Unterborn1

MichaelUnterborn
VickiStalbird
English1201.209
07/21/2015
ShouldDirecttoConsumer(DTC)PrescriptionDrugAdvertisingBeAllowed?
DirecttoConsumer(DTC)prescriptiondrugadvertisingisalargepartofAmericans
daytodaylives,andmostofusdonotevenacknowledgeit.Thestatusquoisthatof
complacency,andthisisduetothedesensitizationofthepublictotheseads,aswellasour
uninformedmindstellingusthatjustbecausesomeonewhoappearstohaveauthoritysays
something,itmustinturnbetrue.Thisisespeciallyprevalentwithtelevisionadvertising,and
onlyrecentlyarewebecomingawareoftheeffectsofthistypeofadvertisingonAmerican
spending.Thecrisishereisthatmanyindividualsarerelyingmoreandmoreonthese
prescriptiondrugsforvariousissues,whereinagoodamountofthesecasesthesideeffectsof
themedicationsoutweighthebenefitsofthem.
Withitsemphasisonapillforeveryillitcreatesademandforprescriptiondrugsthat
maybeinappropriate,medicaliseswhatwaspreviouslyconsideredpartofthenormal
rangeofhumanexperienceandmayleadviewerstobelievethatadoptinghealthy
behavioursisineffectiveorunnecessary(Geyer591).
Withthisreasoning,thisauthorbelievesthatdirecttoconsumerprescriptiondrugadvertising
shouldbeoutlawedintheUnitedStatesbecauseitallowsforthecreationoffactitiousdisorders
inotherwisehealthyindividuals,allowsformediocrityinthecredentialingofphysicians,creates

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anenterpriseoutofthewellbeingofhumanbeings,andfostersanationofdependenceonthese
prescriptionmedications.
In1938CongresspassedtheFederalFood,Drug&CosmeticAct(FDCA),allowingthe
FoodandDrugAdministration(FDA)theauthoritytoapprovepharmaceuticalproductsfor
marketingintheU.S.By1970furtherCongressionalactshadallowedtheFDAtoalsohavefull
controloverprescriptiondruglabelingandadvertising.Atthispoint,intentionsweretoprevent
mislabelingofmedications,aswellaspreventingpotentialaccidentaloverdosesofthese
medicationsduetoimproperlabeling.Advertisementwasseenasameanstoeducatethe
Americanpubliconthepropermedicationstouse,aswellaswhatconditionsthesewereforand
theassociatedrisksoftakingthesemedications.Asthe1980sprogressed,Americanperception
ofthepharmaceuticalindustryshiftedtoamorefavorableone,andin1981Merckranthefirst
printDTCprescriptiondrugad.Bytheyear2000,annualspendingonDTCadvertisinghad
reached$2.5billion(Ventola).
Amoredirectresultofthishighamountofspendinghasbeentheincreaseofthecostsof
thesemedicationstotheAmericanconsumer,averaging$166perprescriptionfordrugs
advertisedontelevision,comparedtoanaverageof$44forgenericdrugsnotadvertisedon
television(Kalyanara).FormanyAmericans,thisdifferenceinpersonalexpensecanbecrippling
overextendedperiodsoftime.Toillustrate,ifanAmericanwereprescribedtwoseparate
medicationsthatwererequiredtoberefilledmonthly,theaveragecostperyearwouldbealmost
$4,000.Althoughinsuranceusuallycoversmostofthiscost,thecostofinsurancecanalmost
equaltheamountofsavings.

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Whilethesecostscansurelyaddupforindividualswhorequiremedications,
pharmaceuticalcompaniescontendthatthesecostsareduetotherisingcostsofResearchand
Development(R&D)fornewandbetterprescriptiondrugs.In2012,thepharmaceuticalindustry
spentover$3billiononDTCadvertising.Thisnumbermayseemhigh,butissmallin
comparisontothecostsofdevelopmentofasinglenewdrug,totallingbetween$411billion
(
procon.org
).ThoseinfavorofDTCprescriptiondrugadvertisingwouldsaythatthecostof$3
billionisasmallpricetopayinordertoincreaseawarenessaboutnewandexistingbrandname
drugs,whichinturnincreasespatientvisits,whicheventuallyallowsfortheindustrytorecoup
thesecostsinordertodevelopbettermedications.However,thisleadstothenextissue:
factitious,ormanufactured,disordersinotherwisehealthyAmericans.
DTCadvertisingincreasespeoplesawarenessofdiseaseandavailabletreatments.
StudiesshowDTCadvertisingbringspatientsintotheirdoctorsofficesandstartsimportant
doctorpatientconversationsabouthealththatmightotherwisenottakeplace(Directto
ConsumerPharmaceuticalAdvertising).Thisstatementfrom
phrma.org
isveryaccurate,as
commonsensewoulddictatethatifanindividualisunawareofcertainnegativephysiological
functions,theyaremorelikelythannotunabletodiscussthemwiththeirhealthcareprovider.On
theantithesis,however,inthe1990sADHDandRitalinwereamajorinfluxofrevenueforthe
companythatmanufacturedthedrug,Novartis.Thiswasdueinparttothemetoomindsetof
parentsseekingasimplecuretotheirchildsnaturalbehaviors.Withtheriseoftheawarenessof
otherdisorderssuchasautismandmassmediasaturatingthemarketwithwellintentioned
information,Americanshaveshownthecapabilityofoverreactingtomedicaldisorders.

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Withincreasedawarenessofthesedrugs,rememberingthatnottoolongagoVioxx(an
antiinflammatorydrug)wasapopularmedicationforarthritis,thereisincreasedriskofthe
exploitationoftheAmericanpublicandinturn,additionalriskstotheirhealth.Vioxxwas
eventuallyfoundtoincreasechancesofsufferingaheartattackorstrokeinthosewhowere
takingittwofold,resultinginthepharmaceuticalcompanyMerckwithdrawingitfrom
circulationin2004.Incidentally,Merckhadjustspent$79.2milliontheyearbeforeonVioxx
advertising,whileonlyayearlateritisbroughttolightthatthedrughadcausedbetweenan
estimated88,000to133,000casesofheartdisease(Kaufman).Unfortunately,theseeffectscan
neverbepredictedwithaccuracyuntilextensiveresearchisdone,sophysiciansrelyonpatient
awarenesstoanextenttoassistthemwithprescribingpropermedications.
ApopularargumentinfavorofDTCprescriptiondrugadvertisingisthatincreased
patientawarenessincreasespatientdoctorcommunication,whichallowsforbetterdiagnosisand
treatmentofmedicalconditions.Accordingtoa2004FDAsurvey,88%ofphysicianswhohad
patientsaskaboutparticularDTCadvertiseddrugshadthesymptomsthatweredescribed,and
thuswereabletobetreatedforthem(TheImpactofDirecttoConsumerAdvertising).
However,accordingtotheverysamesurvey,80%ofthesesamephysiciansreportedthatthey
feltpressuredtoprescribethebrandnamedrugthathadbeenaskedforduringthepatientsvisit.
Unfortunately,onlydoctorstendtoknowthegenericbrandsofthesedrugs,andprescribethe
brandnamemedicationsinordertosatisfytheirpatients.Asurveypublishedin2013describes
50%ofpatientsthatdidnotreceivetheprescribedbrandnamethathadbeenrequestedwere
foundtobedisappointedintheirdoctorafterwards(Ventola),sothatsentimentseemstobe
basedinfact.

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Theshadowofpressurefrompatientstoreceivetheserequestedbrandnamedrugsdoes
notabsolvethehealthcareindustryfromresponsibilityforpropereducationofphysicianswho
areprescribingmedications.Withmoreincentivetowardssavingthepatientcosts,theremaybe
adecreaseinbrandnameprescriptionsbutanincreaseinoverallwellbeingoftheaverage
American.Referringbacktothecostsonaverageforbrandnamemedications,iftheaverage
Americanwereabletosave75%ononeofthebiggestcostsapersoncanface,therewould
theoreticallybelessneedtoworryaboutpayingforrequiredprescriptiondrugs.Increasedpatient
awarenesscanonlyworkwithpropercommunicationwiththosewhoareabletoultimately
determineapatientswellbeing:theirpersonalphysician.Thisisonlyonesideofthecoin,
however.
Thereisaneedforincreasedrestraint,orratherbettermindfulness,onthepartof
physicianstocurbovermedicationofillness.Thiscurrenterathatweliveinallowsforeasy
accesstoahostofinformation,yetphysiciansmoreoftenthannotfailtoeducateonalternatives

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tomedication.Forexample,studiesshowthatonly10%ofAmericanmenareunabletoachieve
anerection.Mostoftherequestsforerectiledysfunctiondrugsareusuallyforotherissuesthat
couldbeconsiderednormal(Ventola).SincemedicationslikeViagraareusedbytensof
millionsofAmericanmen,thelikelihoodthatallareexperiencingactualerectiledysfunctionis
low.AnotherpotentialVioxxincidentcouldeasilyhappenagaininAmerica,withtrendslike
these.
AccordingtotheCDC,almost50%ofAmericanshaveusedaprescriptiondruginthe
past30days(TherapeuticDrugUse).Withantidepressantsbeingoneofthethreemajor
classesprescribed,thiscertainlyraisescauseforalarm.Theissuewiththisriseinantidepressant
prescriptionisthatmostofthetimetheyarebeingprescribedbymedicalprofessionals,as
opposedtolicensedpsychiatrists(Insel).Whiletherecertainlyisnotaviablealternativetousing
medicationwhentreatingdepression,relyingonitaloneormisdiagnosisonthepartof
physicianscancauseotherwisehealthyindividualsexperiencingnormalpartsoflifetohave
adverseeffectstotheirhealthinparttotheseprescriptions.Whenfactoringinthestatisticof
physiciansbeingpressuredtoprescribemedicationsthatarebrandnameandadvertised,this
informationcanbetroubling.
Puttingtogetherthisinformation,onecanconcludethatthereisatroublingriseinthe
prescribingofmedicationstotheAmericanpublic,andtrendspointupwardtomorebeinggiven
accesstothesedrugs.Statisticsshowthatprescriptiondrugsalesareprojectedtoexceed$1
trillionbytheyear2020(James),andatarateof$166peraverageprescriptionthatwouldmean
anaverageof6billionprescriptionswrittentotheAmericanpublic.Whileontheonehandthis
canbeseenasincreasedawarenesscausingincreaseddiagnosis,itisimportanttorecognizethat

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withbettermedicationsshouldcomelessmedication.Eventakingthisoutoftheequation,ata
rateof3prescriptionsperAmericantheremustbesomeroomavailableforhealthierbehaviors.
Withslightmodificationofunhealthylifestyles,thecosttotheaverageAmericanboth
financiallyandhealthwisecouldbereducedsomewhatmarginally.
ThecaseforDTCprescriptiondrugadvertisingcertainlyraisesgoodpoints,namelythat
theincreasedawarenessonthepartofpatientscancertainlyassistingettingtherequired
treatmentthattheyneed,andtheeffectsoftheprogressofmodernmedicineareseeninthose
whohaveovercomecripplingmentalandphysiologicalillnesswiththeseprescribed
medications.Thisresearchpaperisnottotakeawayfromthebenefitsofmedicationinaiding
thetreatmentofillindividualsratheritisintendedtopromotemindfulnesswhendebatingones
treatmentoptionsnomatterwhatmaladymaybeafflictingthem.Itistheresponsibilityof
physicianstoalsoproperlyeducatenotonlytheirpatientsbutthemselvesinparticularaboutall
ofthepotentialrisksofprescribingandoverprescribingcertainmedications.Withtheriseof
prescriptiondrugdependencyinAmericanculture,nowmorethaneverthismindfulnessmustbe
present.
Inconclusion,DTCprescriptiondrugadvertisingcanbelookedatasbothapositiveand
anegativeinthelivesoftheAmericanpublic.Thepositivescancertainlyoutweighthenegatives
ifutilizedinanethicalmanner,sinceproperuseofinformationonlyservestobenefit.Amajor
caveattothisutopianconceptisthenatureofman,andthedesiretogain.Whenusedproperly,a
nationcanbenefitfromnewmedicationsthatareabletobedevelopedwithR&Dfundingthat
comesfromthesaleofbrandname,andconsequentlyDTCA,prescriptiondrugs.Ifused
improperly,aviciouscycleofmediocrity,misdiagnosis,dependenceandpovertycanbefostered

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justaseasily.ThefutureofthecollectivewellbeingoftheAmericanpublicisdependantonthe
properuseofthisinformation,anditiscriticalthateachandeverycitizentreadmindfullywhen
dealingwiththeirownpersonalhealth.

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