January 24, 2019
If you spend any time watching television, you are bound to see “real people” who appear to be healthy and happy bicycling down the road, hugging a grandchild, walking on the beach, or working in the garden. They mention the consonant-heavy name of a pharmaceutical drug you could use. “Ask your doctor, “an announcer suggests, after spouting the product’s benefits—and speed-talking her way through a scary list of side effects.
And it’s not just one ad; it’s several per prime-time show: A recently televised sporting event, for example, featured one ad for a drug to help you fall asleep, followed by another to keep you awake, according to an editorial in JAMA that was written by Howard Bauchner, M.D., and Phil B. Fontanarosa, M.D., (who are, respectively, the editor and executive editor of the Journal of the American Medical Association).
Indeed, according to a Dartmouth College study, over a 20-year period, from 1997 through 2016, drug marketing increased dramatically—from $17.7 billion to $29.9 billion; while regulation did not.
“Because the goal of medical marketing is to shape our perceptions of the benefits and harms of drugs, treatments, and even of diseases, themselves, it can have a very significant impact on healthcare and can even hamper efforts to control unsustainable healthcare spending,” says Dartmouth Institute Professor for Health Policy and Clinical Practice Steven Woloshin, MD, who co-authored the paper with his wife and longtime research partner, the late Professor Lisa Schwartz, MD. (Dr. Schwartz passed away in November 2018).
In their review of spending, Schwartz and Woloshin found that the most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9% of total spending) in 1997 to $9.6 billion (32% of total spending) in 2016.
Over the same time period, the total amount consumers spent out-of-pocket on their prescription medication also skyrocketed to $328.6 billion from $116.5 billion (after industry rebates and discounts), the study found.
Why the explosion in drug ads over the past 20 years? The study notes that in 1997 the Food and Drug Administration began allowing drugs ads to mention side effects with voice-overs, instead of scrolling through a visual list on the screen, which takes more time. Shorter ads can allow for more ads, says Dr. Woloshin.
Another possible explanation is that at the same time that drug companies are spending more on drug ads directed at consumers, they’re also spending more marketing the new drugs to physicians, says Adriane Fugh-Berman, M.D., an associate professor in the department of Family Medicine at Georgetown University who has studied drug advertising. That can increase “irrational prescribing and overuse of medication,” Dr. Fugh-Berman recently told Consumer Reports.
Perhaps the most important reason for the increase: “The ads work,” Woloshin says. “They increase patient requests and prescriptions for advertised drugs, even when there are lower-cost alternatives.”
Indeed, Consumer Reports notes, numerous studies suggest that drug ads increase healthcare costs by promoting higher-cost medications when lower-cost, older ones might work as well.
In recent years, the consumer-oriented news outlet reports, many TV drug ads have focused on expensive drugs used to treat relatively uncommon, and hard to treat, conditions, such as rheumatoid arthritis, psoriasis, rare cancers, and seizures, according to figures from Kantar Media for the year ending in October 2018.
What’s an inundated consumer to do? The magazine warns, those sorts of pricey meds may not be covered by your insurance, especially if you get insurance through your employer. A 2017 survey of employers by the Pharmacy Benefits Management Institute found that when it came to high-cost medications, most of the insurers required a person to try other medications first, required a person to obtain approval from the insurer for expensive medications before filling a prescription, or limited the amount of the drug a person could obtain. Fully 75% of employer plans simply did not cover certain drugs, including high-cost drugs, according to the survey.
There are alternatives, Consumer Reports advises: For complicated medical conditions, which may necessitate higher-cost medications, work with your physician and insurance plan to find covered treatments. Also check NeedyMeds for the drug you’re being prescribed to see what Patient Assistance Programs, manufacturer coupons, or other discounts might be available.
Research contact: firstname.lastname@example.org