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How Does the Drug Industry Get Away with Broadcasting Those Deceptive Ads?

The U.S. is one of only two countries in the world that allows Big Pharma to advertise directly to consumers. How did we get here?

We’ve all seen them in newspapers and magazines, on TV and the Internet -- cheerful people in glossy, picturesque ads claiming that by taking a little magic prescription pill their lives were immeasurably improved.  

As the TV ad fades, a cautionary voice quietly recites a host of “risk factors,” potentially catastrophic consequences that could result from taking the magical pill. One can’t but wonder if the cure is worse than the ailment.

A well-known ad features Dr. Robert Jarvik, a pioneer in the development of the artificial heart, pitching Pfizer’s cholesterol drug Lipitor.  He comes across as a trusted expert with your best interest at heart, but viewers would not know that he is neither a cardiologist, nor licensed to practice medicine. (Lipitor’s 2009 sales were $5.4 billion.)

Another ad features Dorothy Hamill, the Olympic skating champion, skating effortlessly while promoting Merck's arthritis drug, Vioxx. The viewer would not know that Merck had for years knowingly withheld incriminating research from the Food and Drug Administration (FDA). The data would have barred the drug’s commercial release and may have saved the lives of an estimated 27,000 people who suffered heart attacks and sudden cardiac deaths after taking it. After Merck made billions, the drug was taken off the market.

These are two of a never-ending barrage of pharmaceutical advertisements known as direct-to-consumer (DTC) ads that bombard Americans day in and day out.  Such ads are permitted only in the U.S. and New Zealand. They are intended to provoke an individual consumer to request a specific prescription drug from their doctor. In 2009, the pharmaceutical industry spent an estimated $4.5 billion on such advertising. Total 2007 U.S. pharma industry sales were $315 billion. 

DTC ads give viewers the illusion that they can and should be their own doctor; they are designed to make viewers believe that they can and should prescribe for themselves. By fostering a false sense of demand for prescription-required drugs, DTC drug ads undermine the real knowledge that doctors should have when, in consultation with the patient, a treatment plan is established.  

Next time you see one of these ads, make sure you are aware of the detailed risk factors that are either buried at the bottom of the page or mentioned at the commercial’s end. These risks tell only half the story of the drug’s real potential harm; the other half usually doesn’t get told: how the pharmaceutical industry is harming the health of Americans.

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Federal regulation of drugs was the result of public outrage over scandals exposed by early-20th-century muckrakers, most notably Upton Sinclair, who revealed widespread adulterated food products and poisonous patent medicines. This led to the passage of the Pure Food and Drug Act of 1906. In 1938, Congress passed the Food, Drug and Cosmetic Act that gave the FDA authority over drug company marketing materials. In 1962, FDA authority was further extended to regulate advertisements of prescription drugs.  

However, things began to change in the 1980s. In 1981, Merck published the first DTC ad for a prescription drug, Pneumovax, in Reader’s Digest . It was followed by numerous print ads, and in 1983, the first television prescription drug ad for Boots Pharmaceutical’s Rufen, prescription strength ibuprofen.

Over the next decade-plus, the pharmaceutical industry, emboldened by the Reagan-era belief in “limited government,” steadily pushed to deregulate DTC ads. In 1997, the FDA loosened advertising rules leading to an enormous increase in DTC ad spending.  For example, in 1996, less then $1 billion ($985 million) was spent on DTC ads out of the industry’s total promotional spending of $11.4 billion; in 2005, total pharma promotional spending nearly tripled to $29.9 billion and the amount spent on DTC ads quadrupled to $4.2 billion.  

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