TV commercials for prescription drugs are longer and offer less factual information about the medical conditions the drugs treat than they did a decade ago, according to a study published recently in the Annals of Family Medicine. Instead, the commercials tend to focus on the lifestyle improvements the drugs supposedly offer.
That’s a troubling trend, write the study’s authors, because it means “the gap between educational and promotional content within the advertisements has increased.”
Policymakers need to take regulatory action, the authors stress, to make sure that drug ads on television live up to existing guidelines, which urge drug companies to to promote awareness about health and disease above the endorsement of products.
For the study, the researchers analyzed 61 separate prime-time, direct-to-consumer commercials for prescription drugs that ran on four major TV networks (ABC, CBS, NBC and FOX) during a 13-week period in 2016. The drugs were being marketed for a variety of medical conditions, including asthma, erectile dysfunction, psoriasis, type 2 diabetes, overactive bladder and depression.
The researchers then compared the content of those ads with 31 commercials for prescription drugs that were similarly analyzed in a 2004 study.
They found that the 2016 commercials were, on average, about 30 percent longer than the ones than ran in 2004. The newer commercials, however, contained significantly less educational information about the medical conditions for which the advertised drugs are prescribed. For example, the percentage of commercials that explained the risk factors that could lead to developing the medical condition mentioned in the ads dropped from 25.8 percent in 2004 to 15.8 percent in 2016, while those that described how common the condition was among the general population dropped from 24.7 percent to 15.8 percent.
On the other hand, the commercials spent a lot more time linking their products to positive lifestyle changes. The analysis revealed, for example, that 90.8 percent of the commercials in 2016 showed actors receiving social approval as a result of using the drug, compared to 83.1 percent in 2004. And 68.8 percent of the commercials in 2016 showed actors able to enjoy healthy or recreational activities as a result of using the advertised drug, up from 56.2 percent in 2004.
Furthermore, only 7.4 percent of the commercials in 2016 made any mention of how lifestyle changes, such as following a healthier diet and getting more physical activity, also benefit people with the medical condition. That was down from 22.5 percent in 2004.
“Direct-to-consumer advertising continues to promote prescription drugs above educating the population,” said Janelle Applequist, the study’s lead author and an assistant professor of advertising and mass communications at the University of South Florida, in a released statement. “Such expensive promotion of drug benefits could imply off-label outcomes [use of the drugs for purposes for which they are not approved] and encourage an inappropriately broad population to seek the advertised drug.”
Indeed, as background information in the study points out, other research has found that between 18 percent and 30 percent of Americans say they’ve visited a doctor to ask about a drug after seeing an advertisement for it.
Can they be banned?
“The pharmaceutical industry might claim that these ads are intended to raise awareness, but the general public is not the intended audience,” writes Dr. Milton Packer, a cardiologist and researcher at Baylor University, in an article published Wednesday in MedPage Today. “The only goal of these commercials is to prompt patients to initiate conversations with physicians.”
The tactic seems to work, which is undoubtedly why pharmaceutical companies spend $6 billion a year on such advertisements. “Practitioners report being bombarded by patient requests, and many feel pressured to prescribe drugs that have been requested by patients, even if they believe it is inappropriate to do so,” writes Packer. “And the conversation often wastes the limited time the physician has allotted to the patient visit.”
In 2015, the American Medical Association (AMA) voted to ban direct-to-consumer drug advertisements, but the proposal has not gained much traction among policymakers. As Packer explains, “The courts have ruled that product advertisements are a form of commercial free speech protected under the principle that a manufacturer has the right to market its products.”
Packer, who says he stopped working with a pharmaceutical company several years ago because of “a profound disagreement about their efforts related to direct-to-consumer TV advertising,” believes that other steps — short of an outright ban — can be taken to curtail direct-to-consumer advertising for prescription drugs.
“Right now, when a pharmaceutical company advertises, it is required to describe the major adverse effects of the drug,” he writes. “I would add two simple additional requirements. First, I would require manufacturers to describe the size of the expected benefit. This can be a statement of the placebo-correct effect on the primary endpoint of the pivotal trial(s) that led to approval. Second, I would require manufacturers to tell the public how much the drug costs. This should be the list price, not the discounted price (which companies do not disclose anyway).”
President Donald Trump has also proposed that drug companies list the costs of their products in their advertisements. The pharmaceutical industry has come out strongly against the proposal, however, so it’s not clear if drug prices will become permanent fixtures in TV commercials any time soon.
In the meantime, the responsibility for sorting fact from hype in prescription drug ads will continue to fall on the consumer. Caveat emptor.