by Virginia Suarez [firstname.lastname@example.org], a UNC student in public health.
Controversy around heavy advertising of prescription drugs (often called Direct to Consumer or DTC advertising) has been on the rise recently with an increasing number of questions around effectiveness and safety. Just a few examples of recent scandals and drug recalls include:
Vioxx linked to serious adverse events including heart risk, stroke and death
Accutane linked to birth defects and increased risk for heart and liver damage
Ketek linked to liver damage including liver failure and deaths
Zelnorm linked to increased heart attacks and strokes
Lotronex linked to ischemic colitis and multiple deaths
Consumer advertising spending by the drug industry has more than quadrupled in 7 years. According to a Congressional Research Service report, it increased from $791 million in 1996 to $3.2 billion in 2003, for mostly 50 brand name drugs. Overall health costs have nearly doubled over this same time period. Getting this spending under control is a key part reducing health costs both in North Carolina and nationally.
The medical profession agrees. Doctors overall tend to view DTC advertising negatively. Survey results, published in the Archives of Internal Medicine, concluded that a majority of physicians felt that DTC advertisements increase overall drug consumption (61.9%), do not provide enough information on cost (94.9%), lead to patients’ request for specific drugs (80.7%), do not do a good job of informing patients of side effects (54.8%), do not provide sufficient information on alternative treatments (94.9%), increase patient visit times (55.9%), and need better regulation (68.8%).
The FDA also may slowly be waking up to this situation. Before the pharmaceutical company Merck pulled Vioxx out of the market in September 2004, Dr. David Graham of the FDA reported that an estimated 88,000-140,000 excess cases of serious coronary heart disease probably occurred in the USA with a 44% fatality case rate.
DTC advertising not only increases cost of prescription drugs but more importantly it puts many people at risk of serious adverse events including death. Banning DTC advertising is a good first step to start getting costs under control and improving the health of patients.