Since the FDA allowed prescription drug manufacturers to begin advertising drugs on T.V. ten years ago, consumers have been inundated with flashy drug commercials.  Drug companies are spending an ever increasing portion of their budget on commercials that feature talking bumble bees with exotic accents and cartoon characters that suffer from depression. So is direct-to-consumer (DTC) advertising good or bad?

Playing on Our Emotions?

Proponents of DTC advertising claim that the commercials aim to educate the consumer about their conditions and offer them treatment choices they can discuss with their doctor. Opponents claim that these types of commercials look at the drugs through rose-colored glasses and often play on emotions rather than facts.

Earlier this year, researchers at the Annals of Family Medicine revealed the results of a study they conducted on DTC advertising. They concluded that Americans view about 16 hours of drug ads per year. They looked at 38 randomly selected TV drug advertisements that aired during prime time on 4 major networks.  

Researchers found that nearly all DTC ads were based on emotional appeal.  They noted that the commercials used one or more of 7 types of emotional appeals to connect with the audience:

Researchers concluded that although nearly all of the commercials used positive appeal, more than two thirds also used negative appeal, often showing the character in a fearful state before using the product. One third of the commercials used humor appeal. Sometimes this was done by making fun of the character before they used the product.

In addition to the emotional appeals mentioned above, some of these ads appeared to use peer pressure to advertise drugs. In this study, 80% of the commercials showed the character receiving social approval after using the drug.

The study's lead author Dominick L. Frosch, assistant professor of general internal medicine and health services research at the University of California, Los Angeles adds, "We're seeing a dramatization of health problems that many people used to manage without prescription drugs." He went on to add that these types of advertisements send the message that people can’t manage their health without drugs and that without them, “your life will be less enjoyable, more painful and maybe even out of control.”  85% of the commercials featured the character regaining control after using the drug.

Full Disclosure? 
 
Researchers argue that advertisements are often vague about whether the consumer may legitimately need the drug or not. Researchers even claim that drug manufacturers may be trying to convince the public that they are sicker than they actually are and that they need drugs they don’t really need.

Most ads in the study were too eager to promote the use of the drug and did not provide details as to when lifestyle changes may be an alternative to drugs. In fact, some ads even appeared to suggest that lifestyle changes never work and that taking the drug is the only way to treat the condition. For example, one commercial for a popular cholesterol-lowering drug showed a woman suffering from high cholesterol even though she was extremely active, running 3 miles a day and eating salads for lunch.

Safety First? 

Vioxx was just taken off of the market because it was found to increase the risk of cardiovascular disease. Viagra, Levitra and Cialis have revised their prescribing information after many men developed blindness and hearing impairment after their use. Of course these side effects were found after the drugs were released to the public and heavily marketed.

 This is concerning to say the least. There are many in the medical community who are calling for stricter regulation from the FDA on DTC advertisements and perhaps the banning of such types of advertisements altogether. Unfortunately, it looks like the FDA is having a hard enough time regulating the volume of drugs on the market as it is. Data shows that the FDA has sent out less warning letters to drug companies for reckless advertising despite the fact that the volume of drugs on the market has increased.

Education and Empowerment? 
 
Ok. So what about the argument from drug manufacturers that these commercials are educating consumers? Researchers feel these ads do not contain the right balance of information to be educational. Many also feel a 60 second commercial could not possible contain enough information to properly educate consumers on a given drug or condition. Lastly, information in these ads are presented by a biased source.

Still, there are those (mainly representatives from drug companies) that claim DTC ads play a key role in educating patients. To their credit, a survey in Prevention Magazine did show that 29 million patients talked to their doctor for the first time about a health condition after seeing a DTC ad.

How Do We Feel? 
 
It is our feeling at Empowered Medicine that true empowerment and education is best when it is balanced and presented by unbiased sources. The viewing of these types of TV commercials are ok as long as they are taken with a grain of salt. Consumers should beware of what they see on TV, taking care to follow-up on any information with their doctor.