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Ethics Matters

The Double-Edged Sword of Drug Marketing

August 9, 1999
Web posted at: 12:14 p.m. EDT (1614 GMT)

by Jeffrey P. Kahn, Ph.D., M.P.H.
Director, Center for Bioethics
University of Minnesota

You can't open a newsmagazine these days without finding pages of glitzy ads for prescription drugs. Drug marketing directly to consumers has exploded over the past few years: A reported $1.3 billion was spent on such advertising in 1998, more than double the amount spent in 1996. This may seem logical for a culture that has come to expect overstated claims for products and advertising pitches that rely on sex appeal, but for some it is going too far. Should prescription drugs be marketed like cars, beer and shampoo? Or are they a special kind of product that demands special treatment in the marketplace?

for Bioethics

What's your opinion?
Empowering patients?

Pharmaceutical advertising combines medical information for the lay public with images of a healthy and carefree lifestyle. There are photos of smiling, vital people and colorful hot air balloons, along with pages of text -- both basic information in normal-sized type as well as paragraphs of medical indications, side effects and disclaimers in microtype.

The information in these ads does a service in addition to encouraging patients to ask doctors about specific drugs. It educates consumers about the latest developments in drugs for particular illnesses and provides information about what patients can expect when receiving certain treatments. This information must be accurate to do its job, however; and the federal Food and Drug Administration (FDA) has been reprimanding drug companies for creating ads with misleading and even false information.

The FDA continually identifies violations of federal drug advertising rules, citing everything from benefits yet to be proven for a drug for osteoporosis to contraceptive ads that "virtually ensure that consumers will have trouble fully comprehending any of the information."

Can doctors keep up?

Besides needing to stay as informed as their patients about the latest drugs, doctors must now untangle whatever misconceptions are created by ads or convince a patient that a newly released drug is not the panacea it's claimed to be. Patient education is certainly part of what physicians ought to do, but it is already difficult in an era of shortened patient encounters without the need to undo what Madison Avenue has worked so hard to accomplish.

Created demand meets constrained costs

There is significant pressure on drug companies to promote their products, particularly new drugs that have been brought to market after expensive research and development. These drugs need patients to take them and health plans to pay for them, and the combination is bound to create tension, especially as prescription drugs become the focus of continued increases in health care costs. It used to be that physician expertise was about all that decided how drugs were prescribed, and so drug companies would do what they could to influence a physician's mind. But now better informed and more demanding consumers ask for specific drugs and may refuse to accept generic substitutes. As managed care organizations implement drug formularies that restrict what can be prescribed, both physician and patient demands will be increasingly harder to satisfy.

More information about prescription drugs is a good thing -- it can keep patients better informed and help physicians deliver better care. But information in drug advertisements must be correct, understandable and useful. Our society is so used to ads for everything from chicken soup to attorney services that it seems natural to learn about prescription drugs in the same way. But the stakes are higher with prescription drugs, and so should be the standards by which they are sold.

There has been an explosion of prescription drug marketing directly to consumers over the past few years, with a reported $1.3 billion spent on such advertising in 1998, more than double the amount spent in 1996. Should prescription drugs be marketed just like cars, beer and shampoo, or are they a special kind of product that demands special treatment in the marketplace?

Post your opinion here.

Visit the
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.

"Ethics Matters" is a biweekly feature from the
Center for Bioethics and CNN Interactive.

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