Our television watching is in high gear since the beginning of the new year. Basic television will have intertwined their programming with many assorted commercials. This is what pays the bills. The basic premise of a television commercial is to sell a product to a captive audience.
Granted, some viewers take a break from the television action to get a snack or relieve themselves. The thirty-second commercial moment is there to plant a seed into your head. The seed grows into a thought that tells your brain that I need to purchase this product or service. Many of these commercials will include the advertising of prescription medications.
Having worked in healthcare for almost 40 years as a clinical pharmacist, my mission has been the right medication, for the right patient, at the right dose, at the right time. Every recommendation is based on post-trial evidence, clinical guidelines and randomized controlled trials. Is this how the pharmaceutical industry advertises their medications?
I have been observing television commercials for medications since 1983. The very first commercial for a medication was for a pain reliever called ibuprofen. A pharmaceutical company from England was saying that their brand of ibuprofen was significantly cheaper than the name brand product used in the United States. Not once did they talk about what the medication was used for and how it works. It seemed to play on the purse strings of the consumer. This led the FDA to look into this medication commercial and it was pulled.
In the mid-90s, Schering-Plough aired commercials introducing us to Claritin, a non-sedating antihistamine. The first couple of commercials I saw did not tell the consumer what Claritin was used for. The commercial recommended you go to your physician and ask about Claritin. In the commercial you saw families running in the park and couples dancing. I was scratching my head and saying to myself what just happened? I could see the encounter at the physician’s office. “Hi, Doc, I have some pain in my right shoulder and by the way, what is Claritin?” For us pilots, a different Claritin commercial said it is for seasonal allergies and mentioned a few side effects. The television audience saw two young, happy people take off in a hot air balloon. I went into thought saying to myself, “I wonder if one of the passengers was the pilot and is Claritin on the No-Fly list of medications?”
I have a huge passion for helping patients control their lipids. Anti-cholesterol medications have been shown to help prevent heart attacks and save lives. I saw a Lipitor commercial featuring Dr. Robert Jarvik. He has been involved in the work and research on the artificial heart. In the commercial you would see Dr. Jarvik rowing and eating a healthy meal at home. His quote: “I’m glad I take Lipitor as a doctor and a dad.” I could see all the people out in the community who were not in healthcare, saying if he takes Lipitor, I should ask my physician about taking Lipitor. Two facts about this commercial: it was never found out if Dr. Jarvik actually took Lipitor. He also was not a practicing physician. I also discovered later that there was a stunt double for the rowing scenes. Lipitor does have excellent clinical trial data with great outcomes for patients.
There are many newer commercials speaking on anticoagulants like Xarelto® and Eliquis®, Crohn’s disease and ulcerative colitis, rheumatoid arthritis, and many other disease states. The commercials do speak about what they are used for and give side effects and contraindications. The side effects and contraindications are given at a very rapid pace at the end of the commercial. It is hard to comprehend. If you listen closely it does get concerning and could be frightening to the consumer.
It is a fact that television commercials do influence our buying habits. That the consumer may feel that one of these medications may be helpful and provide a benefit to their well-being is a concern. The consumer sees presumed successful, happy, good-looking “patients” who are living a very active lifestyle that does not match most people with the described disease state. This may, in a subliminal way, give patients some false hope for a cure or relief of symptoms. There was a pain medication called Vioxx that used Dorothy Hamill in their commercial. Did including this high-level athlete who is loved by the public in any way influence sales?
The commercial precedes the consumer seeing their healthcare provider. Thirty seconds is not enough time to educate the consumer on a medication that could be the wrong choice for that patient. Do we want consumers/patients asking their physician for a medication because they saw it on television?
The American Medical Association has expressed their view that public advertising of medications should be banned. On November 17, 2015, physicians cited concerns that the growing proliferation of ads is driving demands for expensive treatments despite clinical effectiveness of less costly alternatives. “Direct-to consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate,” said AMA Board Chair-elect Patrice A. Harris, M.D., M.A., press release ama-assn.org.
Billions of dollars are spent on prescription medication advertising. The medications that are advertised are usually very expensive to the patient. Getting one of these new medications paid for takes much effort by the physician and staff. The time to get prior authorization before the patient goes to the pharmacy could take hours to days.
From a political and legal standpoint, can the FDA or the government regulate these commercials? That is the million-dollar question. The Supreme Court considers commercial advertising to be highly protected by the First Amendment.
Sit back, relax, and enjoy those commercials, especially during the Super Bowl. Listen to that inner voice, what is being said, and if interested, put the information into the memory banks. Trust your primary care physician and specialists you may be seeing. They know what is best for your well-being. If one of the medications that you saw on a commercial gets brought up in a conversation with your physician, know it is being discussed because it is the right medication for the right patient (you) at the right time.
