Drug Ads and the Consumer

June 24th, 2008

Drug ads have been around for a long time and, for most of that time, they’ve had a very bad reputation. Fanciful advertisements for medicines in the nineteenth century led to a famous series of articles printed in Collier’s magazine by Samuel Hopkins Adams starting on 7 October 1905:


GULLIBLE America will spend this year some seventy-five millions of dollars in the purchase of patent medicines. In consideration of this sum it will swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver stimulants; and, in excess of all other ingredients, undiluted fraud.

(Source: The Great American Fraud, Collier’s Magazine)

The drugs promised quick and easy relief for hundreds of problems and ailments although most of them actually had few, if any, ingredients that worked. And they were very heavily advertised everywhere. Finally Dr. Harvey Wiley of the United States Department of Agriculture convinced the US Congress to pass the Pure Food and Drug Act which drastically limited advertisement options and started rigorous testing of health products.

Doctors and pharmacists at the time knew that many medicines had no effect or were, in fact, dangerous. Before the passage of the Pure Food and Drug Act it was common for pharmacists to have signs in their windows that stated:

PLEASE DO NOT ASK US What is ANY OLD PATENT
MEDICINE Worth?
For you embarrass us, as our honest answer must be
that
IT IS WORTHLESS

(Source:The Great American Fraud, Collier’s Magazine)

Flash Forward a Hundred Years

A 2002 study by Barbara Mintzes published in the British Medical Journal found that:

Patients' requests for medicines are a powerful driver of prescribing decisions. In most cases physicians prescribed requested medicines but were often ambivalent about the choice of treatment.

(Source: http://bmj.bmjjournals.com/cgi/content/full/324/7332/278)

According to a paper published in the New England Journal of Medicine in 2007 pharmaceutical promotion grew from $11,400,000,000.00 (USD) in 1996 to $29,900,000,000.00 (USD) in 2005. That amount of money means that the ads are omni prevalent and have been for the past ten years. Examples include Lunesta to combat sleeplessness, Prozac for depression, Viagara for impotence and Esomprazole to deal with acid reflux. And the list goes on as sophisticated ads with recognizable voices push brand-name drugs into the public consciousness.


Is It All Bad?


It’s important to note that in Canada Health Canada authorizes advertisements for products and has a variety of special requirements – in many ways Canada is much stricter than the United States. Despite the difference between the two countries however the cross border nature of the ads (where the broadcaster is, etc.) means that many ads are influencing Canadians anyway.

These ads have an effect on both sides of the border and can spur patients to ask their doctors for more drugs and that can lead to over-prescription, with all its dangers.

That is the greatest problem.

However drug ads are not inherently wrong - they can be helpful to patients as long as both the patients and the doctor or pharmacist can communicate. Drug ads:


  • Can encourage patients to seek new treatments for existing problems
  • Can inform patients about risks and conditions

And, most importantly:
  • Can encourage patients to ask questions of their health professionals
And that’s a very good thing indeed because when dialogue begins then everything else will follow.


Wishing you the best of health,
Dennis Wong, Owner of CD Whyte Ridge, Consultant Pharmacist