At war with Big Pharma over TV drug ads

The practice of advertising medications on television is a very bad idea.   I came of age in the medical profession when doctors didn't advertise (just a discreet listing in the yellow pages).   It was considered unseemly to do more, and advertising medicines?   That put your product in company with Carter's Little Liver Pills and Hadacol -- what we used to call "snake oil," hawked by shysters.

Somehow we got from that to now, with drug ads a multibillion dollar business.  And, for me as a tv consumer, it is intolerably annoying --how many times during one tv program do we need to be informed of the benefits of Cialis?    But it's more serious than just annoying.  It has reached the danger zone -- in the U.S., that is.

Jonathan Cohn has written an important piece for Huffington Post on where things stand. 

"In fact, the U.S. is one of only two developed countries in the world that allow drug companies to advertise their products on television. (The other is New Zealand . . .) One study, from the Journal of General Internal Medicine, found that 57 percent of claims in drug ads were potentially misleading and another 10 percent were outright false. . . .

"Last year, the pharmaceutical industry spent $5.2 billion on ads promoting specific drugs—an increase of 16 percent over the previous year. At a time when most other industries are spending less on television advertising, drug companies are spending more. They are also devising new forms of so-called direct-to-consumer outreach, like smartphone apps that consumers may not even realize are a form of marketing and that the FDA is still figuring out how to regulate. . . . 

"Concerns about direct advertisements of pharmaceutical products have become so acute that last November the American Medical Association called for an outright ban, saying that the practice was 'fueling escalating drug prices.'  Spending on prescription drugs already accounts for about one in every six dollars that go into medical care. . . .One of the reasons for the increase is the massive sum that manufacturers pour into advertising."

And then there is the much more serious ethical problem of the pharmaceutical industry pretending to supply reliable information, when in fact they are employing very skillful marketing techniques to create a demand.  Or they promise faster or better relief, then offer a slightly modified drug that is often minimally effective -- at much greater cost than existing remedies -- to a captive audience that has no way of evaluating the truth of their advertising.  Manipulating research data, the coercive influence of their money on academic studies, control over what gets published in scientific journals -- that's all part of the problem.

One current instance of this is Belsomra, a new sleeping medication marketed by Merck, which they tout as a completely new approach to insomnia -- and which they expect to generate more than $300 million in sales this year.  It seems that this does work at a different neurophysiological level than the standard Ambien and Lunesta, which Merck hopes to displace as the leading insomnia drugs.

But, according to information that Jonathan Cohn has unearthed from an academic scientist who reviewed Merck's research data for the FDA, all the hype conceals the fact that, in Merck's clinical trials, Belsomra is not really significantly better.   The company's own data -- in contrast to their advertising hype -- shows:

"People taking Belsomra fell asleep, on average, only six minutes sooner than people taking a placebo and stayed asleep for a mere 16 minutes longer."

And note:  this was in comparison to a placebo -- not to other insomnia drugs.  In addition, there were serious side effects: 

"Some test subjects experienced worrying side effects, like next-day drowsiness and temporary paralysis upon waking. For a number of people, these effects were so severe that the researchers halted their driving tests, fearing someone would get into an accident. Because of these safety concerns, the FDA ended up approving the drug at a lower starting dosage than the company had requested—a dosage so low that a Merck scientist admitted it was 'ineffective.'”

This is what Merck is presenting to an unsuspecting public as a "sea change" in insomnia treatment.

I think we need to take the drastic step of banning television advertising of pharmaceuticals -- like most other countries.   But, with Big Pharma's lobbyists on Capitol Hill, and the Supreme Court likely to rule in favor of the "free speech rights" of the business community, we may be stuck with it.    Remember, "corporations are people."  Thus saith the Roberts Court.

But there are intermediate steps that could be taken.   Hillary Clinton reportedly favors eliminating the tax deduction for advertising costs.    Bernie Sanders has even more radical plans for reforming health care.  I'm sure we'll hear more about this.   With the AMA calling for an outright ban on tv ads, it's going to be an ongoing discussion, one that we need to have.

Ralph