. Advertising agencies have conflicts-of-interest that keep them from presenting unbiased information about their clients’ products. Ad agencies exist to sell products. That is their function, and reason for being. An ad agency that handles a drug company account is hired to help that company sell more drugs and boost profits. But a persuasive pitch for the severity of a drug’s side effects will not sell more drugs. This conflict-of-interest makes advertising agencies institutionally incapable of fairly presenting the risks and benefits of their clients’ drugs. Corporations do not pay millions of dollars to these agencies to sell fewer products, whether of drugs or anything else. This too is an established fact. In a candid moment, two direct-to-consumer (DTC) drug advertising executives at FCB Healthworks wrote: “The ultimate goal of DTC advertising is to stimulate consumers to ask their doctors about the advertised drug and then, hopefully, get the prescription.”4 We also know the strategy works. For example, a study by the Kaiser Family Foundation concluded that “DTC advertising produces a significant return for the pharmaceutical industry: every additional $1 the industry spent on DTC advertising in 2000 yielded an additional $4.20 in sales.”5 The techniques used by pharmaceutical companies and advertising agencies are misleading and create a culture of disease and fear. Pharmaceutical companies and their advertising agencies strive to convince people that they are ill, and to invent new classes of illness. For example, in an article titled “The Art of Branding a Condition,” Vince Parry, a marketing executive, discusses how pharmaceutical companies are “fostering the creation of a condition and aligning it with a product.”6 An article in Reuters Business Insight explains that drug companies can “create new disease markets” through “the medicalization of many natural processes” which are “worthy of medical intervention.” “Pharmaceutical companies are searching for new disorders,” the article continues, “based on extensive analysis of unexploited market opportunities (whether recognized today or promoted as such tomorrow). The coming years will bear greater witness to the corporate sponsored creation of disease.”7 This often involves, according to Vince Parry, “elevating the importance of an existing condition,”8 or “raising the level of awareness about something we don’t even know we have until we began looking at it further.”9 For example, GlaxoSmithKline took the notion of shyness and turned it into “social anxiety disorder.”10 They hired the public relations firm Cohn & Wolfe to help establish “social anxiety disorder” as a way of “cultivating the marketplace” even before the launch of their drug Paxil. The Cohn & Wolfe effort, which involved “aggressive media outreach,” generated “1.1 billion media impressions” in one year, and won an award from the Public Relations Society of America,.11 Later on, GlaxoSmithKline issued a pamphlet claiming that “Social anxiety disorder is a lot more common than you think…1 out of every 8 Americans suffers from social anxiety disorder. The good news is that it is treatable.”12 But after a review of the literature, prominent psychiatrists argue that fewer than 1 percent suffer from social phobia.13 Another example is the marketing of the “erectile dysfunction” drugs Viagra, Cialis and Levitra, which has turned them into recreational drugs. The New York Times reported on “an increasing number of sexually healthy men, many in their 20's, 30's and 40's, who doctors and sex therapists say are using impotence drugs -- Viagra, Levitra and the new Cialis…as psychological palliatives against the mighty expectations of modern romance.”14 There is no justification for prescription drug advertising because consumers cannot obtain prescription medicines without a prescription. What is especially absurd about prescription drug advertising is that pharmaceutical companies are trying to push drugs at consumers – who cannot buy them, or at least not without a doctor’s prescription. For this reason alone, too, DTC advertising should be prohibited. Only doctors and other medical professionals may diagnose disease and prescribe treatment. For over fifty years, since Congress passed the Durham-Humphrey Amendments, it has been illegal for consumers to obtain prescription medications without a prescription provided by a medical professional.15 The law exists because many consumers do not have the knowledge, experience or diagnostic equipment to diagnose their own diseases, and some drugs are too toxic, dangerous, new, complicated or habit-forming to use except under the supervision of a physician. There is no way to reconcile prescription drug ads and the premise behind the laws governing prescription drugs, nor any legitimate justification for advertising drugs to people who cannot directly legally obtain them. There is such a compelling case against prescription drug ads that only the U.S. and New Zealand have ever allowed it. New Zealand is expected to ban it again soon.16 The European Parliament’s Committee on Environment, Public Health rejected an effort to undo the E.U. ban on direct-to-consumer prescription drug advertising, and the Committee’s decision was ratified by the entire European Parliament.17 For more information, please visit Commercial Alert’s drug marketing page.
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