Direct-to-consumer pharm ads need to be regulated

Anyone who has watched television in the last 20 years has most likely seen direct-to-consumer pharmaceutical advertisements — probably about erectile dysfunction, an anti-depressant or an autoimmune treatment.

With the ever-increasing costs of pharmaceuticals for consumers and doubtful benefits to pharma companies, these pharmaceutical ads should be banned.

Surprisingly, direct-to-consumer pharmaceutical advertisements have been allowed only since 1985, but were not a a major factor until the Food and Drug Administration eased regulations about side-effect details in 1997.

According to market-research firm Kantar Media, pharm-industry spending has increased dramatically, from $4.3 billion in 2014 to $5.4 billion in 2015 and has tied the record-high spending from 2006.

Despite the increase in spending, a 2005 study in the Journal of Economics and Management Strategy found that only 30 percent of consumers discussed the ads with their doctors. Furthermore, only 43 percent of those that discussed the ads were actually prescribed the drug they asked about.

While 81 percent of consumers say they believe that these ads inform them of pharmaceuticals, the ads often misinform consumers by glossing over the side effects while overemphasizing the benefits. For example, in 2009 the makers of Yaz, a birth-control pill, received an FDA warning letter for unsubstantiated claims that Yaz could reduce acne and menstrual symptoms.

Adding to the detrimental effects of these ads are the waste of appointment time and the potential strain on relationships between Americans and their health-care providers. Explaining why a particular drug is not best for a patient may leave a patient feeling that their voice is not heard. And patient pressure on doctors after seeing these ads could lead to inappropriate prescribing.

The American Medical Association called for a complete ban on these ads in 2015 but the attempts remain stalled due to a powerful and persuasive drug lobby. The AMA cited the negative economic impact for new and more expensive drugs, even when these drugs may not be appropriate.

How heavy an advertising push do pharmacuetical companies put behind their drugs?

The Congressional Budget Office found that for single-source brandname drugs, upwards of 30 percent of total revenue is spent on direct marketing to consumers.

From 1999 to 2008, the direct-to-consumer promotional spending for 73 newly approved drugs was $71 billion. At just under $1 billion per new drug, a valid argument can be made to redirect some of those advertising dollars toward research and innovations.

The United States and New Zealand are the only two countries in the world that do not ban pharmaceutical advertising to consumers. Which begs the question: Why?

Yes, in this political climate, it is unlikely that a blanket ban could be passed. But at a minimum, new product ads should be delayed until the safety profile has been updated based on postmarketing surveillance.

A 2017 JAMA study found that in a third of the medications the Food and Drug Administration gave approval, the agency took some type of action to address safety issues that occurred after the drugs went on the market. Direct-to-consumer advertising immediately after drug approval raises the chances of more people affected by those issues.

Currently, only 10 states have laws on pharmaceutical marketing, mainly regarding reporting costs and disclosing payments. No state has a complete ban.

Arizona could take the lead and consider prohibiting or delaying direct-toconsumer advertising.

Emily Yee is an Arizona native and is in a master of public health program through George Washington University. Email her at emily_yee@gwu.edu.