As drug prices rise, so do ads promoting them,
SO ARE TV ADS PROMOTING THEM
Aim is to get patients to remember drug ’s name, then ask for it
Laura Ries was moved to action when she saw a TV commercial that portrayed a woman enjoying time with her grandchildren after taking Lyrica, a prescription medication for diabetic nerve pain. Ries’ elderly mother suffered from just that problem.
“The ad showed someone who was enjoying life again,” said Ries, president of a marketing strategy firm in Atlanta, who then researched the drug and spoke with her mother’s doctor. “This … was very relatable to what my mom was experiencing.”
Her reaction was precisely the aim of direct-to-consumer (DTC) advertising: getting patients or their family members to remember a drug ’s name and ask by name for a prescription.
Spending on such commercials has grown 62% since 2012, even as ad spending for most other product types was flat.
“Pharmaceutical advertising has grown more in the past four years than any other leading ad category,” said Jon Swallen, chief research officer at Kantar Media, a consulting firm that tracks multimedia advertising. It exceeded $6 billion last year, with television picking up the lion’s share, according to Kantar data.
But the proliferation of drug advertisements has generated new controversy, in part because the ads inevitably promote highpriced drugs, some of which doctors say have limited practical utility for the average patientviewer. The cost of Lyrica, the drug Ries asked about for her mom, is about $400 for 60 capsules, for example. Critics say the ads encourage patients to ask their doctors for expensive, often marginal — and sometimes inappropriate — drugs that are fueling spiraling health care spending.
The American Medical Association took a hard-line position on these ads in 2015 by calling for a complete ban, saying “direct-toconsumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”
Such a prohibition is unlikely. Prior efforts have stalled, generally on free speech arguments by the powerful drug lobby and assertions that such ads provide valuable information to patients about treatment options. SPENDING ZOOMS One thing is certain: DTC advertising is big.
Some programs — the nightly news and sitcoms aimed at older Americans — get most of their advertising from drugmakers. A Kantar analysis shows 72% of commercial breaks on the CBS
Evening News have at least one pharmaceutical advertisement. Commonly, the ads target a range of conditions that generally affect this demographic, such as dry eyes, erectile dysfunction, pain and constipation. Sixty-two percent of commercial breaks during General Hospital include a drug ad.
“A lot of these ads target the caregivers and the children of older folks,” said consultant Tom Lom, a former managing partner of Saatchi & Saatchi Consumer Healthcare, which created ads for pharmaceutical giants from Pfizer to Merck.
Drugmakers were on track to spend an estimated $6.4 billion on DTC advertising in the U.S. last year, up 5% from 2015, according to Kantar. In 2012, spending for pharmaceutical TV ads was the 12th-largest category. By last year, drug ads were sixth. While substantial, the spending was less than the amount spent by automakers, retail and restaurants. Networks — ABC, CBS, NBC — along with cable channels such as CNN draw a lot of the pharmaceutical advertising. According to Swallen, the effect of the ban on networks would be a daunting 8% loss of total ad revenue, and its impact would be most evident for programming popular with viewers older than 60 — for instance, evening news shows. WHY SOME DRUGS ARE ADVERTISED For years, the DTC industry mostly was focused on drugs that relieved typically non-fatal afflictions such as heartburn (Nexium), allergies (Claritin) and high cholesterol (Lipitor). More recently, advertising has focused on cancer and illnesses affecting seniors. Ads for drugs that target constipation caused by other drugs — opioids — hit the scene last year, reflecting the large numbers of people taking painkillers. In 2016, the top three ads based on total spending were Lyrica ($313 million); rheumatoid arthritis drug Humira ($303 million); and Eliquis, a treatment for a type of heart arrhythmia ($186 million), Kantar says. Reasons why some drugs are advertised more than others vary, with drugmakers evaluating which products are most likely to bring them the most revenue. HOW ADVERTISING PLAYS TO CONSUMERS The U.S. is one of two countries — the other is New Zealand — that allows DTC advertising, a longstanding practice that became more common in the mid-1980s after the FDA issued new rules. More television advertising began appearing when some of the rules were relaxed a decade later.
Lom said the ads give consumers a “head start” on knowing about drugs that might be available for their ailments. But, surprisingly, 62% of physicians said they would or might prescribe an innocuous, even placebo, treatment to a patient who didn’t need it but demanded it, according to a 2016 poll by Medscape, an online physician education website.
Current rules require that if a drug is named in an ad, information must be included about side effects/adverse reactions. That makes it even more important that it’s visually captivating.
The ad for Spiriva, a drug for people with lung diseases that can make it hard to breathe, shows an elephant sitting on actress Jeanette O’Connor’s chest. During the 2016 Super Bowl, viewers saw a man emerge from a restroom with a pleased look on his face in an ad about opioid-induced constipation. Meanwhile, the side effects are glossed over.
And while President Trump said he wants to reduce the high costs of prescription medicines, he is expected to encourage fewer government restrictions on the development and marketing of drugs. But whether the advertising empowers patients or leaves them vulnerable is debatable.
Those that do advertise appear to have a leg up. Ries says it wasn’t just the ad that helped her to remember Lyrica, but the name, too, which was easy to spell and pronounce. Reis said her mother did take Lyrica “and it’s helped.” That’s a good thing, says the brand guru who takes pride in looking out for her mom. “The ad spurred the conversation.”