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Don't Get Sold By Drug Ads on TV, Says Study

Worst Pills, Best Pills Newsletter article May, 2007
Further evidence for the need to check Worst Pills, Best Pills before filling a prescription

So-called “direct-to-consumer” (DTC) ads, urging people to ask their doctors about various drugs, mean big money to pharmaceutical companies: in 2005, consumers filled almost 339 million prescriptions of the drugs advertised directly to consumers, with sales amounting to $37 billion.

Pharmaceutical companies claim that these ads are not specifically aimed at selling the drugs to TV watchers –...

Further evidence for the need to check Worst Pills, Best Pills before filling a prescription

So-called “direct-to-consumer” (DTC) ads, urging people to ask their doctors about various drugs, mean big money to pharmaceutical companies: in 2005, consumers filled almost 339 million prescriptions of the drugs advertised directly to consumers, with sales amounting to $37 billion.

Pharmaceutical companies claim that these ads are not specifically aimed at selling the drugs to TV watchers – they claim the ads are simply “educational.”

But a new study disputes the drug company claims. Not only does the study – conducted by researchers at the University of California, Los Angeles, University of Pennsylvania, and the University of Texas at Austin – say that the ads are not educational, it also says that the ads may oversell the benefits of the drugs and could put the public health in danger.

The authors stated that their findings:

suggest the need to reconsider the distinction between selling soap or other consumer products and selling prescription drugs. Poor judgment among soap brands may have few health consequences; DTCA [direct-to-consumer advertising] influence on drug preferences and the resultant importuning of physicians to prescribe cost-ineffective (or even inappropriate) drugs are a much more substantial concern for health care expenditures and population health.

“One fact is unquestionable: DTC ads do not effectively or consistently convey important information about product risks and benefits,” said Douglas A. Levy, JD, of the University of California at San Francisco School of Medicine, citing statistics that suggest some physicians feel pressure to prescribe drugs asked for by name.

The results of this new study, which was published in the January/February issue of the Annals of Family Medicine, are not unexpected.

A number of groups that monitor the pharmaceutical industry’s marketing behavior, including Public Citizen, have long been aware that drug companies would emphasize the benefits of drugs and deemphasize the risks if the drugs were promoted directly to consumers.

But the Food and Drug Administration (FDA) caved to industry pressure and opened the door for direct-to-consumer television ads in the late 1990s without considering the strong possibility that these ads would be of little or no informational value to consumers or could have negative effects on individual and public health.

Background
The goal of this study was to analyze the content of the messages in direct-to-consumer television ads to better understand how these ads attempt to influence consumers.

The study’s authors noted that television ads combine visual imagery, music and spoken words to create a more complex message than available to consumers in print media, and so appeal to a wider range of consumer emotions.

The researchers analyzed the content of ads played during peak television viewing times (8 p.m. to 11 p.m.) and the evening news broadcasts with the largest audiences – ABC, NBC, CBS and Fox. Researchers recorded the programs running during those viewing times from June 30, 2004 to July 27, 2004.  

A total of 103 different ads were recorded for 24 drugs; these ads made 31 discrete claims. Ads for seven shorter ads recorded by the researchers. The recorded ads included seven out of the top 10-selling prescription drug products in 2004 were recorded.

Results
As required by FDA regulations, all of the ads included information about major risks or side effects.

Usually, the risks are listed in a single sentence close to the end of a 60-second television ad – an inadequate amount of information for someone to fully appreciate or understand the risks of a drug.

The vast majority of the ads used positive emotional appeals, frequently depicting a consumer who is happy after using the drug. Negative emotional appeals were used in more than two-thirds of the ads. These included showing the consumer in a fearful state before using the product. In other words, some ads sell drugs by scaring consumers into purchases. It was found that almost one-third of the ads made fun of the consumer before the using the drug being promoted.

The researchers found that about a quarter of the ads suggested that the condition for which the drug was being advertised, if untreated, may inhibit health or recreational activities, and more than half implied that that the drug allows health or recreational activities.  

Ads for conditions that can be managed without drugs (such as insomnia, high cholesterol and high blood pressure) did not mention non-drug treatments as alternatives. More than 18 percent of the ads implied that non-drug management (such as lifestyle changes) is insufficient to manage the condition.

 

Drugs advertised in this study

BRAND NAME

Generic Name

Advertised Use

Prescriptions 2005

Dollar Sales 2005

Public Citizen's Recommendation

ACTONEL Risedronate Osteoporosis

9,660,000

$792,582,000

Do Not Use
until 2007
ALLEGRA Fexofenadine Allergy

12,796,000

$957,152,000

Limited Use
AMBIEN Zolpidem Insomnia

23,145,000

$1,932,940,000

Limited Use
CELEBREX Celecoxib Arthritis

10,965,000

$1,241,574,000

Do Not Use
CIALIS Tadalafil Erectile dysfunction

3,847,000

$295,191,000

Do Not Use
until 2011
CRESTOR Rosuvastatin High cholesterol

7,797,000

$676,848,000

Do Not Use
DETROL LA Tolterodine Overactive bladder

5,163,000

$534,795,000

Limited Use
DIOVAN Valsartan High blood pressure

12,595,000

$810,581,000

Limited Use
DIOVAN HCT Valsartan with Hydrochlorothiazide High blood pressure

10,292,000

$723,998,000

Limited Use
ENBREL Etanercept Rheumatoid arthritis

Not available

$1,130,642,000

Limited Use
FOSAMAX Alendronate Osteoporosis

17,915,000

$1,484,088,000

Limited Use
LAMISIL Terbinafine Nail fungus

2,192,000

$608,718,000

Do Not Use
LEVITRA Vardenafil Erectile dysfunction

1,987,000

$141,573,000

Do Not Use
until 2011
LIPITOR Atorvastatin High cholesterol

63,219,000

$6,320,522,000

 
LOTREL Amlodipine with Benazepril High blood pressure

12,863,000

$1,109,867,000

Do Not Use
NEXIUM Esomeprazole Heart burn

22,883,000

$3,436,794,000

Do Not Use
PLAVIX Clopidogrel ACS

18,823,000

$2,480,042,000

Limited Use
PREVACID Lansoprazole Heart burn

22,152,000

$3,327,919,000

Limited Use
PROCRIT Epoetin Alfa Anemia

Not available

$393,527,000

 
SINGULAIR Montelukast Allergy

22,167,000

$2,089,348,000

Do Not Use
VALTREX Valacyclovir Genital herpes

6,988,000

$978,443,000

 
ZELNORM* Tegaserod Irritable bowel syndrome

2,127,000

$318,220,000

Do Not Use
ZOCOR Simvastatin High cholesterol

22,325,000

$3,106,628,000

 
ZOLOFT Sertraline Depression

26,976,000

$2,561,069,000

Limited Use

Totals

338,877,000

$37,453,061,000

 
* Tegaserod (ZELNORM) was taken off the market on March 30, 2007.

Worst Pills, Best Pills News: A consumer’s defense against DTC ads
Consumers can use the recommendations found in Worst Pills, Best Pills News and www.worstpills.org to inform themselves about medications, which would help counterbalance the effects of direct-to-consumer drug advertising.  

The research provided by the doctors, pharmacists and pharmacologist on staff at Public Citizen can help consumers make better decisions, which can translate into a positive health and economic impact for consumers.  

For example, of the 24 drugs included in this advertising study, seven are listed as “Do Not Use” in Worst Pills, Best Pills publications. Ten are listed as “Limited Use” drugs, meaning that there may be safer, more effective or less expensive alternatives available to consumers. Three of the drugs should not be used until seven years after the date it came out onto the market, according to Public Citizen.

The seven Do Not Use drugs accounted for almost 83 million prescriptions in 2005, at a cost of more than $9.6 billion. To place these prescription numbers and costs in perspective, consider this: the original estimate for the Medicare drug benefit program was $40 billion per year. This short list of drugs represents about one-fourth of the estimated costs for one year of the Medicare drug program.

What You Can Do
You should consult Worst Pills, Best Pills publications before purchasing a new prescription.

You should not rely on direct-to-consumer television advertisements as a source of drug information.