By Dr. Mercola
Big Pharma has discovered a unique and ruthless way of increasing their revenue dollars without cutting into their budget. Tell the American people what they are experiencing and about a pill their company has developed to solve the problem.
Suddenly, using direct-to-consumer (DTC) advertising, consumers are selling themselves on drugs to solve even the most minor problems. The U.S. is 1 of only 2 countries in the world that allow this type of advertising, and for good reason.
Only the U.S. and New Zealand have permitted a marketing bonanza that has turned the American public into a medicated mass, brainwashed into thinking that pills make all things better. This has been a boon to the pharmaceutical companies and a massive health risk to Americans.
Not only is there a correlation between the amount of money drug companies spend on DTC advertising and the brand of drug patients request from their physicians, but the data shows DTC advertising rapidly converts people into patients.1
The US Only 1 of 2 Countries That Allow Direct-to-Consumer Advertising
As you watch a happy, smiling couple walking their dog, or riding horseback along the beach, it may be difficult to imagine the medication being advertised wouldn’t deliver on the promise.
In the middle of an opioid epidemic, it is important to ask how effective it is to declare a war on drugs and, at the same time, tell people how to get more medication from their doctors.
DTC advertising has had dangerous repercussions. Prescription advertising has demonstrated a huge increase in sales for pharmaceutical companies without a corresponding rise in benefits to health.
In fact, in health rankings published by the National Research Council and Institute of Medicine, health in the U.S. ranks last out of 17 developed countries.2 Some doctors may be unduly influenced by people who are interested in using a quick-fix pill to take care of symptoms, as opposed to making lifestyle changes.
Despite a long laundry list of side effects from many, if not all, prescription medications, no drug ads make suggestions that lifestyle changes could resolve a health condition.
Coupled with the depressing statistic published in the Mayo Clinic Proceedings, that only 3 percent of Americans are living a healthy lifestyle,3,4 drug companies appear to have the upper hand. Fueling their rising profit margins, they push prescriptions.
One common example of the number of prescriptions surpassing the number of people who have a condition, is erectile dysfunction (ED). According to the National Institutes of Health (NIH), approximately 12 percent of men younger than 60 and 30 percent older than 70 suffer from ED.5
However, the market for the top three ED drugs is over $1 billion each year and expected to reach $3.2 billion by 2022.6 This means many men are treating a condition that may be well within the range of normal.
Another method drug companies use to maintain profits is to patent their formulas. However, as a patent expires the company turns to “reinventing” an old drug by making small changes. This allows them to patent a “new” medication so only they can sell it, at a cost only they determine.
Facebook Angling for a Cut of Big Pharma’s Marketing Dollars
This has created a multi-trillion-dollar drug industry that only continues to grow, powered by DTC advertising. Although legal since 1985, it didn’t really take off until 1997 when the U.S. Food and Drug Administration (FDA) eased their requirements for informing the public about the details of drug side effects in their advertising.
Since that time, the industry has been pouring millions of dollars into advertising. In an effort to garner a cut of these millions, Facebook has restructured their advertising blocks to allow scrolling text so pharmaceutical companies can include side effects and stay within the predetermined space limitation of Facebook ads.
This means you’ll likely start seeing more advertising for medications targeted directly at you and your interests.
Facebook uses a sophisticated algorithm to track your interests, who you talk with and what you say, and includes information about your age, gender, income level and a phenomenal number of other specifics that allow advertisers to target exactly who they believe will click on their ads.7
Facebook has made the advertising process even easier and better for drug companies. Normally, when you click an ad to a page on Facebook, you have the ability to leave a comment. In order to help drug companies, Facebook has allowed these comments to be turned off.
This is a huge boost for Big Pharma who could get into real trouble with regulators if comments potentially included adverse effects from the medications that were not reported to the FDA.8
As the final nail in the consumer coffin, Facebook is allowing drug companies to sponsor community pages designed to bring together people with similar medical conditions for which the pharmaceutical company offers a pill.
Although these community pages have existed in the past, Facebook is now assisting the drug companies to design promotions targeting groups. Each of these new features being rolled out by Facebook to accommodate the needs of drug companies will help line the pockets of those very same companies.
The First Advertisement Is on Facebook Mobile
Drug companies have been able to run ads on Facebook for years, according to the social media giant’s rules.
However, without being able to include side effects within a limited space requirement, pharmaceutical companies have been reluctant to participate. The industry spent $5.2 billion in 2015 on DTC advertising. This year Facebook is getting a part of that ad spend.
In order to ease Big Pharma’s concerns about using Facebook to communicate with potential future customers, the company created a team to specifically work out how to advertise within the FDA requirements.
Danielle Salowski, manager for Facebook’s health team explained:9 “This was borne out of tons of interest we were getting from pharmaceutical advertisers to figure out Facebook.”
The first company to use such ads was Bayer in an ad campaign in October for their multiple sclerosis medication.10 Ultimately the company decided to use Facebook in order to take advantage of the mobile platform that allows users to click a button in the ad and make a phone call.
The interface also allows users to request more information without leaving the website. Facebook adds the individual’s name and email automatically, making the process seamless.
Within four short weeks Bayer had gone from idea to publication, and experienced a 96 percent decrease in their cost to acquire a person interested in the drug. And they experienced an increase in the number of people who expressed an interest in the drug.
Although drug companies argue that advertising is designed to inform the public of their choices, Dr. Dee Mangin, associate professor at the Christchurch School of Medicine and Health Sciences, said:11 “The truth is direct-to-consumer advertising is used to drive choice rather than inform it.”
Surveys in New Zealand and the U.S. have demonstrated that when patients ask for a specific drug by name, they will receive it from their physicians more often than not. Mangin said:12 “In an era of shared decision-making, it’s much more likely that general practitioners will just do what the patient asks.”
Drug Companies Take the Sting Out of Negative Side Effects
Pharmaceutical companies are mandated to include the list of potential side effects patients may experience when they take a drug. However, the FDA does not mandate exactly how that information is communicated.
For instance, the small scrolling print in Facebook ads may satisfy the letter of the law, but likely doesn’t satisfy the spirit, as many people don’t take the time to read the small print.
Big Pharma has been using specific strategies to communicate side effects since they began their DTC advertising. Each of these strategies is designed to reduce the likelihood the consumer will perceive the side effects as potentially dangerous and therefore avoid the medication.
Perfection didn’t come immediately. Two decades later actors used to talk about these side effects say there is an art to the communication.13
If you’ve ever tuned out during the side effect portion of drug ads, you aren’t the only one. It is the way the ads are designed and produced. Using actors who have an aptitude for reading off a litany of physical effects, advertisers use images, voice tone and pace to distract your mind and reduce the potential you’ll hear and understand these side effects.
Sometimes the producers use one voice to describe the benefits of the medication and a second to read the list of side effects. In other cases the portion of the ad that lists side effects will be written in a less engaging fashion and with more complex sentence structure, or the actor reading side effects will be kept off screen. In each case it makes it more difficult for the listener to hear and remember the content.
Bayer was on the receiving end of an FDA warning letter for their Yaz TV ads. While reading the list of side effects for the birth control pill, viewers were treated with rapidly moving images. The FDA wrote:14
“These complex presentation distract from and make it difficult for viewers to process and comprehend the important risks being conveyed. This is particularly troubling as some of the risks being conveyed are serious, even life-threatening.”
A Short History of the FDA
Although today the FDA has power to protect U.S. citizens when it chooses, this is a relatively new phenomena. The name of the administration wasn’t changed to the FDA until 1930, but the organization existed as far back as 1906.15 The stated purpose of the FDA has been the same since inception: “protects public health by assuring the safety, effectiveness and security of a wide range of products, including human prescription drugs.”16
It wasn’t until 1962 before the FDA was given power by Congress to be sure drug companies could stand behind the promises they made.17 Today, the FDA has become concerned with the DTC advertising Big Pharma has developed. In an effort to put on the brakes, they circulated a draft proposal in late 2015 that would require the side effects listed by drug companies to be in language non-medical personnel could understand.18,19
This is important since studies have demonstrated that 40 percent of people don’t usually read the warnings included with medications and when they do, 55 percent say they find them difficult to read and understand.20 While the language in this proposal could have been stricter to include the persuasive strategies companies use in their advertising, this type of restriction may have intruded on the right of free speech for commercial entities.
In response to the growing number of DTC ads and the changes experienced by patients and physicians, the American Medical Association (AMA) has proposed an outright ban on this type of communication directly to consumers.21 Their argument is that a “growing proliferation of ads is driving demand for expensive treatments despite the clinical effectiveness of less costly alternatives.” AMA Board Chair-Elect, Dr. Patrice Harris, explains:22
“Today’s vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices. Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”
There May Be a Better Advertising System
Under the assumption DTC advertising is here to stay, it is in the best interest of the American people that a better system of communicating drug benefits and side effects is found. Unfortunately, it probably isn’t in the best interest of Big Pharma, as it would likely be more informative than a driver of consumer choices.
One such drug labeling was proposed by The New York Times contributor, Dr. Richard Friedman, professor of clinical psychiatry and director of the psychopharmacology clinic at the Weill Cornell Medical College.23
In his model, drug labels and advertising would include comparisons against similar medications, prices per month, the number of people in clinical trials who were treated before one had a positive effect from the drug, as well as statistics about how many people are experiencing harmful side effects from the drug.
In other words, Friedman proposes a movement from advertising to providing a scorecard consumers could easily read and interpret, as well as being monitored by the FDA. The scorecard would also release the number of drug trials and the results against placebos. Although this information is available online, most consumers don’t search for the information, and negative trials are not always published in a timely fashion.
The last piece of the puzzle would be a comparison of the current drug against the effectiveness of older and less expensive medications. Each of these factors are important in your and your physician’s consideration of any medication you choose to use to treat a health condition.