Drug Ads Disservice to Patients and Doctors

 

They were once illegal and now they’re ubiquitous. I’m talking about pharmaceutical company advertisements on television.

If you watch television at all you know what I mean. It used to be that you went to your doctor to discuss medications that might benefit your health. Now you’re inundated with ads trying to lower your cholesterol, your blood sugar, and your “A1C” or raise your sexual performance. Worst yet, you’re told which cancer therapy drugs you should be taking if only you have the exact type of cancer they’re describing in terms you can’t understand!

As a doctor I can barely make sense of these ads so I wonder how the average consumer could possibly understand them. Then there’s the litany of side effects and complications they’re required to mention, so by the time they’re through you wonder why anyone would even consider taking them!

Who Benefits?

It’s hard to see how consumers benefit from this kind of advertising. They really can’t understand the medical language used to describe the condition nor the complex issues hastily covered in a few seconds. Yet many come to their doctors with unreasonable requests based on these misleading ads.

Dr. Melissa Young, writing for PhysicianPractice.com, says:

“I don’t like direct-to-consumer advertising of medications. It’s not the same as advertising for other things. There’s a difference between choosing which laundry detergent to buy and which drug is most appropriate.

On the one side, sometimes patients come in with vague requests. “You know that drug they keep advertising on TV? You know, the one that’s supposed to lower your a1c.” Um, you just described every diabetes medication.  Other times they are very specific, “Can I take drug W for my diabetes”. 

Sometimes the answer is yes, but most of the time the answer is no, because a) you don’t need it, b) you are already on something identical to it, c) you tried something like it before and had a reaction to it, d) you cannot be on it because you have kidney/liver/heart/etc. problems, or e) you said you can only take generic drugs due to cost (trust me, if it’s on TV, it’s expensive).  The bottom line is if I thought you should be on it, you’d be on it by now. 

Sometimes they are misled by the advertisement, or perhaps I should say, they misunderstand what is stated in the ad.  “I want to take the shot that’s just once a day.” You are already on a shot you take once a day, that’s your long-acting insulin.  “But I need to take the other shot before each meal.”  Yes, that’s your mealtime insulin, which you will still need to take even if you switch to the one in the ad.  “But the ad says you only need to take it once a day.” That is true, you only need to take it once a day; you still need your mealtime insulin.

Other times, since ads need to be “fair and balanced,” patients say, “I don’t want to take that drug, did you see the commercial? It says it can cause pain and bloating and infections and heart attacks and DEATH! Why would I take something that could cause death?”

Here are some other physician comments in response to her article:

“It was against the law when I started practicing; as was lawyer and doctor advertising! We should go back to the GOOD OLD DAYS!”

“I agree completely.”

Some disagree:

“It is a natural off-shoot of a for-profit medical system. Would we have many new medical treatments if the government ran it?”

Fortunately, in my practice of orthopedics I haven’t had many patients grill me on the drugs being advertised – because they aren’t in my specialty. But I’m sure internists, endocrinologists, cardiologists, and urologists must be inundated with the questions and requests. Perhaps oncologists must bear the largest burden of trying to explain why Drug X is not the cure for their cancer.

I’m all for informed patients who ask meaningful questions and I have a reputation for taking more time than most physicians to answer those questions. But I believe that these pharmaceutical ads, and internet medical web sites, actually undermine the trust between physicians and their patients.

Every patient needs to find a doctor they can trust for their medical decision-making – and then let that doctor guide those decisions. Drug ads aren’t helping that goal.

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