Fixing America – Idea 22 – Ban Direct-to-Consumer Pharmaceutical Drug Advertising
Blog No. 131
June 2, 2021
Fixing America – Idea 22
Reading Time: 8 Minutes
By Mack W. Borgen
University of California at Berkeley (Honors, Economics); Harvard Law School; National Award-Winning Author, The Relevance of Reason (Volumes I and II) (2013) and Dead Serious and Lighthearted – The Memorable Words of Modern America (Volumes I, II, and III) (2018-2019); and The Writings of a Lifetime (2021).
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Introduction
Over the last two and a half years, I have presented a wide-ranging set of ideas for “resetting” and “Fixing America.” This Blog presents Idea 22.
Ban Commercially-Driven,
Direct-to-Consumer Pharmaceutical Drug Advertising
Background: Abraham Lincoln’s 1863 Gettysburg Address was 272 words long. FDR’s 1941 “Day of Infamy” speech after Japan’s attack on Pearl Harbor was just 511 words long. And it took JFK only 1,364 words to explain why we must “ask not what (our) country can do for (us), but (we) can do for our country.”
But none of these compare with the confusing verbosity of pharmaceutical companies in their constant direct-to-consumer (DTC) advertising of prescription drugs. Bristol Myers Squibb’s four-page (!) advertisement in a recent Time magazine for its new metastatic-non-small cell lung cancer medicines, Nivolumab and Ipilimumab, dribbled on for 1,590 words. Novo Nordisk took three pages and 1,534 words to “explain” why we should “ask our doctor” about liraglutide (Saxenda) to lose weight. (Note: Yes, I know it seems silly that I took the time to count the number of words in these ads, but it was a covid-year. I was annoyed, and I had time.)
For a multitude of reasons, these direct-to-consumer, “consult-your-physician” drug advertisements should be banned. And it should be noted that this is also the long-standing position of the American Medication Association, the American College of Physicians, the American Society of Health-System Pharmacists, and the rest of the world. Of the 195 countries in the world, the United States and New Zealand are the only two nations in the world which allow such DTC advertising. Kaminski, Dr. J., The Morning Call, June 1, 2020. The significance of this will be discussed below.
Three Very Separate Reasons for This Banning Proposal
This proposed banning of DTC advertising is Idea No 22 in my Fixing America series of articles (See Full List below). However, this is a unique Fixing America blog because it is included for three very separate reasons.In 2016, more than 770,000 such ads were aired (David Lazarus, Los Angeles Times, April 18, 2018), and even ignoring magazine and other print advertising, Proctor & Gamble (with $718MM) was, by far, the single leading advertiser on broadcast network TV in the U.S. in 2019 (Guttman, A., Hadley-ward@statista.com).
Reason 1. Harm of Consumers; Misinformation and Stimulation of Demand for Unsuitable or Unnecessary Treatments; Intrusion of Doctor-Patient Relationship; and Offensive Inclusion of Lawyering Disclaims and Cautions. These advertisements may be harmful to consumers, and they offer little or no medical assistance. First, the sheer number of such ads evidences their (corporate-serving) commercial success. On average, there are “80 pharmaceutical ads per hour on TV today, (and because of this alone) this is the most frequent form of health communication that the average American sees.” In 2016, more than 770,000 such ads were aired (David Lazarus, Los Angeles Times, April 18, 2018). Even apart from magazine and other print advertising, Proctor & Gamble (with $718MM) was, by far, the single leading advertiser on broadcast network TV in the U.S. in 2019 (Guttman, A., Hadley-ward@statista.com). The fact that the pharmaceutical industry spent more than $6.46BB for such advertising annually (Year 2019, statistica.com, September 24, 2020) once again underscores that such advertising is commercially successful, but possibly such monies could be better spent in lowering drug prices or in promoting more R&D. Worse yet, such advertising “causes considerable public harm through misinformation and the stimulation of demand for unsuitable or unnecessary, costly treatment(s)….” (Britannica ProCn.org). It effectively and intentionally intrudes on the patient-prescriber relationship and (causes) increased healthcare costs….” Id. A Yale University study wisely reminded its readers that the purpose of DTC advertisements was to “sell products – not to inform.” Possibly that is why such DTC advertisements almost never talk about prices. The AMA has suggested that DTC advertising “fuels escalating drug prices…. (and) inflates demand for new and more expensive drugs.” Lastly, wholly apart from the near offensiveness of the bouncy, smiley actors in such ads, a large part of every DTC advertisement is obviously written by pharma’s in-house lawyers protecting their client from consumer litigation claims. This seems evident from the endless and obnoxious series of “tell-your-doctor,” “call-your-health-care-provider,” “side effects may include,” and “consult-your-physician” caveats which dominate each advertisement.
Reason 2. Need for Prudent Self-Skepticism When America Is Operating in Manner Inconsistent with the Rest of the World. America is a sovereign nation. We have our own Constitution. We formulate our own laws. We have our own practices. However, the laws and practices of other nations are also worthy of examination. In those instances where America is acting in a manner wholly inconsistent with literally the rest of the world, it would be prudent for the law or practice to be very closely and periodically reviewed. (NOTE: See my Fixing America Idea No. 6 proposing the formation of an Office of International Comparisons, Blog 107, October 29, 2019).
Reason 3. Fixing America Requires Addressing Both “Large” and “Small” Issues. Fixing America is going to require many reforms. In an age where the headlines are dominated by news of trillion-dollar infrastructure bills, multi-billion-dollar tax cuts, and political hot-button issues such as the formation of the January 6 Commission or the revamping of police practices, it is easy to forget that there are many “smaller” issues which can themselves, especially collectively, make a difference. Banning Direct-to-Consumer Prescription Drug Marketing is one such example, although is not a new idea. The banning of DTC ads debate has been going on for decades. It started when pharmaceutical companies began running TV advertisements in the late 1980s, and it accelerated when these companies nearly doubled their advertising spending between 2014 and 2019. Unsurprisingly, it was noted about 15 years ago that “(t)he current US system of pharmaceutical company self-monitoring and FDA oversight (was) not working.” Stange, K., Annals of Family Medicine, March 7, 2007. The same article noted then, as is true today, that DTC ads “provide biased educational material and emotional appeals that promote drugs over healthy alternatives.” Thus, even a reform of this relatively small matter would be a start. Such a ban would, of itself, contribute towards “Fixing America.” As this author has emphasized before, the good news is that place to begin is everywhere. Joining the other, literally 99% of the countries of this world in such banning of DTC advertising would be one more place to start.
So let us begin. Again.
Idea: Ban all forms of print, television, mail, Internet, and other media direct-to-consumer advertising of prescription drugs.
Implementation: The federal government operating through the Food and Drug Administration has the clear power and authority to implement such advertising. There will be, almost inevitably, First Amendment claims of various forms, however these challenges have been well and frequently addressed before in the context, for example, in the banning of certain types of alcohol and tobacco products.
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See Additional Previously Presented Ideas
Idea 1 – Consolidated Interstate Database for Reports of License Suspension or Revocation (Blog 106, Oct. 14, 2019).
Idea 2 – Term Limits (Blog 106, Oct. 14, 2019).
Idea 3 – The Media – Report Corporate Settlements, Awards and Fines as Percentage of Annual Net Profits (Blog 106, Oct. 14, 2019).
Idea 4 – Award of Attorneys’ Fees to Winning Party (Blog 107, Oct. 28, 2019).
Idea 5 – Inclusion of Positive Aspects of American Society as a Distinct Part of U.S. History School Curricula (Blog 107, Oct. 28, 2019).
Idea 6 – Office of International Comparisons (Blog 107, Oct. 28, 2019).
Idea 7 – The Need for Climate Scientists to Retain Professions for the Development of an Educational Campaign (Blog 109, Nov. 26, 2019).
Idea 8 – Redefining the Concept of “News” The Need for the Regular Infusion of Positive News (Blog 109, Nov. 26, 2019).
Idea 9 – The Necessity of Mandatory Public Service (Blog 109, Nov 26, 2019).
Idea 10 – Cap or Tie Congressional Pay Increases (Blog 110, Dec 7, 2019).
Idea 11 – Scrutinize (and Possibly Eliminate) the Congressional Health Care System (Blog 110, Dec 7, 2019).
Idea 12 – Eliminate the Congressional Retirement System (Blog 111, Dec 7, 2019).
Idea 13 – Cease production and eliminate the use of the U.S. penny (Blog 112, Dec 7, 2019).
Idea 14 – Institutionalized Use of U.S. Military Units in Event of Natural Disasters (Blog 113, Feb 11, 2020).
Idea 15 – Streamline the Federal and State Penal Codes and Address the Issue of Overcriminalization in American Society (Blog 114, Feb 25, 2020).
Idea 16 – It’s Time to Reset America (Blog 118, Jun 30, 2020).
Idea 17 – If They’re Good Enough for Our Capitalism, They’re Good Enough for Our Democracy – Monthly Bonus Payments for Excellence in Citizenship (Blog 119, Jul 15, 2020).
Idea 18 – Let Us Try – The Simple Utility of Remembering America’s “Good Celebrities” (Blog 120, Aug 2, 2020).
Idea 19 – – If We Get It Right – The Next “Greatest Generation” (Blog 121, Aug 18, 2020).
Idea 20 – -The Truth Problem – The Need for Rating Newspapers, Magazines, Columnists, and Television and Radio Stations, Shows and Commentators (Blog 123, Sep 22, 2020).
Idea 21 – We Attorneys Are a (Big) Part of America’s Problems (Blog 125, Dec 1, 2020 (Part 1) and Dec 3 (Part 2)).
Idea 22 – Ban Commercially-Driven, Direct-to-Consumer Pharmaceutical Drug Advertising (Blog 131, June 2, 2021)’
Copyright 2021 by Mack W. Borgen. All rights reserved. No part of this article may be reproduced or transmitted in any form or by any means, electronic or mechanical, except in the case of brief quotations embedded in critical articles or reviews, without prior written permission by the author.
