Drug Commercials in the U.S.A.

There is a new American phenomenon: TV commercials on prescription

drugs. Only one other country, New Zealand, allows drug companies to market their
products directly to consumers; all others deem it too dangerous. Yet in the U.S.,
targeting consumers has become a huge business. But is advertising prescription drugs
good or bad for the average consumer?
One of the most important strategic actions to boost a firms profit is
advertising. Advertising is a one-way communication whose purpose is to inform
potential customers about products and services and how to obtain them. Every major
medium is used to deliver these messages, including: television, radio, movies,
magazines, newspapers, video games, the Internet, and billboards. Advertising is often
placed by an advertising agency on behalf of a company.
Even though other media are overtaking television because of a shift towards
consumer's usage of the internet as well as other devices, the TV commercial is still
generally considered the most effective mass-market advertising format. An example to
sustain this is given by the high prices TV networks charge for commercial airtime
during popular TV events.
One of the industries that took this and used it in their advantage was the
pharmaceutical one.
Turn on any TV in the U.S. and you will not fail to notice the amount of drug
commercials that are airing: from a cute, animated bouncing ball that was just
medicated with Zoloft, to a young woman suffering from social anxiety disorder that by
taking Paxil is now capable to integrate better. How did it get here?
When more than a decade ago, the U.S. Food & Drug Administration (FDA)
eased up on it’s regulations concerning the drug commercials, this business registered a
boom, making drug firms triple their annual expenditures on ads. Since 1997, TV drug
advertising surged to $5.3 billion in 2006, up 14% from 2005, according to New York-
based ad tracker TNS Media Intelligence.
Lunesta, Detrol, Nexium, Levitra, Vioxx and Cymbalta are just a few of the
most advertised drugs on the market, and even though these are all prescription drugs,
the big pharmaceutical companies took a direct-to-consumer (DTC) approach, in varied

1
forms: TV, radio, magazines and newspapers. Why would this happen, if the doctors
and the pharmacists should be their main targets?
One of the answers can be found in a survey in the medical literature that
revealed that in 70 percent of the cases, when a patient requests a specific medication,
the doctor writes the prescription. Another reason would be that not only the presumed
patient is influenced by these commercials, but also the doctor and the pharmacist.
From another survey, made in 2002, we find out that 25 percent of responders said that
they have responded to direct-to-consumer ads; while another research shows that if
their doctor refuses to prescribe such a drug, one-quarter of the people that are
influenced by these commercials seek the prescription elsewhere, while 15 percent are
willing to change their doctor, in order to get what they want. So, of course the drug
companies are taking full advantage of this situation, spending more than $10 billion a
year promoting their merchandise, out of which, $3 billion on TV ads alone, ads
directed to both doctors and patients alike.
In the book ‘Healthcare Online for Dummies’ by Howard and Judi Wolinsky,
is stated that the pharmaceutical industry is one of the largest, most powerful industries,
with annual U.S. revenues of about $100 billion and worldwide revenues of $300
billion. And in their pursuit of the maximum profit, drugs in America cost more than in
any other country.
The consumer has a casual attitude towards legal medication, even though he
is aware of the horrible effects that the addiction to ecstasy, cocaine and heroin has on
people. And this is what the producers exploit to the maximum.
The FDA's Division of Drug Marketing, Advertising, and Communications
(DDMAC) is in charge of following up the promotional labelling and the advertising
for the prescription drugs. This division helps ensure that pharmaceutical companies
accurately communicate the benefits and risks of an advertised drug. This does not stop
the pharmaceutical moguls from giving the public misleading and false information
concerning the medication, though their ads, but also by calling them risk free.
The effects that these ads have on the consumer are both good and bad.

In the three FDA surveys, patients reported recalling this information from
TV ads:

2
 On one side, the general public, thanks to TV advertising, sees the use of these
drugs like an everyday convenience rather than an important decision worthy of serious
consideration.
Michael S. Wilkes, M.D., vice dean of the medical school at the University of
California, Davis, says that two reasons he doesn't like DTC advertising are that
patients may withhold information from their doctors or try to treat themselves. Aiming
prescription drug ads at consumers can affect the "dynamics of the patient-provider
relationship," and ultimately, the patient's quality of care, Wilkes says.
A consumer that watches TV is easily impressed by what he sees. If he has a
medical problem, or is just feeling a little down lately can easily think that the specific
drug is the solution to all of his problems. The commercial, thanks to DDMAC is
forced to demonstrate the symptoms for the specific disease, and of course the person
identifies with them. Having this in mind, he or she visits a doctor to witch he or she
recites the exact symptoms he heard on TV, not forgetting to add at the end the drug
that the person is searching for and stands a 70 percent chance of getting it, according
to Strand.
Repeated television commercials make drug-trade names familiar to the
public. As shown in the statistics above, the consumer can be quite stubborn when he
has his mind set on something, and this can harm him more than anything. No matter
how much his doctor tries to convince him otherwise, the impact that the advertise has
on the subconscious is very high, making him seek the medicine elsewhere.

3
 Second of all, the dangers are especially worrisome with newer prescription
drugs whose long-term side effects may still be in question, hence Representative
Henry Waxman’s legislative effort to restrict TV ads for drugs that have been on the
market for less than three years. Unfortunately, Waxman’s guidelines lost out in
Congress, but Representative Pete Stark has proposed legislation that’s still in the
running.
An example to sustain this is given by Vioxx. Television advertising caused
the market for Vioxx to expand greatly beyond the patients for whom it was intended.
Physicians should have prescribed Vioxx only when a patient had gastric side effects
from older, less expensive arthritis drugs. But ads convinced patients (and too many
physicians) of this medicine's superiority and safety. Unfortunately, neither belief was
true.
And in addition to the serious health-related issues these ads evoke, many
viewers find them annoying, distasteful, or just plain depressing. The manufacturers
jam-pack prescription drug commercials into certain TV programs, most notably the
national network evening news broadcasts. For the viewer that is perfectly healthy, this
is just disturbing, while for the person that is already taking the respective medication
for those condition might not appreciate being forced to think about it while watching
the news.
On the other side, these commercials have influenced another type of
behaviour:
For example, the FDA surveys found that among patients who visited doctors
and asked about a prescription drug by brand name because of an ad they saw, 88
percent actually had the condition the drug treats. This is important, because physician
visits that result in earlier detection of a disease, combined with appropriate treatment,
could mean that more people will live longer, healthier, more productive lives without
the risk of future costly medical interventions.
Also, the many Americans who don’t visit doctors regularly, deserve to hear as
much as possible about pharmaceutical remedies. If learning of a new erectile
dysfunction drug prompts a viewer to make an appointment with a physician, he may
also receive the benefit of an overdue prostate exam.
And patients already taking older prescription drugs whose performance has
disappointed them have a right to know about new alternatives on the horizon.

4
 Moreover, many doctors neglect to take the time to explain all the potential
side effects of a drug. Likewise, many patients fail to thoroughly read all the literature
the pharmacy provides with the prescription. The TV commercial may represent the
consumer’s most realistic chance of getting all the facts before taking a new drug.
Finally, once the Food & Drug Administration has approved a new drug, why
should another government entity second-guess it by restricting communication
conduits to the public? The FDA’s imprimatur, combined with that of the physician
who ultimately will prescribe the drug, constitutes a reasonable amount of precaution.

In three FDA surveys conducted in 1999 and 2002, physicians reported that
DTC ads had these beneficial effects for patients:

Legislatively speaking, many political figures are concerned by the

advertising prescription drugs phenomenon and are trying very hard to limit the
damages by imposing some restrictions on the big moguls.
Representative Henry Waxman has spent much of the summer pushing
legislation to limit direct-to-consumer advertising of drugs that have been on the market
less than three years. His efforts came up short. Congress considered the ad restrictions
Waxman and others were trying to attach to a big drug safety bill they passed in July.
But after a debate about drug companies' right to free speech, the ad restrictions were
stripped out.

5
 The mighty drug lobby has chalked up another victory--but the fight over drug
advertising isn't over. Critics are increasingly concerned that the ads encourage
consumers to demand drugs they don't need and that may cause harmful side effects
down the road. A moratorium on advertising, some say, would give the Food & Drug
Administration and pharmaceutical companies more time to understand the risks before
ads for these remedies are plastered all over the place.
One watchdog, Representative Pete Stark has an intriguing idea. He recently
introduced a bill proposing that if a drug maker runs consumer ads for a product that
has been on the market less than two years, it cannot claim them as a business expense
on its taxes. Hitting the industry where it hurts--the bottom line--is his attempt to
discourage advertising while skirting concerns about freedom of speech. The ads, Stark
says, "don't tell the whole story. We need to give people time to understand the pros
and cons of a drug."
In conclusion, the direct-to-consumer advertising of the prescription drugs has
its pros and cons. Unfortunately, without the appropriate legislation that can limit the
disadvantages and make this approach safer for the average consumer, the bad side
weights a lot more than the good side. Of course the big pharmaceutical moguls only
seek their own gain, and that gain is quite big, considering the increase numbers that
they have registered in the last 10 years, but the government should think in favour of
the consumer, because they are in the service of the people, even though the American
Constitution gives the drug industry ‘enough room to play’ without breaking the law.

Bibliography:

1. Jeffrey M. Perloff – ‘Microeconomics’, Chapter 14: Strategy (Advertising);

2. N. Gregory Mankiw and Mark P. Taylor – ‘Economics’, Chapter 17: Monopolistic
Competition (Advertising);
3. Wikipedia.org
4. Articles:
‘Dispence with TV Drug Ads’, (8/6/07), BusinessWeek;
‘The Drug Advertising Debate’, (16/7/07), BusinessWeek;
‘Putting Drug Adds Back in the Bottle’, (13/08/07), BusinessWeek;
‘More Frewuent Dose of Dollars for Drug Adds’, (15/08/07), BusinessWeek;

6
‘Truth in Advertising: Rx Drug Ads Come of Age’, (07-08/07), FDA Consumer
Magazine;
‘Take Drug Ads of the Air’,(06/12/05), USA Today;
‘The Great Direct-to-Consumer Prescription Drug Advertising Con’, (08/09/05),
newstarget.com.

Iordache Mihaela Madalina,

Group 922.