To the Good Life

Photo ilustration by CHRIS HUNT and SARAH COX / Cox News Service Carolyn Mellon gets antsy when she sees drug ads on television touting "everything you can think of and things you don't," mostly because she feels the barrage of sales pitches waste her time, and even question her intelligence.

"There's something for everything and something for everyone," says Mellon, 64, a real estate agent and self-professed jogging addict who lives in Atlanta.

"I run all the time, weigh 115 pounds, and don't have any achy joints, and I kind of smile when the TV says to 'ask your doctor if you have this or that,' " Mellon says.

TV ads for all sorts of drugs may be annoying to Mellon and other consumers, but not to pharmaceutical company execs or their advertising gurus.

The ads sell, and, critics say, perhaps too well.

In 2005, drug companies spent more than $4 billion on what's termed directto consumer advertising, according to the Government Accountability Office. That's about one-seventh of the amount the companies spent on research and development, according to the GAO report.

Photo ilustration by KEITH HADLEY/ Cox News Service About $1.2 billion of that was spent on TV ads.

Nearly one-third of that TV ad money was for sleep medications, according to a recent editorial in the Annals of Family Medicine. But drugs to lower LDL cholesterol, relieve heartburn, help men achieve an erection, lubricate dry eyes and heal toenail fungus - what some people consider "lifestyle drugs" - are just some of the regular stars of the TV ads.

A growing number of doctors and consumer advocates think such ads for prescription drugs, which are permitted only in the United States and New Zealand, should have stricter limits. They believe the ads drive up health-care costs and seduce millions into asking their doctors for drugs they don't need for diseases they've never heard of, like restless leg syndrome.

Syracuse University professor Robert Thompson worries that men who see TV ads for drugs like Viagra might get psychologically hooked and have "performance anxiety" about quitting the pills.

"As the ads get more frequent and aggressive, of course doctors are going to get asked for drugs," said Thompson, professor of media and popular culture.

Most critics of the ads do not want an outright ban - just better limits, such as the restriction on ads for the first two years a drug hits the market. Also, Sens. Edward Kennedy (D-Mass.) and Michael Enzi (R-Wyo.) introduced a drug safety bill in February that includes a provision to give the Food and Drug Administration the authority to have pre-clearance on advertising on certain drugs.

"There's no way we're going to put the genie back in the bottle," said Dr. David Kessler, a former FDA commissioner and the author of a recent editorial in the Annals of Family Medicine.

Catching patients' attention

And for many patients, the ads represent a new age of communication in medicine. Whether it's a Lipitor ad featuring Dr. Robert Jarvik, inventor of the artificial heart, rowing on a beautiful lake or a Lamisil ad showing ugly yellow creatures tucking themselves under your toenail, the ads are often approachable and understandable.

The "advertising empowers patients, i n c r e a s i n g p e o p l e ' s awa r e n e s s of diseases and available treatments," Ken Johnson, senior vice president of

Photo ilustration by KEITH

the Pharmaceutical Research and Manufacturers of America, said in a prepared statement. Johnson also said that surveys show that the advertising brings patients into their doctors' offices for important talks about their health.

And thousands of patients have learned, for instance, that there is treatment for their asthma or help for their depression because of direct-to-consumer advertising.

A

luna moth helped catch the attention

of Patricia Riddell, 65, of Dacula, Ga.. She asked her doctor for Lunesta, a sleeping pill, after seeing the ads with the ethereal glow-in-the-dark bug.

She was happy for the information they carried about insomnia - and the pill.

"What I was on," Riddell said, "just wasn't working."

A recent Consumer Reports article found that about three-fourths of doctors said that patients have asked them for drugs they have seen advertised.

But some doctors worry that the drugs cause people to ignore lifestyle changes that may actually be more beneficial than a drug, as in the case of statins, drugs that lower bad cholesterol.

And more importantly, some think the ads often lead patients to self-diagnose.

Dr. Sandra Fryhofer, an Atlanta internist, said she's asked by patients quite often for medications they see promoted on the tube. Many are not aware of side effects of certain drugs, she said.

"It's good when certain ailments are brought out into the open and destigmatized," she said. "However, we are all deluding ourselves if we think that directto consumer advertising is about anything but selling."

Patients are "simply not fully qualified to provide accurate self-diagnosis," she said. "Branding ads paint a rosy picture that may create unr e a l i s t i c expectations for patients."

Suf fering from excruciating arthritis, Brenda Slater, 62, bought the marketing campaign for wonder drug Vioxx in 2001. She immediately asked her doctor about it.

Her physician not only answered her questions, but handed her a prescription.

"I loved it," Slater said. "I never had the first side effect with it."

Thousands of others loved it, too - leading to $2 billion in sales for its manufacturer, Merck & Co., in 2003 alone.

But in 2004, Vioxx, whose main benefit over other anti-inflammatory drugs was that it caused no gastrointestinal side effects, was pulled from the market after studies showed that it doubled the risk of heart attack.

Slater, of Atlanta, now takes an older drug for her arthritis, but it gives her stomach problems.

"Boy, am I suffering now," she said. And if she could - despite the risk of heart attack - she would still be taking Vioxx.

So is she still happy she saw the initial ad for the drug?

"For sure," she said.

Are ads really that bad?

How much influence - both positive and negative - do these ads truly have?

The first study to examine content of direct-to-consumer advertising published its results in February in the Annals of Family Medicine. The study aimed to see whether the educational content of the ads outweighed their emotional pull.

While 82 percent of the ads did have factual content, the authors concluded that emotional appeals were "almost universal" - 95 percent.

It also reported that 18 percent of the ads suggested that lifestyle changes, such as losing weight or adopting a healthier diet or exercise, were insufficient to manage the condition.

"Our findings suggest the need to reconsider the distinction between selling soap ... and selling prescription drugs," wrote the authors.

The Pharmaceutical Research and Manufacturers of America responded by saying that the analysis was based on TV ads from 2004, before voluntary guidelines - which include such things as making sure that the ads clearly state the health conditions for which a drug is used and information that lifestyle changes can help a condition - were in place.

However, some critics have suggested

other steps to keep advertising in check,

such as making the safety profile of the drugs more prominent in the ads or telling consumers that less expensive options might be available.

And doctors stress that the ultimate decision on whether a drug is appropriate is best left to - surprise! - a doctor, after discussing a patient's needs.

"I've had patients ask about Viagra," said Dr. Richard Winer, a Roswell, Ga., psychiatrist. After last year's Super Bowl, for instance, people started asking for the erectile dysfunction drugs.

"But people who don't need the ED drugs shouldn't take them," Winer said.

Dr. Dominick Frosch, lead author on the recent article on the content analysis of TV ads, said he isn't calling for a ban on the ads, just for changes.

"There should be more open acknowledgment of other treatment options, and talk about lifestyle options," Frosch said. "There's room for a lot of improvement." n