How Americans Pay the Price for Drug Advertising


Marketing Turns Normal Conditions into Diseases

With the rise in drug advertising has come the rise in drug prescriptions. In 1992, the average American had seven prescriptions. In 2008, that number soared to 12.

Critics of direct-to-consumer drug advertising blame this increase on ads. “The information is designed to tell you what it is for and why you need it—but not if you need it,” said Dr. Ameet Sarpatwari in an article for Harvard Men’s Health Watch.

Thanks to the internet, American patients are now more empowered than ever, which can be a good thing. Educated patients may be more likely to seek medical attention for a condition, seek other medical opinions, etc. But without a medical degree, they lack a thorough understanding of a drug’s potential side effects or the exact symptoms of a rare medical condition that a doctor would know.

Big Pharma’s “disease mongering,” critics argue, can exaggerate how frequently a rare medical condition occurs, or turn a natural condition (like aging) into a disease that requires a pill. These conditions often rely on vague symptoms for a diagnosis that can apply to lots of people, which ultimately helps companies sell more of the medication.

“If you want to stir up worry in the public, and you’ve got the advertising dollars to do it, you can turn almost anything into a disease.”

Arthur Caplan, a professor of Bioethics at the University of Pennsylvania, said in an interview for 60 Minutes, “If you want to stir up worry in the public, and you’ve got the advertising dollars to do it, you can turn almost anything into a disease.”

Critics point to the increased numbers of diagnoses for adult ADHD, social anxiety disorders, erectile dysfunction, and similar conditions as a byproduct of the pharmaceutical industry. While there are certainly people who genuinely suffer from these conditions, they are often much smaller in number than those who receive treatment.

“We seem to be living through the most extraordinary paradox: We have never been healthier, yet we seem to consider ourselves sicker and sicker than ever. Mild symptoms, inconvenience, being at low-risk, aging, human life, and death, are rapidly being medicalized,” said Dr. Ray Moynihan in an article for The Atlantic.

Testosterone Therapy Ads Sell Drug to Healthy Men  

Only half of men with a prescription for testosterone therapy had been diagnosed with hypogonadism in the previous year.

Testosterone therapy offers the perfect case study for how dangerous misleading drug advertisements can be. Testosterone therapy drugs are intended to restore hormone levels in men who suffer from serious injuries or diseases like hypogonadism. But the ads tell a different story.

Testosterone ads, like that for AndroGel, position testosterone therapy as an anti-aging cure-all. The ads often ask men if they feel tired or not like they used to—common side effects of getting older.

This strategy has worked; sales for testosterone therapy increased by 69% between 2005 and 2011.

But the health risks of testosterone therapy may seriously outweigh the benefits, especially for men who shouldn’t be using it. It has been linked to an increased risk of heart attack and stroke, and nearly 4,000 reports of serious complications.

A study published in JAMA Internal Medicine looked at ten years of androgen research and found that only half of those with a testosterone therapy prescription had been diagnosed with hypogonadism in the previous year. Similarly, the FDA found that 25% of men using testosterone therapy had never had their hormone levels tested, so there was no definitive way of knowing whether or not they needed the drug.

“The permissive guidelines [for prescribing testosterone] offered a ticket for drugmakers to just go full-bore with advertising campaigns,” Thomas Perls, a professor at Boston University, said in an article for Forbes.

Because of this spike in off-label prescriptions, the FDA demanded that testosterone therapy labels specify that they were only recommended for men with hypogonadism or other serious injuries.

Adverse Events Have Soared

One consequence of unnecessary prescriptions is a steep increase in adverse event reports.

In 2004, the FDA received 206,000 adverse event reports for medications and medical devices. In 2015 that number reached 1.2 million.

The FDA is now considering a policy change to allow drug companies to advertise off-label uses, which would likely only cause the number of adverse events to increase.

In 2015 the FDA received 1.2 million adverse event reports.

Currently drug companies are only allowed to advertise the FDA-approved uses of a given drug or device. Doctors can prescribe a medication for off-label purposes, though, and a 2006 study reveals that this is the case for one out of every five prescriptions.

Unfortunately, off-label uses typically aren’t supported by strong safety data. In fact, off-label prescriptions are 54% more likely to cause adverse side effects.

Doctors Feel Pressured to Prescribe

However successful direct-to-consumer drug advertising is, doctors are still the last line of patient defense. In many cases, though, this isn’t a hurdle for patients who want a particular medication.

Many doctors admit to prescribing drugs to patients if they ask for it—even if they think it’s unnecessary. A Medscape poll conducted last year found that 62% of doctors would prescribe an unnecessary drug if a patient demanded it.

Sixty-two percent of doctors would prescribe an unnecessary drug if a patient demanded it.

A 2005 JAMA study involving actors pretending to be patients saw this in action. In the first group, the patients reported classic depression symptoms that usually prompt further treatment. The second group expressed that they felt down after recently becoming unemployed—a state for which doctors would usually wait before prescribing an antidepressant.

One group of patients mentioned Paxil (an antidepressant), while the other group didn’t. Researchers found that doctors were more likely to schedule mental health appointments and prescribe antidepressants for the patients that mentioned Paxil, regardless of the severity of the symptoms they reported.

While doctors are supposed to have our interests at heart, they admit to worrying about retaining patients and avoiding lawsuits. But, even more dangerous are the number of doctors being paid by drug companies. ProPublica found that doctors who receive money from pharmaceutical companies are more likely to prescribe their drugs.

Hold Drug Manufacturers Accountable

Until Big Pharma’s advertising empire is reined in, patients must continue to be vigilant and question the information they receive from drug companies.

To find out if your medication has harmful side effects, check out our information on current drug lawsuits. If you or a loved one were harmed by a drug or medical device, reach out to our team of attorneys for a free, no-obligation legal review. We will help determine if you have a case against the manufacturer.

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