Should We Market Prescription Medicine to the Masses?

One thing that always frightens me when I turn on the TV is the sheer volume of commercials for prescription drugs.  The commercials are usually highly-polished, with nice-looking actors and gentle piano music in the background. They’re so common that you can probably think of a few right now: Cymbalta, Advair, Ambien, Latisse.  Although it’s certainly bothersome that drug companies market drugs to people who cannot purchase them directly (without a prescription), the thing that bothers me most is that they used highly polished adds to gloss-over some very serious side effects.  This just seems so dangerous.  Should we allow drug companies to market powerful prescription drugs to the masses?

Image from a commercial for Advair Diskus

One example is Advair, an inhaler used to treat asthma and chronic obstructive pulmonary disease (COPD).  The commercials for Advair have everything you might expect: good lighting, nice people, soothing music.   A woman who says she suffers from COPD talks about her switch to Advair, and then she is shown outside at a party, frolicking with her grandchildren.  While all the good stuff is going on, you hear a voiceover that discusses the risks of Advair, while a list of caveats is displayed at the bottom of the screen: Adviar works differently, It is not known how inflammatories work on COPD.  It’s probably harmless, right?  After all, they are just providing people with COPD a means to end their suffering and get back to life as usual.

But then go to Advair’s website.  As a general rule, the websites for band-name drugs are a lot less polished than their commercials.  There, they outline the caveats and warnings in black-and-white detail.  But who wants to read something that looks like it came from a doctor’s office?  But you should, because the details are often frightening;  they make you wonder whether the drug is useful at all (the bold highlighting is mine):

People with asthma who take long-acting beta2-adrenergic agonist (LABA) medicines, such as salmeterol (one of the medicines in ADVAIR), have an increased risk of death from asthma problems. It is not known whether fluticasone propionate, the other medicine in ADVAIR, reduces the risk of death from asthma problems seen with salmeterol.

And Advair’s not the only one.  There’s a host of prescription drugs that are marketed in this way.  And what confuses me is why market to consumers anyway?  Would you ever take a day off work to schedule a doctor’s appointment just to ask about some brand-name drug?  And are regular folks like us the best to decide which drug to take, especially when we’re too distracted by dandelions to appreciate all the risks?  Drugs are serious business (in every sense of the word), and a pretty package doesn’t make it any less dangerous.  Like marketing sugary foods to children using their favorite cartoon characters, I’m not sure we should market powerful prescription drugs to consumers either.  We can’t appreciate all the risks.  But then there’s always the caveat: ask your doctor if it’s right for you.

I wonder whether people who come in to request brand-name drugs are a common nuisance for physicians.


4 thoughts on “Should We Market Prescription Medicine to the Masses?

  1. I’m sure its probably illegal, but I have no doubt that drug companies find ways to pay physicians to prescribe their drugs. If nothing else, they’re always dropping off samples that doctors can give the patients to try. (I have often taken advantage of those samples, but luckily, I don’t have to worry about the side effects of test strips and lancet devices.) I also think you’re correct that some doctors are probably annoyed by patients that come in requesting certain medication. The problem is, these people can just go to another doctor willing to prescribe them. We can thank lobbyists for Congress allowing prescription companies to start making ads in the first place, which have been on the air less than 20 years.

    I know its tangential, but I found your post interesting when combined with an article in the Washington Post this past Monday:
    I can’t help but wonder how many ways drug companies are affecting our health care system.

  2. In researching my recent book, “The History and Evolution of Health Care in America: The Untold Backstory of Where We’ve Been, Where We Are and Why Health Care Needs More Reform,” I came to conclusion that one of the many issues we have in our current health care system are the myths we carry about the current system, which is in reality not a system at all. One of the main myths is our perception of the concept of our “cures.

    In the battle with the other species, they do not sit quietly and wait to become eradicated and made extinct. They evolve, they adapt, and they have continued to find effective ways to defeat out continued chemical attack. It is no anomaly that we are seeing a rise in super resistant strains of bacteria. We are often only a single mutation away for viruses to change infection methods and patterns. Can you imagine if the AIDS virus, one of the more adaptable viruses, was to change the mechanics of it method of infection to direct fluid contact to aerosol or airborne infection?

    Pharma is running out of magic bullets, as they have picked most, if not all, of the low hanging fruit. It is no coincidence that the new drugs we hear about on TV seem to have an ever increasing list of harmful side effects. Soon in order to get a prescription for treatment, the pharmacist will need to know our genotype and phenotype (individual body chemistry) in order to provide the variant of the drug that won’t harm or kill us, vs. the other one that will.

    We have a long history in America of this kind of marketing of supposed cures. In my book I have an extensive session of patent medicines and you can see an excerpt on my blog here.
    A bigger point is the practice of disease shopping. The following is a brief excerpt on this topic:

    In 1879, Dr. Joseph Lawrence and his partner, Jordan Wheat Lambert, came up with a formulation of menthol, thymol, methyl salicylate, and eucalyptol dissolved in a solution of 21.6 percent alcohol. The combination, they felt had a significant antiseptic effect and they also believed that the methyl salicylate had an anti-inflammatory effect.

    They initially marketed their product as a surgical antiseptic, but it met with little success. Still searching for that magic market, it was next sold as a floor cleaner and as a cure for gonorrhea. Next, in 1895, the pair started to sell it to dentists for oral care. In 1914, it became the first “over-the-counter” mouthwash. By the 1920’s Jordan Lambert became confident that he and his partner had found a cure; all they needed was a disease. Finding an obscure medical phrase, “Halitosis” (bad breath) they soon married their theory to the product which quickly became the vehicle for their success. Listerine, as they aptly named it, became the cure for this horrid condition that the manufacturer said, if left untreated, could “blight anyone’s chances of succeeding in romance, marriage or work.”

    Warner Lambert was the first to stumble onto the now universal technique of inflating a common everyday condition to the level of a pathology, that will simply destroy your chances of ever _____________ ! (Feel free to fill in the blank with whatever comes to mind. That is what Lambert and his partner did!)

    Along that line of thinking, some of the “illnesses” we see advertised today include:
    Erectile dysfunction Female sexual dysfunction
    Bipolar disorder Attention deficit hyperactivity disorder
    Restless leg syndrome Osteoporosis
    Social shyness Irritable bowel syndrome
    Balding Enlarged prostate
    High cholesterol Mildly excess weight (not clinical obesity)

    This is not to say these conditions don’t exist. As with many of these modern cures, the underlying disorder is problematic for some people. The problem is the extent of the illness, the relevance of the issue to the life and health of the individual, and the effectiveness of the treatments which are wildly exaggerated.

    The truth is we still have the “patent” medicine men in our midst today. Finally, the saturation of media to sell these dubious cures is also not new. Go online and look up newspapers from the 1860 through 1920s and you will see an amazing amount of coverage for patent medicines, in many cases 80% of the pages in either articles or advertisements. Another thing you will find is they were selling the same things then as now. The more things change the more they stay the same holds tightly true!

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