PRESCRIPTION DRUG ADS: AN ESCALATING PROBLEM

The problem is even worse than I thought! Just released by Kaiser Health News: Pharmaceutical company spending on direct-to-consumer advertising has grown 62% since 2012, even as ad spending for most other products has remained static. Pharmaceutical ads tracked by Kantar Media exceeded $6 billion in 2016, with most of that spent on television.

The American Medical Association (AMA) recently called for a ban on direct-to-consumer drug ads, arguing that such ads promote demand for potentially inappropriate use. Unfortunately, a ban is unlikely because of arguments by the drug industry around free speech (first amendment rights), and that the ads are providing “valuable” information to patients about treatment options. For more perspective, the United States is 1 of only 2 countries that allows drug ads; the other is New Zealand.

In 2016, the top 3 ads based on spending were Lyrica, Humira, and Eliquis.

Lyrica is used for various types of neurological pain caused by diabetes “fibromyalgia,” and others. Despite its high cost, its efficacy is marginal, especially when compared with ordinary inexpensive pain medications such as Advil.

Humira is a so-called “biologic” drug used for various types of arthritis, inflammatory bowel disorders, psoriasis (skin disorder) and others. In most instances, Humira (and others in the same class) should be reserved for cases that are severe and do not respond to cheaper, older alternatives.

Eliquis is an anti clotting agent that can be used for problems such as heart (atrial fibrillation) and vein disorders that predispose toward dangerous blood clotting. Again, cheaper, effective alternatives are available.

In all the examples cited above, as in the case of most other drugs promoted on TV, one ‘s own physician should be consulted—and not pressured—before a decision to embark on such therapy. Cheaper alternatives should always be considered.

WHAT SHOULD BE DONE ABOUT THIS PROBLEM

The AMA has called for a ban on direct-to-consumer marketing of prescription drugs and medical devices, a position adopted at the Interim Meeting in November, 2015. The physicians adopting the new policy pointed to excessive advertising budgets in the billions of dollars and the increasing unaffordability of prescription drugs as reasons why the ban is necessary. Excessive advertising is often causing patients to demand new, expensive drugs when older drugs are usually less costly, more effective, safer, and more appropriate for the patient’s specific situation.

AMA members who voted for the policy also cited consolidation in the pharmaceutical industry and anti-competitive practices among drug companies as creating an untenable situation that leads to artificially inflated drug prices. Sadly, drug companies devote approximately 30% of their costs to this purpose, in comparison with about 15% allotted toward research on new, potentially more important products.

“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,” said AMA Board Chair-elect Patrice A. Harris in a press release. “Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”

In addition to suggesting a marketing ban, the AMA announced it will step up efforts to monitor the pharmaceutical industry and advocate for federal regulators to take action when anti-competitive practices limit the availability of generic medications or manipulate the market to favor an expensive medication.

This is a welcome position by the AMA, and in my opinion, it is long overdue. For the benefit of all consumers, I hope it will eventually result in governmental legislative action! In the meantime, take all these ads with a healthy dose of skepticism!

 

 

 

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