Prescription Drug Commercials: Educational or Unethical?

My Dear Reader,

My Madre is a big believer in staying informed and educated after formal education has ended, and it's not hard to catch her reading things like Scientific America or watching programs on C-Span. One of her favorite programs happens to be on C-Span 2, called U.S. Senate, which is essentially a recording of the proceedings in the Senate and House of Representatives, and, as you can imagine, is just about the most boring thing imaginable. Last week, I woke up to find that Madre had turned this program on and fallen asleep on the couch opposite me. Since it was two days after my surgery and it was painful to move, and since the remote was well out of my reach, I was essentially stuck there until someone came by to rescue me. I was not pleased.

I'm sure that it's not hard to understand the complete agony that I was in. But as I was debating as to whether the pain of watching congressional hearings was more excruciating than the pain in my newly-bolted shoulder, I realized that it was a hearing about one of those congressional subjects that I'm actually interested in: the ethics of commercials for prescription medications. It's one of those subjects that gets more interesting the more you learn about it. For example, did you know that the drug companies get six dollars of revenue for every dollar they spend on advertising? Of course, prescription drugs are generally considered to be good things, but there's a reason that you have to go through a doctor to get them: they're a little more dangerous than other things you might see advertised on the television. And when they're put in the same sphere as things that you can just get whenever you want, like McDonald's, it's easy to get confused. And sometimes, the commercials themselves don't exactly help.

For example, part of the testimony given at the hearing was a study that showed that these commercials tend to present the benefits of their drugs in a prominent, easy-to-remember fashion, while presenting the side-effects in a way that made them easily forgettable. In one instance, a commercial had a flying bee that hovered unassumingly while the narrator spoke of the benefits, and flapped its wings when the side-effects were being described, essentially distracting the viewer. At the same time, many commercials try to "sell" their drug as something other than it is, touting benefits that aren't what the FDA approved them for. It's these kinds of problems that raise some concerns with these commercials.

One of these concerns was that people will sometimes trust these often misleading commercials more than their doctors. Most of the time, when a person goes to the doctor to ask about the drug he or she saw on T.V., the doctor will prescribe instead a lifestyle change (such as a diet, etc.) or an over-the-counter medication. When this happens, however, some patients will get upset that the doctor will not prescribe them the medication that they saw on T.V. and switch to another doctor. This kind of reminds me of when I was five and convinced that I had to have a Happy Meal in order to be considered a human being. When Madre and Padre refused my many requests, I remember wishing that I could switch parents, but it wasn't as easy as switching doctors. In both cases, however, there was one party that had the responsibility of making decisions based on superior knowledge and experience, and in both, this party is also obligated to act in the absolute best interest of the less-informed party. And when patients think that they know better than their doctors, there's trouble a-brewing.

Another concern is that while the FDA has the responsibility to approve the drugs themselves, it does not have the authority to pre-approve these commercials to ensure clarity and accuracy. When the FDA comes across a commercial that they find inappropriate, they are able to demand that the commercial be taken off of the air, but this process could take from six months to a year. By that time, most of the damage has already been done.

A third and more brief concern is that the money spent on advertising drugs make these drugs more expensive, and most people aren't aware that many medications have a generic alternative that is chemically identical to its brand-named competitor. Since drugs are already expensive enough, this can be a problem. Of course, the easiest way to solve it is to always ask the doctor to prescribe a generic if available.

On the other hand, though, there are definitely benefits to having the commercials on the air. One of the benefits is that it informs people of possible treatments, some of which are new. So if a patient came down with Malady X five years ago, and after consulting a doctor about possible treatments for said malady discovered that none were available, it would be a good thing if he or she saw Commercial Q five years later, which would allow him or her to learn that Cure J was now available. How wonderful for him or her.

Anyway, I think that by now my opinion on the subject has been made clear, due to my not-so-balanced treatment: I think that these commercials, while informative, often mislead the viewer in a most unethical matter. That's why I think that each commercial for a prescription drug should be approved by the FDA. I also think that people should realize that a prescription drug is not a Happy Meal. In all cases, I'm glad that Madre has the wisdom to keep herself and her children informed.

Regards, best wishes, and not Malady X,

-Cecily Jane

P.S. By the way, I would like to announce that for their awkward treatment of embarassing subjects, Drug Ads have won the Plain Vanilla Thanks-for-Sharing Award: