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As drug advertisements expand to ever-wider audiences, Northeastern experts debate whether such advertisements should be allowed.
Television audiences may recall the “O, O, O, O-zem-pic” jingle or how erectile dysfunction can be treated with two bathtubs on a scenic cliff.
If so, it’s a pretty good sign you’re either an American or a Kiwi — as only the United States and New Zealand allow drugmakers to advertise directly to consumers.
But as drug advertisements expand to the recent Super Bowl and ever-wider (and sometimes confused) audiences, Northeastern University experts debate whether such advertisements should be allowed.
“In general, the drug ads make me cringe, and I don’t think they are good for us,” says Jeanne Madden, an associate professor in Pharmacy and Health Systems Sciences in the School of Pharmacy at the Bouvé College of Health Sciences at Northeastern University.
However, Gary Young, director of the Northeastern Center for Health Policy and Healthcare Research and a professor of Strategic Management and Healthcare Systems at the university, says that he’s not opposed to direct-to-consumer advertising (DTCA) by drug companies.
“I think direct-to-consumer advertising is really consistent with where we’re going as a country,” Young said, noting the self-help movement and consumer technology that encourages constant health monitoring. “I think it’s also in line with what we believe as a country, which is that we like to see individuals have an active role in their own decision-making and probably a little less involvement on the part of the government in terms of sort of saying what information we should have and how we should be making decisions.”
Drug advertising — and concerns over drug advertising — have long been a part of American life, Madden notes, referencing ads from the early 20th century promoting “sanitized tapeworms” for weight management and noting the Vioxx scandal in the early 2000s.
But in the late 1990s, the U.S. Food and Drug Administration clarified guidance on what TV and broadcast ads needed to include for the pharmaceutical company to avoid legal trouble — essentially opening up DTCA for pharmaceuticals to broadcast on television.
Add in an aging baby boomer population and the development of “blockbuster” drugs — or drugs with annual sales of over $1 billion which, traditionally, contribute significantly to funding research and development for new medications — and the stars aligned for the rise of Big Pharma.
“Since then, the TV ads have just exploded,” Madden says.
In fact, pharmaceutical companies increased spending on direct-to-consumer advertising from hundreds of millions of dollars in 1995 to roughly $5 billion in 2006, according to a 2009 report by the Congressional Budget Office. Annual DTCA spending by pharmaceutical companies since 2016 has hovered between $6 billion and $7 billion.
But that DTCA explosion has raised concerns over whether the drug ads are appropriate — after all, in many countries, they have been outlawed.
Indeed, the American Medical Association and the American Society of Health-System Pharmacists have both urged in the last decade that direct-to-consumer drug advertising be banned, saying the ads essentially warp health information and communication about medications by pushing only the latest and most expensive drugs.
Madden and Young note that the debate is complex.
Madden notes evidence that the drug ads raise awareness around some serious health conditions and associated treatments and lead to more engaged patients.
Young notes concerns that DTCA can boost the use of some drugs, thus leading to higher prices. He also notes that in a world where consumer ratings for physicians can be tied to reimbursement — as well as a world of Dr. Google and WebMD — there are concerns that physicians will prescribe treatments that are medically unwarranted but which patients demand.
Moreover, as both experts point out — the Food and Drug Administration (for prescription drugs) and the Federal Trade Commission (over-the-counter drugs) do regulate what the drug ads can say.
“It’s not entirely the Wild West,” Young says. “The FDA and the FTC have joint jurisdiction, regulatory oversight, over this activity and we need them to be vigilant.”
“But I don’t see any major retrenchment away from direct-to-consumer advertising,” Young continues. “I think the idea of giving information to consumers directly is very much in line with how we think about health care culturally and politically.”
Madden adds that the enforcement seems “pretty effective.”
“The companies seem to try to follow what rules we have,” Madden says. “The drug companies and the media companies seem to enjoy having these ads, and I haven’t seen a big movement to make change in this area.”
“But it’s worth keeping a close eye on this,” Madden continued.
She expressed concerns that right-wing pressure to allow corporations to have more free speech rights along with the upcoming Chevron case before the Supreme Court and its potential to gut the jurisdiction of federal regulatory agencies, could mean major changes.
“I get a little ill even thinking about it, and I have difficulty imagining what would happen next,” Madden says. “If the FDA gets gutted by the Supreme Court, it’s possible there would be less FDA oversight or enforcement, more corporate freedom, and the ads could get wilder.”