Yay or Nay: DTC Prescription Drug Marketing

Prescription drug advertisements are everywhere

You can’t avoid them if you’re in the U.S. – prescription drug ads are everywhere. They are in print magazines, online, on TV, and even on bus shelter walls. They show happy, smiling people, usually outside doing fun things, like zip lining or having dinner with friends. Couples are happy and holding hands. These happy, active people want you to have the same life. They offer hope for diseases from asthma to breast cancer and so many more.

An ad workaround

As a Canadian, I always find these ads a bit jarring. That kind of direct-to-consumer (DCT) advertising isn’t allowed here, but the clever marketing people at the pharmaceutical companies have found a way around that. And they don’t have to spend half the ad time slot or magazine page telling people about just some of the side effects they could experience.

Instead, we see and hear ads that are something like this: A woman looks at the camera, addressing you directly, and says, “Have you ever heard about [XXX drug]? No? Your doctor has. Ask your doctor if XXX is right for you!” In another ad, two friends are in a coffee shop. One woman asks the other, “Have you asked your doctor about [ABC drug] yet?” “No,” the woman responds, “not yet.” Another customer overhears her and says, “ABC? I’m going to ask my doctor!” The barista chimes in by calling out ABC instead of the customer’s name and then looks flustered, repeating the drug name, saying she now has it in her head. At the end of both ads, the voice-over says, ask your doctor about XXX/ABC or go to [insert appropriate website]. In other words, we have no idea what those drugs are for and why you would even ask for them. But they must be great because these actors are telling you to ask for them.

Whether you see these ads in the U.S. where the drugs’ purposes are identified or in Canada, where you have to guess, is this type of DTC appropriate for medications? Many say yes. I say no.

The first DTC drug ads

Traditionally, prescription medications were marketed to physicians only because they presumably knew what to do with them and which patients might benefit. According to Stat, an online health/medical news organization, the first such DTC ad aired in March 1983, sponsored by Boots Pharmaceuticals. It was an ad for a prescription pain reliever called Rufen. It ran for 48 hours before the Food and Drug Administration (FDA) ordered it taken down. But the damage was done.

Photo by Olga DeLawrence on Unsplash

If the pharmaceutical marketing people hadn’t considered DTC before, they did now! I don’t know how much pressure the companies put on the federal government for changes to allow them to advertise. Still, eventually, the FDA relented, and in 1997, drug companies were allowed to advertise their wares directly to the people who might take them. Unsurprisingly, they also saw a massive uptick in profits, to the tune of $10 billion a year, with no slowing down in sight. The U.S. remains only one of two countries that allows DTC advertising for prescription drugs. The other is New Zealand, which allowed it in the 1980s.

Pros for DTC drug ads

Indeed, there are some benefits of telling consumers that certain drugs are available and might help them treat whatever condition or disease they have. The FDA points out that ads like these can inform people about different options and may open communication between patients and their physicians. This could be particularly helpful if patients feel they aren’t being told about their options. Others point out that advertising the drugs makes them not have to sit back and suffer and that there are possible options for them. Some also argue that such ads may even encourage patients to see a doctor about a problem they had been avoiding.

Photo by CDC on Unsplash

But in my opinion, the biggest pro is for the drug companies. Did you take note of their increase in profit since they started advertising?

One evening, my husband and I watched a U.S. newscast's tail end as it led into our favorite show Jeopardy. We counted five prescription drug ads within 15 minutes. (The others were for medical insurance, reverse mortgages, and toe fungus treatments.)

Now for the cons

Are there cons? In my mind, there are more cons than pros.

In an article published in 2018 in the Journal of Internal Medicine, the authors wrote: “Perhaps the most significant critique of DTC advertising is its effects on rising drug costs due to over-prescribing of both inappropriate and brand name drugs (especially when cheaper generics are available).”

A Washington Post article published earlier this year said the same thing and added that the ads could be misleading. It used two examples: “Consider an inspiring ad for an AIDS drug, featuring a former basketball star suggesting the drug can help most or all HIV patients. In reality, however, the drug was only effective for 37 percent of patients. A prescription medication for thicker eyelashes displayed a stunning fashion model on its website, while downplaying the risk that hair could grow outside the treatment area or that the person’s eye color could be permanently darkened.”

In other words, these ads can misinform patients by over-emphasizing treatment benefits and underplaying the risks they might encounter. This article from Forbes.com was published in 2010, but it’s a good example. It featured 10 misleading drug ads, showing how some companies tried to skirt the rules.

When looking at the relationship between patients and physicians, these ads can have a negative effect there too, as the authors of this article wrote: “Most also agreed that DTC advertising has an impact on the physician-patient relationship by influencing patients to request specific medications and altering patient expectations of physicians' prescribing practices.”

So, what do you think?

I’d love to read your thoughts about this below, in the comment section. As for me, I am still not a fan of prescription drug advertising, especially now with the internet so accessible. Researching treatment options is so much easier now than it was 25 years ago. Given how expensive advertising is, and how long and involved the ads are, pharmaceutical companies are spending a fortune on DTC. This means they must be getting way more back in profits – or else they wouldn’t be doing it.