10: Most pharmaceutical ads are educational

Corollary- If There Are Advertising Lies, They Are Obvious

The assessment of the educational value of these ads depends on who is answering. PhRMA , speaking on behalf of the pharmaceutical industry, asserts :

A nationally representative survey of 32261 US residents concluded that poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples

 “America’s pharmaceutical research and biotechnology companies understand that accurate information about disease and treatment options makes patients and doctors better partners. And getting that information to patients and consumers is the goal of direct-to-consumer (DTC) advertising about prescription medicines. DTC advertising increases people’s awareness of disease and available treatments. Studies show DTC advertising brings patients into their doctors’ offices and starts important doctor-patient conversations about health that might otherwise take place.” PHRMA – Direct to Consumer Advertising

Research on physicians show that they hold conflicting opinions about DTCA- appreciating the conversations they stimulate patients to initiate with their providers and concerned that the material is misleading or misrepresenting health information. [Kravitz RL, Epstein RM, Feldman MD, Franz CE, Azari R, Wilkes MS, Hinton L, Franks P. Influence of patients' requests for direct-to-consumer advertised antidepressants: a randomized controlled trial. JAMA. 2005 Apr 27;293(16):1995-2002. ] Doug Paauw,MD, a general internist, explains, “One of the good things about direct consumer marketing is it’s brought up patients discussing their depression a lot more often. It’s brought a lot more men talking about their erectile dysfunction, that they never would because they were embarrassed by it and now, now it’s not an embarrassing thing, it’s on TV every half hour or so It brings it out where they’ll, and it gets those good discussions that maybe weren’t there before.”

Barbara Mintzes, a researcher on DTCA, expresses concerns: “What the advertising does is shift the threshold at which a person might consider using a medicine so we’re getting medicine used for milder and milder conditions. At that point there certainly are a number of situations in which the balance shifts so that actually the potential for harm becomes higher than the potential for benefit.”

“Because it focuses on new drugs, particularly when they’re harmful effects, and even the potential for benefits in the longer term are less well understood, there’s concern for public safety, …[with] very rapid widespread use of medicines when we really know very little about their effects in the human body because they’ve been tested on about 3,000 to 5,000 people, usually pre-market, and they might end up being used in millions of people afterwards. And we already found out with the situation with Vioxx that that could actually lead to considerable harm. Rofecoxib (Vioxx), the arthritis drug that was withdrawn from the market, was one of the most heavily advertised drugs on the market.”

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9: Most consumers aren’t influenced by DTCA

Corollary- DTCA Is Important Patient Education

A study of the effect of direct to consumer advertising found that in 2005, 53 billion patients asked their doctor for a DTCA medication. 80% of the patients who requested a medication got it. (Perri, Clin Ther, 1999) Jennifer Wesselius, pharmacy manager for one of Group Health’s clinics, comments on similar results from recent study by the Kaiser Family Foundation, “I think that says a lot in the way of advertising as it may not have been the best therapy for the patient, but because they asked for it and the provider may not have wanted to say no to the patient, they actually received the medication.”

Barbara Mintzes, quoted above, adds “DTCA is providing misleading information to people about prescription medicines, about the pros and cons of using prescription medicines, because the aim is to sell a product, the aim is not neutrally to provide health information to the public. It’s not education, it’s sales.”

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8: Most providers’ prescribing practices aren’t influenced by DTCA

Studies have shown that providers’ prescribing practices are changed by patients’’ requests for medications prompted by DTCA advertising. Mintzes, a Canadian researcher, found that the patients in Sacramento, California were about twice as likely to ask for an advertised medicine as the patients in Vancouver, BC , a Canadian border town that has minimal exposure to DTCA as the practice is prohibited in Canada but crossover American TV advertisements might be viewed. . But if patients asked for an advertised medicine, they were very likely to get it in both settings; about three quarters of the time they walked out of the doctor’s office with a prescription for that specific drug. If they didn’t get the drug that they asked for, they were very likely to be prescribed something else. So DTCA had an effect on prescribing volume as well, if you compared those consultations to the other consultations on the same days to other patients.

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7: Free samples are “free”

Corollary- Free Samples Help Poor People

Free samples can seem like a good thing as you’re giving a free medication to a patient who can try that medication and see if it works for them, but in, in reality you’re giving them a much more expensive medication than the patient may need because it’s free and it’s there instead of necessarily the right medicine to give to them. Free samples are generally for medications that are used long term and require a prescription to follow-up of the free sample. Analysis of patients out of pocket costs found that patients who received free samples spent about $166 in out-of-pocket costs on prescription drugs in the six months before receiving the samples, $244 for the six months in which they received samples.

A nationally representative survey of 32261 US residents by Cutrona et al concluded that poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples. While free samples are given to a wide range of patients, several recent studies have found that a majority of these samples are used by the doctors and office staff for personal use.

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