In 1997, the Food and Drug Administration permitted prescription drug companies to start publicizing their products directly to consumers in television advertisements. Compelled by the persuasive spots, patients petitioned their physicians for drugs to alleviate mood disorders, cardiovascular issues, and various other chronic conditions. But two studies released this year both came to a sobering conclusion about this direct-to-consumer approach: While advertising is persuasive by nature, drug spots may actually be misleading.
In a report published in the Journal of General Internal Medicine, researchers at Yale University looked at 97 drug ads that aired on television in 2015 and the first half of 2016. Most were targeted to people with arthritis, diabetes, and other ailments that require continuous care. None of them offered objective information about the potential risks of the drugs; the focus was instead on relative improvement in quality of life. In 13 percent of the ads, the drug companies suggested that various diabetes medications could be used off-label to reduce weight or lower blood pressure, a violation of FDA policy.
The spots also emphasized positive results of clinical trials. These efficacy statements dominated the narrative, with statements like “most people using [the drug] saw 75 percent clearer skin,” or “my doctor said [the drug] helps my bones get stronger.” The Yale study concluded that these and similar claims were potentially misleading and difficult to analyze objectively.
Another recent study published in the Annals of Family Medicine [PDF] examined the abundance of lifestyle depictions in the spots. Rather than dwell on risk factors, the 61 ads that researchers analyzed were predominantly made up of footage that made a direct connection between using the drug and an improved quality of life. Many of the ads were addressing conditions (like diabetes and depression) that might benefit from therapies other than medication. Roughly 59 percent of ads depicted a person losing control of their life as a result of their condition, while almost 69 percent suggested the advertised drugs enabled a more active and healthy lifestyle.
The FDA is responsible for making sure companies don't mislead consumers, but critics charge that the agency is not doing its part. It doesn't review prescription drug ads in advance, nor does it restrict ad spending. “Everyone on the ads appears healthy, happy, dancing, and they get better,” internist Andy Lazris, M.D. told Health News Review. “So people are led to believe a) the drug will be effective (which is often not the case), and b) that they should replace their old therapy with the newer one because it’s better (again, which is often not the case)."
“And if they give you any numbers at all, they’re almost always the deceptive relative numbers that look really good, not the more realistic absolute numbers," Lazris added. "So the benefits are over-exaggerated, the harms are downplayed or missed, and that’s how patients can get hurt.”
Because the spots are so short—usually 30 to 60 seconds—it’s difficult to communicate the risk-to-benefit ratio clearly. Even when ads go into a laundry list of side effects, it can become white noise compared to the happy, smiling faces appearing onscreen. (Soon, the FDA might even allow companies to shorten that list, based on its own study that found fewer mentioned side effects allow consumers to retain more information about the drug’s risks.)
The one part of the spots most critics agree is accurate? When they urge viewers to talk to their doctor. Weighing the risks and benefits of prescription medication outside of the fictional and persuasive images of drug spots is the only way to be sure a product is right for you.
[h/t Los Angeles Times]