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Direct-To-Consumer Advertising Takes Direct Hit From FDA

May 31, 2005 | Investor's Business Daily
Direct-To-Consumer Advertising Takes Direct Hit From FDA

It Pays To Advertise. But Sometimes Ads Can Boomerang.

That's the lesson big drug firms learned from their direct-to-consumer ad efforts. Those vague TV commercials for pills to treat virility, acid reflux and hay fever have backfired, says the Top Gun of the industry's own trade organization.

Billy Tauzin, the former congressman who heads the Pharmaceutical Research and Manufacturers of America, proposes that drug firms embrace a voluntary code of ethics for drug advertising.

Many ads offer little or no real information and merely hype high-margin products, Tauzin says.

"People don't see the new technology behind the pill," he said. "All they see is what's on TV. If that creates a bad image, it hurts the industry."

A bad image is exactly what many drug ads have created, says Bruce Vanden Bergh, professor of advertising at Michigan State University. In an effort to build business, too many ads raise consumer anxiety.

"Some ads create the ailments they purport to cure," Vanden Bergh said. "This is what advertisers do when they're heavily regulated. They can't make specific verifiable claims, so they make their messages ambiguous."

The Food and Drug Administration, which regulates drug industry advertising, has been cracking down.

In April the agency ordered Bayer (BAY) and GlaxoSmithKline (GSK) to withdraw commercials for Levitra, a virility drug co-marketed by the two firms.

The FDA nailed the 15-second spot on three counts: It did not state possible side effects, did not prove its claim of superiority over competing drugs, and could not substantiate the claim that it gives women greater sexual satisfaction with their partners.

Mixed Messages?

It's not as if the FDA hadn't warned the industry. In November the FDA ordered a Pfizer (PFE) ad for Viagra off the air for similar reasons.

But the FDA helped create the problem in 1997, when it approved direct-to-consumer advertising on television.

Drug companies spent $158.9 million on TV ads in '97. Last year they spent more than $4 billion on all forms of advertising. The U.S. and New Zealand are the only two countries that allow pharmaceutical pitches direct to consumers.

Drug makers have pushed more ads in front of consumers because their stocks are down, says Russell Gilbertson, a medical doctor and analyst for Caris & Co.

"(The result is that) many drugs are being used for things not intended," Gilbertson said. "The marketing that's going on tends to promote the drug beyond its label indications. Advertising could be a good thing because it could provide some education, but it's not now."

Direct-to-consumer drug ads put a burden on doctors as well, says Richard Kravitz, a medical doctor and head of the University of California, Davis, Center for Health Services Research.

Doctors Are Five Times More Likely To Prescribe A Heavily Advertised Antidepressant.

Kravitz authored a report in the April 2005 Journal of the American Medical Association based on a study that showed doctors are five times more likely to prescribe a heavily advertised antidepressant if a patient said he saw it on TV.

In an analysis in the same issue of the Journal of the American Medical Association, Matthew Hollon, a medical doctor at the University of Washington's Medicine Department, compared U.S. drug demand to that in Canada. Canada bans direct-to-consumer advertising.

"Patients in the United States were twice as likely (as Canadians) to request advertised drugs and . . . those who requested (direct-to-consumer advertising) drugs were nearly 17 times as likely to receive a new prescription," Hollon wrote.

The picture isn't all bleak. Advertising has helped destigmatize some conditions, Kravitz says.

"Ad campaigns have impressed on the public that depression is a medical condition with a biological substrate," he said. "And before advertising, patients wouldn't talk to us at all about erectile dysfunction."

The problem is the medium: TV.

"It's hard to explain in a 30-second spot that major depression is a serious and treatable disorder, but not every episode of sadness needs to be treated with a pill," Kravitz said.

Doctors themselves are not just innocent bystanders. A 2004 report for the Web site of the medical journal, Health Affairs, said almost 80% of doctors think direct-to-consumer advertising encourages patients to seek drugs they don't need.

Yet doctors give in.

"In our study, doctors did not exercise much resolve in turning away patients with mild depressive symptoms when they requested antidepressants," Kravitz said.

That's partly because saying no has consequences like losing the patient to a competitor.

Conflict Of Interest

The biggest problem might be a clash of cultures between science and marketing, says Tauzin.

"Marketing departments have a single focus to sell products," he said. "The research departments have a social conscience. That disconnect has to get cured."

Tauzin's solution? The code of ethics he proposes.

"It will inform the marketers (that) ads have to target those with the problem or disease and stop pushing drugs on those who don't have a need," he said.

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