Monday, October 30, 2006

Offensive

Like everybody else, I have gotten used to the unfortunate number of ads in which drug companies encourage consumers to push their physicians to prescribe the latest in expensive new therapies. But, the NYTimes Magazine had a supplement this weekend that, to me, was really offensive.

It was entitled "From cause to cure, a patient's guide to advances in mental health" and presented articles about Alzheimer's, bipolar disorder, epilepsy, and schizophrenia -- fully intermingled with full page ads from drug companies pushing their products which, by the way, were often featured in the articles themselves. I can't tell you how relieved I was to know that Bristol-Myers Squibb thinks that "treating bipolar disorder takes understanding"; that UCB is "the epilepsy company" that lets you have "life on your terms"; that Pfizer is "working for a healthier world"; that AstraZeneca is wants us to know that "sometimes there is another side to depression" -- and offers a postcard we can send in on which we list our diagnoses and what medications we are currently taking.

The articles and ads were illustrated by manipulative photos of people in various stages of sadness, thoughtfulness, and happiness. I believe that this kind of approach to reaching people -- especially those with mental illness -- and their family members is so cynical as to be offensive.

But, maybe I am just out of date and should learn to expect and accept this form of advertising. What do you think?

Please understand that I highly value the work these companies do: My problem lies in the way they deliver their message.

20 comments:

Anonymous said...

I agree with you, and I feel the same way about drug commercials on television. It almost seems as though the trend is to create "diseases," (i.e., "ED" and "Restless Leg Syndrome") so that the public can be coerced into asking for new, expensive drugs. I am wholly behind the biotech industry and the drug companies, because I think their research has made life immeasurably better for nearly everyone. But to wring every available dollar out of the public in this unnecessary way is not only offensive, but, in my opinion, dangerous. It undermines the ability of doctors to effectively treat their patients and is at least one cause of rising health care costs.

Star said...

I cannot abide the phrase, "Ask your doctor about..." For one thing, shouldn't the doctor know about this stuff and recommend it if appropriate? And secondly, it's not like you call the doctor and ask a question.

Anonymous said...

Restless leg syndrome is a real problem for people who have it. I agree that it is rare, and marketing goes over the top, but don't marginalize a real condition that keeps people from sleeping (a pretty necessary function) just because you don't agree with the way companies deliver the message.

fred trotter said...

I totally agree with your take on the ads, I just wonder how it is this kind of thing has happened? Some market force must be making this necessary. I would assume that the following applies, and if you disagree I would like to hear your assessment of "why do they do this?"...

In order for drug companies to survive, they need to convince doctors to choose their products. From a marketing perspective this creates an imbalance, since the "chooser" of the medication is not the "consumer" of the medication.

The trouble is that the drug companies have saturated and poisoned the standard marketing channel. They can no longer successfully market directly to the doctors. The doctors rarely take a claim that a new drug is "better" merely because the drug company says it is, since this has turned out to be false so many times. Further there are so many new drugs that generally doctors have trained themselves to ignore the constant marketing that they see regarding drugs. How do they actually make the decision about which drug to use? Who knows? But I think it is fair to say they are not simply listening to the drug companies any more.

I think that must be how you get such strange ads. After all, a patient really has to be motivated to go to a doctors and insist on drug X when the doctor is recommending drug Y for the same problem.

Anonymous said...

I'm not sure that drug companies are "creating diseases". However, I'd agree with you that they are highly motivated to "squeeze out every cent"(reinventing existing Rx with different dosing, etc.)

I also find it really frustrating to watch how marketing/advertising works within the realm of healthcare. Can we really say that these ads are driven with the intent of "educating" the consumer? I'd have to argue not - educating a consumer regarding a health condition involves much more than a glossy and sensational piece of marketing.

I think this kind of partial and biased information sharing is actually quite harmful to the public's perception of a health condition as well as the proper management of any such condition.

Anonymous said...

Do you know that Jane Pauley sued the New York Times for the last such supplement? Pauley said she thought the writer had misrepresented herself as writing for an "informational supplement" when she was actually writing for an "advertising supplement". http://www.nytimes.com/2006/10/26/business/media/26times.html
http://www.thesmokinggun.com/archive/1025061pauley1.html
This is different from the issue that you raised, although it is related.

Roy M. Poses MD said...

Unfortunately, over the top marketing now seems the rule rather than the exception for many kinds of health care organizations. On Health Care Renewal (http://hcrenewal.blogspot.com/) we have documented many questionable marketing tactics by pharmaceutical, biotechnology, and device companies.
Unfortunately, over the top marketing is not restricted to such companies, but is also seen in managed care/ insurance, and in hospitals and health care systems.
For an example of the latter, see this post: http://hcrenewal.blogspot.com/2005/03/how-academic-health-centers.html/
It would be nice if people who value their health care organization's mission could rein in the marketing types who tooo often seem to dominate health care organizations.

David Harlow said...

My favorite (apocryphal?) story along these lines: A woman comes in to her doctor's office with a magazine ad for an allergy medicine featuring a smiling bride in a field of wildflowers and says, I'm getting married, would you give me a prescription for this pill, please?

Direct-to-consumer marketing like this ("ask your doctor if _____ is right for you") is of a piece with the current trend towards consumer-directed healthcare generally. The federal government seems to think that market forces will improve health care (well, at least some of the federal government, some of the time).

Without dissing consumers generally, I think it is still fair to say that most of us are not equipped to make health care purchasing decisions without some expert input. Not because we are all more expert at analyzing the consumer electronics offerings out there than the health care offerings out there, but because the stakes are higher if we choose poorly.

BC said...

I think there is a big difference between a patient asking the doctor about a drug he or she saw advertised on TV and insisting that it be prescribed. Shame on any patient who insists on a prescription for a drug based on advertising but against the doc's advice.

Anonymous said...

Sadly, advertising works. We still think our hair is going to look straight and shiny, that beer makes you more popular. Who let the drug companies start advertising? Was it the FDA? Can this clock be set back?

margalit said...

The ads that bother me the most are the ones for ADHD medications. Isn't it hard enough for a parent to decide to medicate their ADHD child without the drug manufacturers feeding the anti-med frenzy. I'm so tired of people ASSuming that because I medicate my severely ADHD/bipolar child I apparently have fallen into the trap of 'believing' that medication is necessary when I should be following some ridiculous diet and restricting pretty much everything from his diet.

Every time I see an ADHD advertisement with some happy adorable kid post meds, I want to scream at how unrealistic this is. Honestly, ADHD is a huge problem and it isn't solved by a pill. It's solved by a combination of medication, therapy, and growing up and accepting that you have this problem and you need to continue to get help.

Daniel Haszard said...

Thanks for posting about this issue.

What irks me is that the Eli Lilly company's blockbuster Zyprexa has been implicated in causing TEN times greater risk of developing type 2 diabetes.
They then turn around and sell other blockbuster drugs to treat the same diabetes.
--
Daniel Haszard

Paul said...

A heads up: I have posted Daniel's comment without doing any independent analysis as to whether his assertions are correct or proven. I do so in the spirit of free and open discussion, but I make no warranty as to the accuracy of what he has said.

I welcome others' thoughts on whether you think I should post this kind of comment, i.e, in which the efficacy of a particular product is characterized.

Alexis said...

I don't think it would be fair for anyone to hold you responsible for the statements of others made in comment to your blog. As long as the comments are made with a decent amount of respect and politeness, even if the commenter is angry, then leaving them up their shouldn't put you in blogging etiquette/ethically questionable position. If people are going to buy into what anyone says without doing research into its truth (and I haven't looked into the Zyprexa issue at all), then that's not anything you have control over. If you're going to endorse a commenter's view, then you should definitely have the research to back you up, but otherwise, I think you're okay.

sunshine said...

While we're pointing a finger at the drug companies for all of the advertising, we need to look at the reason all this advertising exists. One word: Congress. The laws that allow this advertising, as well as the Medicare drug benefit, were created by legislators who were bought and paid for by this industry.

Without question, drugs save lives. But it's just wrong that our representatives in Washington put the pharmaceutical industry in driver's seat of public policy. I sincerely hope that the voters keep this in mind on election day.

Carolyn Kent said...

I'd like to address "Star's" comment. In today's world of consumer-driven healthcare, it very much IS like people to ask their doctors not only about treatment options, but about payment, insurance, etc. Consumers are beginning to take the reigns when it comes to their care, and I do not think it unreasonable for pharmaceutical companies to encourage this.

Also, we must remember that for most of these pharmaceutical companies, their #1 goal is profit maximization. After all, they are a business and hold obligations to their shareholders. I think that many of the comments on this particular entry reflect a societal issue that any organization in the healthcare industry (pharma companies, hospitals, etc.) are going to be under fire regardless of what they do. It's easier for consumers to point the finger of blame for high costs of care to the companies that actually provide the care than it is to try and understand what is fundamentally wrong with the healthcare system as a whole.

However, in direct response to this entry, I agree. I would have found that particular campaign offensive.

Anonymous said...

I am a doctor and I think that advertising drugs should be outlawed (as we do with tobacco products).

"Ask your doctor about..." is crap.

Carolyn Kent said...

To all the doctors out there, I am curious about how many of your patients actually DO ask you about a drug they've seen on TV or in a magazine. What is your typical reaction to these inquiries (if you have a "typical" reaction)?

Paul said...

Good question, Carolyn!

Maxine said...

I have mixed feelings but those ads. Sometimes I wonder if such conditions actually exist or have they just wasted funding and are now trying to recover costs. Other times I actually do ask about something.
Fortunately, my doctors are very cautious with me and my allergies. If there is a disclaimer way down in the tiny fine print that says "a very small section of the population may get a respiratory allergy reaction", they have learned as I have that I'm that person.
so while I might ask about a medication, and they might write me a scrip for it, we both know I may or may not give it a try once I've read all the literature.