Dr. Samuel Woo doesn’t trust drug company reps. It’s not so much
that they’re part of a multi-billion dollar advertising machine.
It’s just that the prescription drugs they’re pushing are often new
and unproven in long-term studies.
Dr. Samuel Woo doesn’t trust drug company reps. It’s not so much that they’re part of a multi-billion dollar advertising machine. It’s just that the prescription drugs they’re pushing are often new and unproven in long-term studies.
“I’m very conservative,” said Woo, vice chairman of medicine at St. Louise Regional Hospital and an internal medicine specialist. “I don’t go with the new drugs to begin with. I want to see how they work and if they have any problems.”
Popular, Food-and-Drug-Administration-approved drugs can still have significant unforeseen problems.
Case in point, the arthritis drug Celebrex, which was recently pulled from pharmacy shelves after studies linked it with increased risk of heart trouble. An FDA advisory panel has since recommended that the drug be allowed on pharmacy shelves, albeit with a firm warning.
Advertisements for new pharmaceuticals used to be limited to trade journals and in-house information distributed by drug company representatives, who often throw parties for medical staffs, bring them lunch at the office or give office-related gifts from pens and notepads to clocks and paper plates.
But in August 1997, the FDA revised its guidelines regarding prescription drug advertising. They allowed companies to enter the forum of radio and television advertising without the need to list all product risk information, with the belief it would help to create consumer awareness of prescription drugs and foster a more complete doctor-patient dialogue.
Instead, direct-to-consumer advertising has become a profit booster for the $500 billion per year pharmaceutical industry, ensuring public clamor for new drugs and allowing companies to make profits on today’s shorter patents.
While Woo may take a wait-and-see attitude, it doesn’t mean patients will, and that’s exactly what companies are counting on, according to Harvard professor and former New England Journal of Medicine editor, Dr. Marcia Angell.
Angell, who authored the 2004 book, “The Truth About Drug Companies: How They Deceive Us and What to Do About It,” claims that drug manufacturers like Merck, Pfizer and Astra-Zeneca spend 2.5 times the amount they devote to new research on advertising and administration costs.
She also said the majority of the pharmaceutical industry’s new products are what she calls “me too” drugs.
These are pills that are virtually identical to existing market offerings, but get FDA go-ahead because they meet the requirement to be more effective than a placebo.
In the giant marketing machine of prescription drug companies, whose profits are greater than the rest of Fortune 500 companies combined, according to a 2004 Mother Jones report, direct to consumer advertising is a small but visible segment.
In 1998, the first full year after the FDA’s revised guidelines were unveiled, drug companies spent $1.3 billion of their $12.7 billion advertising budgets on direct consumer advertising, according to a Stanford University report.
In 2003, they spent $3.3 billion of their $25.3 billion advertising budgets, according to literature published by the industry group Pharmaceutical Research and Manufacturers of America.
“From the drug companies’ perspective, they try to promote their brand names as much as they can because that’s where they have spent most of their R&D budget,” said Dr. Jun Ma, a Stanford researcher who studied drug industry profits for 1998. “We have seen data that its use has increased dramatically over the last few years.
Even thought it has not been accepted with doubt, controversy, and both doctors and patients have expressed doubts over these methods, I think direct-to-consumer advertising is here to stay.”
What Ma would like to see in television advertising is balance.
Unlike free samples, which are handed out in doctors’ offices for a wide variety of ailments along with complete risk information, direct ads target a few fields of intense competition and are not required to list all potential risks of a drug.
In 1998, the top of these prescription categories were smoking cessation, allergies, urinary tract symptoms and menopause symptoms.
Today, drugs for erectile dysfunction, cholesterol, allergies and depression receive top billing.
Representatives of Pharmaceutical Research and Marketer’s of America, a pharmaceutical trade group, did not return a request for comment.
Advertisements generally push the 50 most popular drugs, according to the National Conference of State Legislatures, and the idea has paid off.
Between 1999 and 2000, the number of prescriptions written for the 50 most advertised drugs rose 24.6 percent, versus an overall 4.3 percent rise in prescription recommendations.
The rise in prescriptions has caused a resulting rise in overall health costs for Americans who, along with Canada, already shoulder 50 percent of the world’s drug costs, according to research done by the industry researcher IMS Health.
And the consequences of this FDA-approved issue have hit state treasuries hard, because patients demanding name-brand drugs are driving up the cost of state-run medical care.
Florida, Michigan, Oregon and Vermont are attempting to curb demand for name-brand pharmaceuticals by creating drug lists for Medicaid patients that push generics, and five states, including California, have enacted laws or resolutions that affect pharmaceutical marketing.
State Sen. Deborah Ortiz, D-Sacramento, introduced a 2004 bill that called on the president and Congress to recognize problems caused by direct-to-consumer advertising.
This term she has introduced a bill that would stop pharmacists from handing out prescription information cards sponsored by drug companies.
“They couch (advertisements) within the scope of the health information,” said an Ortiz staffer. “You go to the pharmacy to pick up drug X, and you get information with it. Patients have a very trusting relationship with their pharmacists, and it can look like they’re saying, ‘You should be taking this drug instead of what your doctor gave you.'”
The bill went to health and judiciary committees on Feb. 24, and must pass both before moving to the Senate appropriations committee, then to a majority vote, said the staffer.
In his Gilroy office, Woo said he will continue advising patients of the best drug for them, regardless of how much advertising a particular name is getting.
United States pharmaceutical companies register annual profits of just under $500 billion per year. To put that figure into perspective, try this on for size:
That number is roughly equivalent to what U.S. taxpayers contribute to education through federal, state and local taxes each year. It’s also equivalent to the amount of money stored in the Cayman Islands and the gross domestic product of Russia.
Sources: IMS Health,
the Washington Times and the
Center for Defense Information.