The puppy-monkey-baby Doritos commercial from the 2016 Super Bowl gave me nightmares. The Audi commercial with the David Bowie song in the background gave me chills. The actual football bored me to death, but the commercial that gave me the most pause was the ad with the guy that was obsessed with other people going to the bathroom.
This ad was for a drug that combats the effects of Opioid-Induced Constipation by the pharmaceutical company AstraZeneca, which is worth $87.7 billion dollars. At a cultural level, there isn’t anything really distinctive about AstraZeneca’s net worth or their advertising the medication on television. According to the American Medical Association (AMA), the pharmaceutical industry, a $300 billion-dollar-a-year industry, spent 4.5 billion dollars on advertising in 2015 — a 30 percent increase over the previous two years.
Now that may not seem that remarkable to us at first. There are plenty of industries that spend at least this much on advertising in the United States; according to statista.com, the biggest spenders are the retail and automotive industries at $15.8 and $14.2 billion, respectively. We’re used to all kinds of advertising being thrown at us from all sides, just like much of the rest of the world. However, in every country in the world besides the United States and New Zealand, medical advertising such as the Opioid-Induced Constipation ad is not legal.
There are a few legitimate arguments in favor of allowing prescription drug advertising to continue, but in my opinion the negative consequences far outweigh the positive ones. Some claim that this type of advertising removes the stigma associated with medical disorders, like Opioid-Induced Constipation (if indeed there is one), provides the funding that is necessary to continue the expensive research and development (R&D) needed to continue to make meaningful medical advancements and helps make those suffering from ailments aware of possible treatment options.
There is significant evidence that medical advertising drives up the price of medication that some patients desperately need and clouds their judgment as to what medication is really best for them. There are also some who strongly believe that medical advertising is at least partially responsible for the overprescription of medications in the United States; we prescribe 25 times the amount of ADHD medication than any European country, and spend twice as much on prescription drugs per year.
According to the AMA, prices on both brand name drugs and their generic counterparts have been on a steady incline and rose 4.7 percent in 2015 alone. In addition, the advertising can cause patients to request the more expensive brand name version of a drug even when their doctor suggests an equivalent generic brand, which could cost as much as 80 percent less. According to AMA Board Chair Patrice A. Harris, “Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”
It is also questionable how reliable the information in the ads for the next new miracle drug are. Drug companies have historically been very misleading in the way they present medical information, which is partially a byproduct of attempting to advise people on complex conditions in a 30 to60 second commercial. A bulletin by the World Health Organization (WHO) describes a commercial in which a self-proclaimed “doctor” and the “inventor of the artificial heart” endorses a drug to help control cholesterol levels — you can watch the ad here if you want.
According to the bulletin, “Robert Jarvik, the distinguished “doctor” in the boat, had never been licensed as a medical doctor, could not legally prescribe anything and was not the inventor of the ‘artificial heart.’” The commercial presented him as all of those things in a deliberate attempt to lull consumers into a false sense of security so that they felt inclined to request this medication over others from their doctor. If that isn’t blatantly false advertising, I don’t know what is.
“The truth is that direct-to-consumer advertising is used to drive choice rather than inform it,” says Dr. Dee Mangin, associate professor at the Christchurch School of Medicine and Health Sciences in New Zealand to the WHO. I am inclined to agree with her. The only people I think should be legally allowed to counsel me on medical issues that have strong consequences on my health and safety are the trained professionals with whom I have entrusted my physical well being, not some board of marketing specialists who know how to play to the primal human fear of death that lies in everyone.