Friday, May 16, 2008

Of Buzzing Bees and Direct-to-Consumer Drug Ads

Congress is scrutinizing direct-to-consumer drug marketing, and Allison Bass (author of a new book on the deceptive marketing of Paxil) posted this interesting entry on her new blog. Researchers at Duke University have listed cognitive techniques drug-makers use to distract them from comprehending all the pesky negative information that the FDA requires be disclosed. For example, in an ad for the allergy drug Nasonex, a distracting animated bee appears during the rapid fire recitation of side effects. But when the benefits of Nasonex are described, the bee hovers quietly.

In the past, I have supported DTC ads (see here) because I have felt the public health benefits may outweigh the problems with biased drug information. After reading about this new study, I may have to revise my position!


Anonymous said...

Yes, you should, since the ads routinely present misleading information. See any ad for Zoloft or Paxil which describes the known cause of depression: Serotonin deficiency, which is corrected by taking a SSRI.

[Instead of just being honest and saying the drugs help some people and we're not sure exactly why]

Supremacy Claus said...

I saw the commercial. That observation shows paranoid schizophrenic grade over-reading.

Anonymous said...

Interesting to see comments are few and far between for the past week. Maybe prepublishing review is holding people back from interacting.

Here's one suggestion to minimize inappropriate dialogue: people who are well known to the site should send you a private email to identify at least what they represent in the blog interactions so you could email them back if such individual is getting out of hand. That's would I would consider if I had a blog. Plus, it gives me the oppportunity to get to know my usual players.

As per this posting, I really can't believe you once felt DTC advertising had a reasonable place in the patient-physician interaction. Optimism should be grounded with some reality, hmmm?

Supremacy Claus said...

TF: You are proposing complex bureaucratic procedures for a personal blog. Are there any appeal procedures for adverse decisions, in your proposal?

I note some libertarian tendencies in Dan. I still have some hope facts will influence him. He supports over the counter availability of SSRI's. Consumer advertising does a lot to increase awareness of medical management. Everyone now knows, a baby aspirin for new onset angina. Just that may save 1000's of live a year. People with restless legs go undiagnosed for years. Now, that is impossible. What do people with RLS do? They fall asleep in the daytime, and kill people on the roads.

Anonymous said...

Re Iowa Doc's comments in recent past postings: welcome to the ongoing commentary as moderated by this Blog owner. I personally would like to hear from colleagues about the issues at hand.

I don't know if you read any of my past postings about the use of atypicals for diagnoses like depression or anxiety, but if you would like to weigh in with an opinion to any applicability, or not in my opinion, please consider commenting. Dr C is going to speak about the atypicals in his next Report.

I cannot speak for others, but I am interested in civil, responsible discourse that has a reasonable direction via the commentary.

Welcome and hope it is valuable.

Therapyfirst, a psychiatrist located in Maryland.

Anonymous said...

Your Television as you doctor?

Often, usually on television, one viewing will often at times see an advertisement for some type of medication- usually one involved in a large market disease state and the commercial is sponsored usually by a big pharmaceutical company for a particular network. This is called direct to consumer advertising, and doctors would prefer they did not exist.

Since 1997, when the FDA relaxed regulations regarding this form of advertising, the popularity of the creation of such commercials has greatly increased. The pharmaceutical industry spends around 5 billion annually on this media source now. Normally, the creation of such a commercial becomes visible to the consumer within a year of the drug’s approval, which raises safety concerns. And involves money spent that could be applied to greater uses, according t many, but we are dealing with a corporation here.

The purpose of DTC ads is not education, in my opinion, as others have claimed. Any advertising of any type shares the same objective, which is to increase sales and grow their market and, in this case, for a particular perceived medical condition or disease state. The intent of DTC advertising is to generate an emotional response from the viewer, such as fear or concern, believing upon research that the viewer will then question as to whether they need to seek treatment for what may be an unconfirmed medical condition. Furthermore, the FDA has admitted that they are ignorant as far as the content of such DTC ads, in relation to their accuracy and clarity, as well as their effect on the health care system.

DTC advertising is also a catalyst for and similar to disease mongering.

Disease mongering is the creation of what some believe to be medical flaws, and illustrated by the creators through exaggeration and embellishments through media sources as an avenue for suc propaganda, as is often seen with DTC advertising. Yet the flaws may not be medical, but corporate creations of these questionable human ailments that do not require treatment, possibly, and may be an attempt to develop a particular medical condition to acquire profit. One of my favorite DTCs is the new indication for the use of an anti-depressant for a social disorder. This used to be called introversion, a term created by Dr. Carl Yung. And it is a personality trait, not a medical disease. There are other questionable medical conditions claimed in the contents of DTC commercials, as the creators wish to grow the market for a particular, and possibly fictional, disease state. Then there is baldness treatments advertised, as another example. Lifestyle meds are not treatment meds for illnesses, and should not be portrayed as such.

Also, DTC ads discuss only one treatment option normally, so it seems, when likely several treatment options exist for authentic medical disorders. This should be left to the discretion of the doctor, as they assess your health, not your television or another media source. That’s why most of the world does not conduct DTC advertising, with the exception of our country and New Zealand.

Finally, DTC advertising and its ability to influence viewers to make their own assessment instead of a medical professional remains largely unregulated, yet apparently effective for the DTC creators. People are prone to believe what they see and hear, regardless of whether or not it is actually true. Many, after viewing a DTC ad, seek out a doctor visit and request whatever product that was advertised, which makes things cumbersome for the doctor chosen for such a visit.

So the doctor and patient relationship is altered in a negative way, because most DTC ads require a prescription.
Medical information and claims of suggested health ailments should come from those in the medical field instead of the corporate world. Perhaps this will save some over-prescribing, which will benefit everyone in the long term. And the Health Care System can regain control of their purpose, which is far from financial prosperity.

“Men of ill judgment oft ignore the good that lies within their hands till they have lost it”


Dan Abshear