Friday, November 6, 2009

There's Gold in Them Thar' Pills

Between 1996 and 2000 US pharmaceutical companies spent nearly $2.5 billion dollars on advertising aimed at consumers, a seven-fold increase in spending. Then it nearly doubled again, reaching $4.5 billion in 2006. Criticism of direct-to-consumer advertising has intensified since 2004, after Merck withdrew Vioxx, a heavily advertised painkiller, when a clinical trial showed that it sharply increased the risk of heart attacks and strokes. While accounting for only about 16% of the total spent promoting drugs in 2000 (the rest was spent on promotions aimed at doctors and health care professionals), television ads have come under intense scrutiny of late.

A 2007 study at UCLA suggests that TV ads may influence American consumers to over-medicate. Among the findings were that "the ads had virtually no educational value, failed to describe who is most at risk for which illnesses, what their symptoms might be, and whether non-medicinal alternatives such as changes to lifestyle like exercise and diet might also be viable options." Other troubling conclusions were that the ads: failed to described the symptoms and causes of illnesses,  mentioned the associated risk factors and how common or rare they are only about 1 time in 4; portrayed people losing control over their lives and then regaining it once they took the medication; used emotional appeals to influence viewers; and failed to show lifestyle and behavior change as viable alternatives except to suggest that changes to lifestyle would not be enough to deal with the illness.

For pharmaceutical companies there is a lot of money at stake here. According to the UCLA study Americans are exposed to as much as 16 hours of televised drug ads each week. As many as 1/3 of these viewers go on to ask their doctors about the drug, and as many as 2/3 of those who ask eventually receive a prescription for it. Since 1992, the number of prescriptions used by the average American has risen from 7 to 12. This is an increase of nearly 60% and has added about $180 billion to our annual healthcare spending. Sales of Seldane, one of the first drugs to be advertised on television after the FDA relaxed the rules in 1986, increased from $34 million to over $800 million. It was withdrawn from the market in 1997 due to serious (sometimes fatal) interactions and side effects.

There is no doubt that drugs can save lives. But we need to stop looking at them as harmless miracle cures for chronic conditions brought on by poor lifestyle choices. And when so much money is involved, we need to be doubly alert to look out for ourselves. Prescription medication is now the second-largest cause of "accidental" deaths in the United States, a 5-year 68% increase. Make sure you don't become part of these statistics.

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