The great direct-to-consumer prescription drug advertising con

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Thursday, September 08, 2005

 

The great direct-to-consumer prescription drug advertising con: how

patients and doctors alike are easily influenced to demand dangerous drugs

 

A cute, animated ball bounces around very sadly until he takes a magic

potion; suddenly, it becomes happier than ever. No, that isn't the

plot of a new children's movie. On the contrary, it's the storyline of

a Zoloft commercial – yes, Zoloft, a powerful antidepressant drug. In

the 1990s, direct-to-consumer advertising like this increased at a

compounded-annually rate of 30 percent, according to Ian Morrison's

book, Health Care in the New Millennium. In fact, by 1995, drug

companies had tripled the amount of money they formerly allotted to

consumer-directed advertising, writes to Gary Null in Death by

Medicine. Since then, pharmaceutical advertising has grown to an

entirely new, pop culture-savvy level.

 

These days, it's hard to tell the difference between pharmaceutical

commercials and car commercials. Both are almost always intended to

look " cool. " Car and pharmaceutical commercials use the same hooks --

popular music, good acting and lofty promises -- to hook consumers and

reel them in. Falling prey to car commercials results in little more

than hefty car payments; however, becoming seduced by pharmaceutical

companies can result in the consumer willingly taking powerful drugs,

at the risk of serious illness and even death. In spite of this

tremendous risk, pharmaceutical advertisements are becoming

increasingly common and, unfortunately, increasingly effective.

 

In 2000, pharmaceutical companies spent $2.5 billion on mass media

pharmaceutical advertisements, according to Mike Fillon in Ephedra:

Fact or Fiction. This number increased to over $3 billion in 2003,

according to Dr. John Abramson's book Overdosed America. In his book,

Death by Prescription, Ray D. Strand looks at these high figures and

poses the question: " Why? " Why do pharmaceutical companies spend

billions of dollars on direct-to-consumer advertising, when consumers

can only obtain prescriptions for these drugs through a doctor?

Wouldn't it seem that consumers have no influence whatsoever on the

success of a prescription drug, so advertising should be directed

entirely toward doctors?

 

That makes sense, but it's not the way things work. Pharmaceutical

companies wouldn't spend billions of dollars on direct-to-consumer

advertising if it didn't work. In fact, the advertisements are working

… too well. Fillon writes, " The average number of prescriptions per

person in the United States increased from 7.3 in 1992 to 10.4 in

2000. Along with this increase in demand, there has been a shift

towards the use of more expensive medications. It's more than a

coincidence that many of the most expensive medications happen to be

those medications that are most heavily advertised. " In fact, between

1999 and 2000, prescriptions for the 50 most heavily advertised drugs

rose six times faster than prescriptions for all other drugs,

according to Katharine Greider's book, The Big Fix. So, how is

direct-to-consumer advertising so effective in a system in which

doctors write out the prescriptions?

 

Telling clever stories with misleading ads

Well, first, let's explore direct-to-consumer advertising, namely the

television commercial. Most prescription drug commercials follow the

same script progression: First, the commercial shows how bleak life

was for a person or character before taking whatever prescription

medicine the commercial is advertising. Then, the protagonist

demonstrates or tells how wonderful life is while on the drug.

Finally, a voiceover obligingly lists the side effects, often speaking

as quickly and inaudibly as possible.

 

Take, for example, a Paxil commercial that was recently popular. At

the beginning of the commercial, the typical 30-something-year-old

woman is standing outside a house, looking through the window at the

happy party going on inside. She looks so lonely and depressed that it

must break nearly every consumer's heart. " What's wrong with her? " we

compassionate humans gasp in unison. The voiceover answers our

question as we think it: The woman has social anxiety disorder, a

condition that can be treated with the prescription drug Paxil.

 

Suddenly, the now-medicated woman rings the doorbell and, with a huge

smile on her face, joins the party. We see how much fun she is having

and we are so happy for her! Of course, the voiceover quickly goes

through the list of Paxil's potential side effects, but how can we

concentrate on that, when we're so busy rejoicing at the woman's new

happiness? Whoever wrote that commercial should write Hallmark movies.

After seeing it a few times, I was convinced that most of my

non-immediate family had social anxiety disorder and I even called one

relative up to suggest that she take Paxil. I'm not even a gullible

person, yet I was persuaded by pharmaceutical company advertising.

 

Doctors prescribe whatever the patient names

We are what Strand calls a " self-medicated " society. Consumers do not

actually write their own prescriptions, but they practically do, based

on whatever drugs they see advertised on television. Strand writes,

" Surveys reported in our medical literature reveal that when a patient

comes into a doctor's office and requests a specific drug that he has

seen advertised in the media, the doctor writes the exact prescription

the patient requested more than 70 percent of the time! "

 

So, let's say that a consumer who has been feeling a little sad lately

sees a commercial for the antidepressant drug Zoloft. The commercial

demonstrates the symptoms for depression and the consumer identifies

with them. Suddenly, he or she thinks, " I'm not just sad. I'm

depressed, which is a 'medical condition that can be treated by the

prescription drug Zoloft.' " With this in mind, the consumer goes to a

medical doctor and says, " I've been really depressed a lot lately.

I've been [the consumer recites the depression symptoms listed in the

Zoloft commercial]. I think I need Zoloft. " So, according to Strand,

there's a 70 percent chance the doctor will prescribe Zoloft, the

exact prescription the consumer requested. That's how pharmaceutical

commercials really work. They directly influence consumer behavior,

yet drug companies claim they only " educate " patients, but don't

persuade them to do anything.

 

Doctors are easy to manipulate, drug companies discover

You may be wondering why doctors base their prescriptions on the

requests of their patients, who usually have no medical training

whatsoever. That's a good question with a simple answer. The

pharmaceutical-advertising machine seduces doctors, too.

 

According to Burton Goldberg's book, Alternative Medicine, paid

pharmaceutical advertisements are the main source of the Journal of

the American Medical Association's revenues. The American

Psychological Association is equally under the pharmaceutical

companies' spell, as 15 to 20 percent of the American Psychological

Association's (APA) income comes from pharmaceutical advertisements in

its journals.

 

In Innocent Casualties, Elaine Feuer calls these advertisements

" intentionally misleading " because they promote the pharmaceutical by

" exaggerating a drug's benefits while downplaying its hazards in small

print in the addendum. " This is very similar to the obligatory " side

effects " voiceover recited at the end of a pharmaceutical television

commercial; neither consumers nor doctors pay much notice to the

" final voiceover " or " fine print. "

 

Just in case advertisements in the Journal of the American Medical

Association (JAMA) haven't properly seduced doctors, pharmaceutical

companies take an extra promotional step by aggressively " detailing "

doctors, which involves promoting drugs through door-to-door giveaways

of free information and samples, according to Health Care in the New

Millennium. Morrison writes that " Pfizer alone has 4,500 people in its

sales force, " but these employees' salaries are small change compared

to the increased revenue they encourage.

 

The next time you watch television or read a magazine, pay special

attention to pharmaceutical advertisements. Notice their promotional

hooks and be grateful that you, unlike most consumers, are no longer

susceptible to their influence. That's what knowledge, unlike naiveté,

brings you.

 

The experts speak on pharmaceutical advertising:

In the pharmaceutical area, DTC advertising has been increasing in the

late 1990s at a rate of around 30 percent compounded annually. Once

prevented by regulation from advertising aggressively, pharmaceutical

companies now see DTC advertising as a major source of stimulating

demand for their product; they spent $1.3 billion on DTC advertising

in 1998 alone. This has had two key effects: (1) it has built brand

awareness and product awareness in the minds of end users (consumers),

who are increasingly taking medications for chronic conditions in

increasingly crowded and competitive therapeutic

categories—cholesterol management, cardiovascular diseases, asthma,

allergy, and other forms of respiratory ailments; and (2) more

directly, it has encouraged users to visit their doctors and ask for

the product by name.

Health Care in the New Millennium by Ian Morrison, page 44

 

In order to reach the widest audience possible, drug companies are no

longer just targeting medical doctors with their message about

antidepressants. By 1995 drug companies had tripled the amount of

money allotted to direct advertising of prescription drugs to

consumers. The majority of the money is spent on seductive television ads.

Death By Medicine by Gary Null PhD, page 13

 

In 2000, pharmaceutical companies spent $2.5 billion on mass media ads

for prescription drugs. Admittedly, this is a small portion of the

$101.6 billion spent on advertising of mainstream consumer products in

the United States.

Ephedra Fact And Fiction by Mike Fillon, page 75

 

The stage could not have been set more perfectly for prescription drug

advertising to become a major force in American medicine. And so it

did. In 1991 the drug companies spent a paltry $55 million on

advertising drugs directly to consumers. Over the next 11 years, this

increased more than 50-fold to over $3 billion in 2003. The ads appeal

to viewers as independent decision makers—capable of forming their own

opinions about which drugs they need—and resonate with the growing

concern that HMOs and managed care plans tend to withhold the best

care to save money.

Overdosed America by John Abramson MD, page 81

 

While $3 billion in advertising may seem like an awful lot, rest

assured that the drug companies aren't worried. Why? Americans are

expected to spend over $500 billion on drugs this year—not including

the extra $100 billion estimated for the Medicare drug benefit

program. Spending on prescription drugs is now the fastest growing

portion of healthcare spending in the United States.

Ephedra Fact And Fiction by Mike Fillon, page 176

 

Many of us don't find the amount of money spent on marketing

prescription drugs to physicians surprising, but when considering the

billions of dollars spent on marketing prescription drugs to the

public, don't you wonder why? After all, you can obtain prescriptions

only through a doctor. Pharmaceutical companies are willing to spend

this kind of advertising money on only their most recently approved

medication.

Death By prescription by Ray D Strand, page 48

 

The average number of prescriptions per person in the United States

increased from 7.3 in 1992 to 10.4 in 2000. Along with this increase

in demand, there has been a shift toward the use of more expensive

medications. It's more than a coincidence that many of the most

expensive medications happen to be those medications that are most

heavily advertised.

Ephedra Fact And Fiction by Mike Fillon, page 77

 

According to a report prepared by the National Institute for Health

Care Management, a nonprofit research foundation created by the Blue

Cross Blue Shield health insurance plans, the fifty most-advertised

prescription medicines contributed significantly last year to the

increase in the nation's spending on drugs. The increases in the sales

of the fifty drugs that were most heavily advertised to consumers

accounted for almost half the $20.8 billion increase in drug spending

last year, according to the study. The remainder of the spending

increase came from 9,850 prescription medicines that companies did not

advertise, or advertised very little. The study attributed the

spending increase to a boost in the number of prescriptions for the

fifty drugs, and not from a rise in their price.

Ephedra Fact And Fiction by Mike Fillon, page 77

 

Pharmaceutical companies are in business to make money; with the

exception of over-the-counter medications that will be sold in great

numbers, the only way a pharmaceutical company can make lots of money

is by developing medications that can be patented. Natural herbs and

foods as well as medications that can no longer be patented won't be

" pushed " in advertising because there's no real money to be made on them.

Attaining Medical Self Efficiency An Informed Citizens Guide by Duncan

Long, page 11

 

Not surprisingly the " super aspirin " have received lots of favorable

press on the TV since there's money to be made. With the dollars

pharmaceutical companies make, translating into greater advertising

revenues for broadcasters and publishers, the rush is push the super

aspirin and play up the " dangers " of common aspirin.

Attaining Medical Self Efficiency An Informed Citizens Guide by Duncan

Long, page 13

 

The cheap-but-effective medications that can't be patented are also

kept out of the limelight by the big companies paying for advertising

and the mass media intent on making money through advertising.

Attaining Medical Self Efficiency An Informed Citizens Guide by Duncan

Long, page 19

 

When you go into a pharmacy to get a prescription filled, you can

often pay considerably less by choosing a " generic " drug over a brand

name. The generic drugs are often made by the same manufacturer as the

name-brand medication — the extra price is in the packaging and

advertising. Even when a different company makes the generic

medication, it is every bit as good as the brand name because it is

required to meet certain standards before it can be sold in the US.

Attaining Medical Self Efficiency An Informed Citizens Guide by Duncan

Long, page 183

 

In contrast, most physicians are unaware of the considerable risks and

limited benefits of commonly used prescription cholesterol-lowering

agents. In addition, since niacin is a widely available " generic "

agent, no pharmaceutical company stands to generate the huge profits

that the other lipid-lowering agents have enjoyed. As a result, niacin

does not enjoy the intensive advertising that the HMG CoA reductase

inhibitors and gemfibrozil enjoy. Despite the advantages of niacin

over other lipid-lowering drugs, niacin accounts for only 7.9 percent

of all lipid-lowering prescriptions.

Encyclopedia Nutritional Supplements by Michael T Murray ND, page 90

 

In addition, since niacin is a widely available " generic " agent, no

pharmaceutical company stands to generate the huge profits that the

other cholesterol-lowering drugs have enjoyed. As a result, niacin is

not intensively advertised like the other drugs. Despite the

advantages of niacin over the cholesterol-lowering drugs, niacin

accounts for only 7.9 percent of all lipid-lowering prescriptions.

Encyclopedia Of Natural Medicine by Michael T Murray MD Joseph L

Pizzorno ND, page 352

 

In 1996 Russia spent about $1.75 million on testing. But 1997 opened

with a smaller HIV/AIDS budget, unpaid doctors and nurses countrywide,

and hospitals with empty pharmaceutical shelves. Far from being able

to afford $10,000 to $40,000 a year to treat HIV patients in ways that

met U.S. standards, or to continue a nearly $2 million testing

program, Russia couldn't even find the wherewithal to buy television

advertising time on national television to promote AIDS education.

Betrayal Of Trust By Laurie Garrett, page 205

 

According to the study, Vioxx, an arthritis drug sold by Merck &

Company, was the most-heavily advertised prescription drug and also

accounted for more of last year's increased drug spending than any

other single drug. Merck spent $160.8 million to promote Vioxx to

consumers—more than PepsiCo spent to advertise Pepsi or Budweiser

spent to advertise its beer, the study said. With the help of the

advertising, Vioxx sales quadrupled to $1.5 billion last year from

about $330 million in 1999.

Ephedra Fact And Fiction by Mike Fillon, page 77

 

And if that weren't enough, the British pharmaceutical company

GlaxoSmithKline spent more on consumer advertising than any other

company. It spent $417 million on advertising last year—an increase of

40 percent from the previous year.

Ephedra Fact And Fiction by Mike Fillon, page 178

 

Hundreds of millions of dollars are spent by pharmaceutical companies

to research and then advertise their patented medical drugs to

physicians and consumers. No such bankroll exists for nutritional

supplements. That's because nutritional supplements, based on

vitamins, minerals, herbs, and natural substances such as MSM, are not

patentable.

The Miracle Of MSM by Stanley W Jacob, page 13

 

The reason drugs cost more in America than in any other country boils

down to one simple factor: the pursuit of maximum profit. The

pharmaceutical industry has taken every opportunity, used every ploy,

to deceive the American people. To derail efforts at making

pharmaceutical benefits an integral part of Medicare, they spent tens

of millions of dollars on an advertising campaign to discredit the

Canadian system, and even created a bogus organization, " Citizens for

Better Medicare, " to try to lend credibility to their efforts. And now

they are introducing piecemeal discount card programs in an effort to

defuse efforts for more comprehensive change.

Health Care Meltdown by Robert H Lebow MD, page 263

 

But Canada's system has born the brunt of negative advertising

campaigns in the U.S., campaigns which have been successful in

coloring Americans' perceptions of the Canadian system. The American

Medical Association spent several million dollars in the early '90s to

discredit the Canadian system and create doubts in the mind of the

American public about a government-managed system for universal

coverage. And in 2000, in a somewhat less successful ad campaign that

cost perhaps $60 million, the American pharmaceutical industry tried

to discredit the Canadian system. A ubiquitous " bus from Canada "

appeared in a plethora of TV spots and full-page newspaper ads across

the U.S. The goal was to derail efforts to make pharmaceutical

benefits an integral part of Medicare.

Health Care Meltdown by Robert H Lebow MD, page 149

 

Most, but not all, megasites support themselves with ads for

prescription drugs, vitamins, and medical sundries, as well as

laptops, life insurance, and books — typical Internet commerce.

Therefore, advertisers may influence the information you find on the site.

Healthcare Online for Dummies by Howard and Judi Wolinsky, page 23

 

With annual U.S. revenues of about $100 billion and worldwide revenues

of $300 billion, the pharmaceutical industry is one of the largest,

most powerful industries, producing some of the most sophisticated

marketing and advertising anywhere. Marketing is the economic

equivalent to waging war—sizing up your own forces, your enemy's (the

competition), and emphasizing your own strengths and your enemy's

weaknesses. Marketing strategy meetings are akin to war rooms where

generals map out their plans for attack and defense.

Syndrome X by Jack Challem Burton Berkson MD and Melissa Smith, page 55

 

The reason that prescription drugs are not recognized as one of the

biggest killers in America is complex. Drug companies who make huge

profits from the sale of drugs spend more than $10 billion a year

promoting drugs, and spend next to nothing warning the public about

potential risks. Drug companies also engage in misleading advertising

campaigns which make outright false or unrealistic claims, but which

convince that vast majority of the public that most or all

prescription drugs are not only safe, but the key to better health and

a better life. The doctors themselves are also a part of the problem.

Doctors chronically under-report and even ignore the deaths or adverse

reactions to the drugs they prescribe because it is not in their

professional self interest to raise public awareness to the danger.

Doctors are afraid of being sued, they maintain a culture of denial,

and they also profit from there relationships with the big drag

companies. The government is also part of the problem because it does

not have the resources or the political will to do more about the

dangers of prescription drags. Also, powerful members of the American

government, from the President on down, are all lobbied heavily by the

cash rich drug companies.

Prescription Medicines, Side Effects and Natural Alternatives by

American Medical Publishing, page 16

 

First of all, consider the fact that the American prescription drug

industry - the giant pharmaceutical companies — is the most profitable

industry in the world. Drug companies make more money than banks, more

money than oil companies, more money than Ford or GM, more money than

anybody. Drug companies spend billions of dollars on advertising and

promotion -- some $10 billion every year. This advertising is directed

at both doctors, and directly to the public.

Prescription Medicines, Side Effects and Natural Alternatives by

American Medical Publishing, page 11

 

The United States is currently the only country in the world that

allows drug companies to advertise prescription drugs directly to the

consumer. It used to be that prescription drugs could only be touted

to physicians. But now consumer ads on TV tantalize you with great

promises of health and well-being, skim through the side effects as

quickly as possible and then suggest you contact your physician or a

drug company hotline for more information. The drug companies are also

responsible for the expensive, slick, four-color ads you now see in

consumer magazines and newspapers. You are bombarded with $3 billion

worth of advertising for prescription and over-the-counter drugs every

year. That should give you an idea of how valuable you are as a drug

consumer and of the staggering profits the drug companies rake in

every year.

Prescription Alternatives by Earl Mindell RPh PhD and Virginia Hopkins

MA, page 531

 

Pharmaceutical companies spent $2.5 billion in 2000 promoting

prescription drugs, an increase of nearly 45 percent over 1999. These

advertisements contribute to rising costs by inducing consumer demand

for newer, higher-priced drugs, when the older ones may work just as well.

Prescription For Dietary Wellness by Phyllis A Balch, page 285

 

Claritin, a formerly prescription antihistamine used to control

allergic symptoms, was far and away the most heavily advertised

prescription drug in the two years following the FDA's 1997 rules

change. They resisted the idea that there were equally good and

perhaps even better ways to relieve their allergy symptoms than a new

(and therefore less well tested) drug. Moreover, they were unconcerned

about Claritin's cost (more than $2.10 per day): most had prescription

drug coverage as part of their health insurance. With an advertising

budget greater than that of Budweiser beer or Coca-Cola, Claritin took

off: sales grew from $1.4 billion in 1997 to $2.6 billion in 2000.

Overdosed America by John Abramson MD, page 153

 

Thus, it is not surprising that direct-to-consumer prescription drug

advertising is expected to increase to $7.5 billion by 2005, a 1,200%

increase over a decade, as drug manufacturers decide, as Vodra put it,

to " fight fire with fire in the marketplace. It's only a small step

from that to the adoption of an 'offense is the best defense' policy

as marketing pressures intensify. "

Overdose by Jay S Cohen, page 162

 

The medication marketplace is a very competitive world. At

pharmaceutical companies, doctors usually don't make the final

decisions—business people make them. In order to sell medications,

good and bad, elaborate marketing and advertising strategies are

necessary, and impressive rates of effectiveness are essential.

Overdose by Jay S Cohen, page 35

 

A self-medicated society

 

Not only are we an overmedicated society, we are a self-medicated one.

It's true, physicians are prescribing more drugs than ever before, but

not only is the pharmaceutical industry effective in advertising

prescription medications, it has overwhelmingly persuaded the American

public to buy tons of over-the-counter medications.

Death By prescription by Ray D Strand, page 169

 

Surveys reported in our medical literature reveal that when a patient

comes into a doctor's office and requests a specific drug that he has

seen advertised in the media, the doctor writes the exact prescription

the patient requested more than 70 percent of the time!

Death By prescription by Ray D Strand, page 49

 

But, again, there is a problem. While TV ads for drugs do indeed list

potential harmful side effects, the slickly produced ads gloss over

them so fast, and with such finesse, it creates an overwhelming

impression among the public that these potential dangers are all but

nothing to worry about. Also, TV ads do not list all of the potential

side effects, but rather, just the most common side effects. So in

effect, advertisements for prescription drugs on television are

literally lying by omission.

Prescription Medicines, Side Effects and Natural Alternatives by

American Medical Publishing, page 13

 

30 percent of consumers reported having talked with their doctor about

a drug they'd seen advertised. Nearly half of those who asked for an

advertised drug—13 percent of all consumers—came away with a script.

In another Kaiser study, co-sponsored by The NewsHour with Jim Lehrer,

nearly half of American consumers said they trust advertisements to

provide them with accurate information. But perhaps most telling are

these results of a recent NIHCM study: Between 1999 and 2000,

prescriptions for the fifty most heavily advertised drugs rose at six

times the rate of all other drugs. Sales of those fifty intensively

promoted drugs were responsible for almost half the increase in

Americans' overall drug spending that year. Makers of the new

arthritis drug Vioxx spent $160 million pushing it to consumers in

2000, more advertising dollars than were dropped on Pepsi Cola,

Budweiser beer, Nike shoes, or Campbell's soups. Vioxx sales shot up

360 percent.

The Big Fix by Katharine Greider, page 30

 

Only the United States and New Zealand permit advertising of

prescription medicines to consumers.

Ephedra Fact And Fiction by Mike Fillon, page 255

 

This practice of massive advertising campaigns for drugs in order to

convince us and our doctors that we " need " various drugs and

specifying which drugs we do need should be a great concern for us.

CONSUMER REPORTS discussed this issue at length in two articles which

ran concurrently in the February and March 1992 issues entitled

" Pushing Drugs to Doctors " and " Miracle Drugs or Media Drugs? " They

estimate a figure of 5 billion dollars was spent in 1991 for this type

of advertising and add, " Though doctors insist their scientific

training, high intelligence, and sophistication enable them to resist

manipulation, the truth is that skillful marketers can influence M.D.s

just as easily as they can sway the rest of us.. " The pharmaceutical

companies spend more on this advertising than they spend in research

and development of products.

PROZAC Panacea or Pandora by Ann Blake Tracy PhD, page 43

 

Merrell Dow pharmaceuticals mounted a massive advertising campaign

admonishing, " If you want to quit smoking for good, see your doctor. .

.. . Now your doctor can provide a treatment to help control nicotine

withdrawal symptoms. " The smoking industry is too vast and the number

of smokers wishing to quit too lucrative for smoking to be overlooked

as a medical problem.

Diseasing Of America by Stanton Peele, page 119

 

The unnecessary surgery figures are escalating just as prescription

drugs driven by television advertising. Media-driven surgery such as

gastric bypass for obesity " modeled " by Hollywood personalities

seduces obese people to think this route is safe and sexy. There is

even a problem of surgery being advertised on the Internet. A study in

Spain declares that between 20 and 25% of total surgical practice

represents unnecessary operations.

Death By Medicine by Gary Null PhD, page 19

 

Since the mid-1990s, pharmaceutical companies have tripled the amount

of money they spend on direct-to-consumer advertising prescription

drugs. From 1996 to 2000, totals rose from $791 million to nearly $2.5

billion. And despite the huge increase, drug companies spend even far

more dollars in advertising their products to physicians, not

consumers. The $2.5 billion figure for consumer ads is concentrated on

a relatively small handful of medications.

Ephedra Fact And Fiction by Mike Fillon, page 176

 

Eli Lilly's advertisements in the general media for Prozac

specifically state: " Like other antidepressants, it isn't habit

forming. " No wonder so many patients are not informed either about

serious withdrawal syndromes or dependence. Obviously such statements

by pharmaceutical companies and drug advocates are attempts to

" educate " the public out of their healthy concerns about drugs in

general, including Prozac-type medications. Although aggressively

advanced, such pronouncements are at odds with the clinical reality

for many patients on the drugs.

Prozac Backlash by Joseph Glenmullen MD, page 89

 

Yet the healthcare industry — as with most other industries — is slow

to recognize the Internet's potential business opportunities and

threats. In addition, there is strong and irrational Internet

resistance from physicians, who control about 80 percent of healthcare

resources. Not surprisingly, pharmaceutical companies are switching

their advertising budgets to target consumers rather than physicians

in an attempt to influence how consumers determine their medical

treatment needs.

Future Consumer com by Frank Feather, page 190

 

The pharmaceutical companies have been quick to realize the potential

of this expanding market and are beginning to target advertising for

prescription medicines directly to consumers, on television and in

print. These developments can be positive, but they do require more

effort and responsibility from all of us.

Graedons Best Medicine by Joe Graedon & Dr Terasa Graedon, page 111

 

Among the wealthy nations that support the global pharmaceutical

industry, the United States is by far the most permissive in its

regulatory scheme. As other countries move to control prices and

sharply limit advertising, the industry increasingly turns to American

consumers for its profits.

The Big Fix by Katharine Greider, page 172

 

The Kaiser Family Foundation reports that with thousands of drugs on

the market, 60 percent of DTC spending in 2000 went to plug just

twenty products. This intensive exposure creates what ad people call

" brand awareness. " A recent survey by market research firm

Insight-Express found that, for example, 74 percent of respondents

knew Claritin by name. More than half recognized Paxil, 45 percent

knew the cholesterol-lowering Zocor, and nearly 80 percent were aware

of the pharmaceutical phenomenon Viagra. All have been among the most

heavily advertised drug products.

The Big Fix by Katharine Greider, page 91

 

This translates to a likelihood that prescriptions are being given for

drugs that are more dangerous and less effective than patients—or even

doctors—realize. Until changes are made, both physicians and patients

will be harmed by prescribing decisions based on all-too-frequently

generalized and misleading information from advertisements.

Ephedra Fact And Fiction by Mike Fillon, page 178

 

Pharmaceutical companies have overcome the obstacles of managed care.

They have sophisticated pharmacoeconomic teams to negotiate the

presence of their products on the formulary, and they have understood

how to use both legislative action and sophisticated marketing to

ensure that their products are not cut out of either Medicaid or

private sector formularies. They have been significantly investing in

DTC advertising as well as expanding their sales forces for detailing

physicians. This is the business model for the pharmaceutical industry

in the late 1990s, and industry leaders anticipate that these good

times will continue rolling into the future.

Health Care in the New Millennium by Ian Morrison, page 48

 

Yet the mainstream media operate with somewhat of a double standard.

They are willing, even eager, to use the video news releases from the

pharmaceutical and medical technology industry. The morning talk shows

are full of medical technology miracles; they cover the wonders of new

drugs and medical devices and technology using the canned television

images provided by the industry. More recently the media have been

given further conflicting incentives with the enormous explosion of

direct-to-consumer advertising; page after page of pharmaceutical

industry supplements appear in popular media. For example,

pharmaceutical giant Pfizer purchased all of the advertising space in

an entire issue of Time magazine on the " Future of Medicine. "

Similarly, Johnson and Johnson purchased the advertising space of an

entire issue of Newsweek.

Health Care in the New Millennium by Ian Morrison, page 79

 

Another issue associated with the cultural view of menopause has to do

with issues of youth and femininity. As Dr. Andrew Weil writes in his

Self Healing newsletter, " there is an unstated selling point that is

quite clear in pharmaceutical company advertisements: that it is a

chemical fountain of youth offering persistent beauty, attractiveness,

and satisfying sexuality in the face of advancing age.

Herbal Defense by Ralph T Golan ND, page 210

 

Anyone who watches television cannot but help notice a new trend in

the past couple of years — suddenly our TV programs are flooded with

advertisements for dozens of new prescription drugs. And they seem to

promise everything. Night after night, television commercials paid for

by drug companies are promising to fix or cure everything from

depression and sleeplessness, to arthritis and allergy problems. You

name it, they've got a drug for it, be the problem as serious as

cancer, or as trivial as baldness and unattractive toenails.

Prescription Medicines, Side Effects and Natural Alternatives by

American Medical Publishing, page 12

 

The 1997 change unleashed an unprecedented onslaught of commercials.

By 1999, the average American was exposed to nine prescription drug

advertisements on television every day. The number of television ads

increased 40-fold between 1994 and 2000. Suddenly it became a normal

part of our everyday experience to be confronted with the idea that we

or a loved one might be suffering from ED (erectile dysfunction, for

those not in the know), arthritis pain, high cholesterol, nasal

congestion, osteoporosis, heartburn, or even the heartbreak of toenail

fungus. In the " teachable moments " created by these skillfully raised

concerns, consumers are " educated " about readily available drugs to

solve the problem.

Overdosed America by John Abramson MD, page 152

 

Pharmaceutical advertising in medical journals and though 'detailing'

seduces doctors

 

By 1900, there were 22 homeopathic medical schools and nearly 100

homeopathic hospitals in the U.S. In fact, 15% of all American

physicians practiced homeopathy at the turn of the century, according

to Trevor Cook, Ph.D., D.I.Horn., President of the British Homeopathic

Medical Association. " However, by the same time, the bond between the

AMA and the pharmaceutical companies was firmly established. Paid

advertisements from pharmaceutical companies in the AMA's journal were

the AMA's main source of revenue (as it is today). Prominent

physicians were paid to endorse proprietary drugs and doctors were

deluged with free samples of pharmaceutical drugs. Through a series of

maneuvers including a new rating system for medical schools aimed at

eliminating homeopathic colleges, the practice of homeopathy had

nearly disappeared as a force in American medicine by 1930.

Alternative Medicine by Burton Goldberg, page 520

 

Drug company money influences every aspect of modern-day psychiatry.

The American Psychiatric Association is literally built on a

foundation of drug money: millions of dollars of pharmaceutical

advertising money are poured into the APA's publications, conferences,

continuing education programs, and seminars. In return, the APA bends

over backward to help drug companies promote their products. And 15 to

20 percent of the APA's income in recent years has come directly from

drug company advertising in APA journals—another means of guaranteeing

good press for new drugs.

A Dose of Sanity by Sydney Walker III MD, page 230

 

Pharmaceutical ad campaigns and the distribution of free samples

usually determine the drugs doctors use to treat patients with.

Advertisements in prominent medical journals are intentionally

misleading, exaggerating a drug's benefits while downplaying its

hazards in small print in the addendum. Although the FDA requires

advertisers to present a " fair balance, " Cheryl Graham, Acting of the FDA's Marketing Division, admits that one-half of the

journal ads violate this standard. And since the FDA screens only 10

to 20 percent of all drug promotions, physicians are forced to take

drug companies at their word.

Innocent Casualties by Elaine Feuer, page 73

 

Direct-to-consumer marketing increased 30 percent in 1998 alone.

Through TV, magazine, and newspaper advertising, pharmaceutical

companies are taking their message directly to the public. If it

weren't for pharmaceutical advertising supplements, Newsweek would be

only three pages long. Similarly, pharmaceutical companies have

focused on " detailing " physicians very aggressively (that is,

promoting products through sales calls to doctors to provide

information and free samples). Pfizer alone has forty-five hundred

people in its sales force. Bristol-Myers Squibb and Hoffman-La Roche,

for example, added over one thousand salespeople over the last couple

of years. Drug companies know that putting sophisticated detailing

teams in the field to promote their products to doctors makes a

difference in prescribing behavior. Doctors may find this offensive,

but detailing works.

Health Care in the New Millennium by Ian Morrison, page 30

 

The FDA's bias is further shown by its selective implementation of

policy directives. Its duty, by law, is to set standards for drug

advertisements. Yet, according to a study conducted at the University

of California and published in The Wall Street Journal, 60% of the

pharmaceutical ads from medical journals violated FDA guidelines. But

the FDA, to this day, has done nothing about these violations.

Alternative Medicine by Burton Goldberg, page 48

 

Such results can be reported by medical journalists—which are also

hired by these PR firms—in unsuspecting medical journals. Healthcare

PR firms also undertake conventional lobbying strategies, such as

opposing restrictions on " direct-to-con-sumer " advertising, which

allows companies to market prescription and OTC drugs using the same

techniques as toiletry items. They can also move very quickly and

deftly to " squash " any negative news about their clients, as well as

to promote damaging news about others. Could it be this is a strategy

being deployed against the dietary supplement industry?

Ephedra Fact And Fiction by Mike Fillon, page 146

 

Furthermore, physicians who abide by a conventional Western medical

perspective are more likely to publish papers and be on editorial

boards of scientific journals than their peers who hold to different

philosophies. " There is kind of a self-selection process where

physicians who are against alternative medicine end up being on the

editorial boards of the journals, " Dr. Gaby says. It's important to

bear in mind that many medical journals receive a substantial amount

of revenue from the advertising dollars they get from the

pharmaceutical industry, whose interests would not be served by

articles and studies that recommended the use of alternative medicine

over drugs and surgery.

Alternative Medicine by Burton Goldberg, page 51

 

We are fully aware that what stands in the way of change are powerful

pharmaceutical companies, medical technology companies, and special

interest groups with enormous vested interests in the business of

medicine. They fund medical research, support medical schools and

hospitals, and advertise in medical journals. With deep pockets they

entice scientists and academics to support their efforts. Such funding

can sway the balance of opinion from professional caution to

uncritical acceptance of a new therapy or drug. You only have to look

at the number of invested people on hospital, medical, and government

health advisory boards to see conflict of interest. The public is

mostly unaware of these interlocking interests. For example, a 2003

study found that nearly half of medical school faculty, who serve on

Institutional Review Boards (IRB) to advise on clinical trial

research, also serve as consultants to the pharmaceutical industry.

Death By Medicine by Gary Null PhD, page 10

 

Yet doctors repeatedly make new drugs bestsellers within months. Drug

reps fill doctors' cabinets with " free " samples, knowing that if

patients do well on them, they won't want to switch. Drug advertising

seizes upon any difference, no matter how trivial, to sway doctors to

prescribe expensive new drugs with no track records, and doctors

readily oblige. You'd think that after recent disasters with Baycol,

Rezulin, Lotronex, Duract, Redux and Fen-Phen, doctors would learn,

but they keep prescribing new drugs like Clarinex, Nexium, and Bextra

at greater risk and cost. These repeated problems compelled Drs.

Marcia Angell and Arnold Relman, another former editor of the New

England Journal of Medicine, to warn, " Few Americans appreciate the

full scope and consequences of the pharmaceutical industry's hold on

our health care system. "

Disease Prevention And Treatment by Life Extension Foundation, page 725

 

At first, pharmaceutical companies stepped up advertising, some of

which ran for four pages, in the medical journals and weekly magazines

sent to doctors' offices. Soon, such ads constituted the medical

journals' major source of funding, and while they continue to deny it,

publishers are influenced by the pharmaceutical industry in choosing

which articles to print. Articles concerning alternative treatments,

such as the use of nutritional supplements, are few in number in

clinically oriented journals, and usually are routinely rejected in

favor of articles extolling the virtues of a prescription drug or

surgical procedures.

Health And Nutrition (see related ebook on nutrition) Secrets by

Russell L Blaylock MD, page 344

 

Recently, pharmaceutical companies have launched an even cleverer

plan. Whereas, in the past they depended on frequent visits to the

doctors' offices by drug reps to convince doctors to use their drugs,

now they've bypassed doctors altogether and advertise directly on

television and the radio, urging people to tell their doctors they

want to try the advertised drug.

Health And Nutrition Secrets by Russell L Blaylock MD, page 366

 

If you scan most clinical journals, you will see that they are filled

from cover to cover with ads from pharmaceutical companies and medical

supply dealers. These are very expensive ads. In addition, many of

these companies give grants to the journals in which they advertise.

Unfortunately, this is also true of many nutrition journals as well.

Doctors tend to read the articles that deal with new drugs being

developed, new surgical techniques, and advances in diagnosis. The

scattered nutritional or biochemical articles are rarely read.

Health And Nutrition Secrets by Russell L Blaylock MD, page 367

 

This subtle type of bias sometimes becomes more blatant. For example,

a former editor of the Journal of the American Medical Association

(JAMA) alleged that Pfizer, a major pharmaceutical company, had

withdrawn $250,000 worth of advertising because an article appearing

in JAMA had cast one of their drugs in an unfavorable light.

Preventing And Reversing Osteoporosis By Alan R Gaby MD, page 249

 

Another area in which pharmaceutical companies wield enormous

influence is medical " education. " Most doctors in this country are

visited on a regular basis by " representatives, " salesmen from large

pharmaceutical companies. In surveys, doctors list pharmaceutical

salesmen as one of their most important sources of information about

new drugs. Salesmen and drug company " literature " are where doctors

first learn about things like " serotonin imbalances " and serotonin

" selectivity. " Lavish advertisements in medical journals carry similar

messages.

Prozac Backlash by Joseph Glenmullen MD, page 226

 

Doctors have access to many other sources of medical information. Some

invite pharmaceutical representatives into their offices and

conferences, and some attend industry-sponsored conferences. Some

avidly read free pamphlets and journals sent to them by pharmaceutical

companies. By contrast, some read only the journals that come as part

of membership in a professional society, and pay their own money to

to sources that are not dependent on pharmaceutical company

support, contain no advertising, and are funded entirely by

subscription fees.

On The Take by Jerome P Kassirer M.D., page 84

 

Dr. Richard Smith, editor of the British Medical Journal, has raised

the concern that lucrative advertising and reprint sales can be a

corrupting influence. One experience at the Annals of Internal

Medicine in 1992 sent a chill down the spines of editors and

publishers alike. When the (then) editors, Drs. Suzanne and Robert

Fletcher, published a study sharply critical of the pharmaceutical

industry, pharmaceutical advertising in the journal declined

substantially, and remained lower than usual for months thereafter.

For editors of many journals whose profit margins are not robust, that

experience might lead them to be chary about criticizing the

advertisers who support their publications.

On The Take by Jerome P Kassirer M.D., page 91

 

Drug companies often claim that they are just helping the public by

providing physicians the best information possible. They admit that

they might make friends and generate goodwill for their companies in

the process, but their primary goal, they claim, is education, not

marketing. One provider of medical education, Joe Torre, the chief

executive of an advertising agency that owns its own clinical research

company, said, " Very often doctors are more influenced by what other

doctors say than what pharmaceutical companies have to say. So

companies work through medical education companies to have doctors who

support their products talk about their products in a favorable way.

That's called medical education. "

On The Take by Jerome P Kassirer M.D., page 93

 

In effect, the publication is more a paid advertisement for industry

than a publication of a learned medical society. In fact, the

misleading headings are only part of the deception. The title,

Symposia Excerpts, misleads the reader to thinking that he is reading

selected summaries of key talks on the formal schedule of the

conference. In fact, they are summaries of after-hours conferences

sponsored by pharmaceutical companies. Despite the assertion on the

cover that the Symposia Excerpts is a publication of the ATS, the ATS

carefully disavows responsibility with a disclaimer that reads: " The

opinions expressed in this publication are those of the speakers and

do not necessarily reflect the opinions or recommendations of their

affiliated institutions, the publisher, the American Thoracic Society,

or any other persons. "

On The Take by Jerome P Kassirer M.D., page 121

 

The PDR, free meetings and gifts, and direct contact by drug-company

representatives constitute three major ways that drug companies

influence physicians' choices of medications. A fourth way is

advertising. Most of this advertising is done in medical journals,

which also serve as an important source of information for physicians.

Overdose by Jay S Cohen, page 56

 

In fact, pharmaceutical companies spend more than 21 billion dollars a

year on promoting and marketing their products, of which about 88

percent is directed at physicians. With approximately 600,000

physicians in active practice this amounts to more than $30,000 spent

on each physician. Although industry market research data are

unavailable, studies of physicians show what common sense predicts,

namely that physicians are influenced by all kinds of marketing tactics.

On The Take by Jerome P Kassirer M.D., page 78

 

Beyond these direct influences, drug companies exert broad influence

over the drug information received by doctors and consumers. The vast

majority of everything physicians and consumers read and know about

medications comes from the drug companies. Medication package inserts,

drug advertising toward physicians and consumers, and the information

in the ubiquitous Physicians' Desk Reference come directly from the

drug companies. Where do most doctors turn for medication and dosage

information? To the PDR, to drug company representatives who make the

rounds of doctors' offices, and to advertising in medical journals.

Yet, the medication information offered by these

drug-company-supported sources is often biased, incomplete, and

sometimes inaccurate.

Overdose by Jay S Cohen, page 16

 

A cursory look at almost any medical journal will reveal dozens of

advertisements by the drug companies. Glossy ads promote the efficacy

or ease of usage of drugs. Some ads boast that physicians don't have

to bother reducing the drugs' dosages for older people, not even for

those with other disorders or taking other medication. The content of

these ads is based on the information in package inserts, with the

same limitations or omissions of important side effects and/or lower,

safer doses.

Overdose by Jay S Cohen, page 56

 

A historical perspective of pharmaceutical advertising

 

One may guess that papers taking advertising dollars from poppers'

pharmaceutical source were in no hurry to dig up the unflattering

history of animal experiments that did see immune damage stemming from

use of the drug.

Aids A Second Opinion by Gary Null PhD with James Feast, page 200

 

Back in the World War II era, it was the same for tobacco. Page

through a few magazines of the day to look at the advertisements for

Pall Mall or Lucky Strike and you will find that smoking is not only

proclaimed to be safe but even said to promote health! Moreover,

everybody was lighting up, just as in a certain strata, everybody was

inhaling. Poppers and cigarettes were sexy, for god's sake. What is

being asserted, then, is that certain practices that now seem

unconscionably risky were once seen as innocent, as innocent as, in

days gone by, puffing on a Lucky.

Aids A Second Opinion by Gary Null PhD with James Feast, page 265

 

Fishbein was the most powerful man in American medicine in his day.

The AMA (and Fishbein) consolidated their hold over American medicine.

Subscriptions to the Journal had increased from 13,078 in 1900 to over

80,000 by 1924. Income from pharmaceutical advertising was already in

the hundreds of thousands of dollars. Yet AMA leaders were conscious

of the threat posed by irregular practitioners. Ironically, the

long-time General Manager of the Association, George H. Simmons, MD,

had himself been a homoeopathic practitioner in Lincoln, Nebraska,

" and one of a rather partisan hue. "

Herbs Against Cancer by Ralph W Moss PhD, page 75

 

FDA control (or lack or control) of pharmaceutical advertising

 

Another connection between the FDA and the pharmaceutical industry is

through the pharmaceutical Advertising Council (PAC). In 1985, the PAC

teamed up with the FDA to solicit funds from the pharmaceutical

industry for the purpose of combating medical quackery. " The

pharmaceutical Advertising Council and the FDA also issued a joint

statement addressed to the presidents of advertising and PR agencies

nationwide asking them to cooperate with a joint venture anti-fraud

and quackery campaign, " according to Mark Blumenthal, Executive of the American Botanical Council.

Alternative Medicine by Burton Goldberg, page 48

 

The primary culprit in promoting the misprescribing and

overprescribing of drugs is the pharmaceutical industry, which now

sells about $80 billion worth of drugs in the United States alone. By

intimidating the Food and Drug Administration (FDA) into approving

record numbers of me-too drugs (drugs that offer no significant

benefit over drugs already on the market) that often have dangerous

adverse effects and by spending well in excess of $12 billion a year

to promote drugs, using advertising and promotional tricks that push

at or through the envelope of being false and misleading, this

industry has been extremely successful in distorting, in a profitable

but dangerous way, the rational processes for approving and

prescribing drugs. Two studies of the accuracy of ads for prescription

drugs widely circulated to doctors both concluded that a substantial

proportion of these ads contained information that was false or

misleading and violated FDA laws and regulations concerning advertising.

Worst Pills Best Pills by Sidney M Wolfe MD and Larry D Sasich PharmD

MPH, page 10

 

The division at FDA responsible for policing prescription drug

advertising has not been given adequate resources to keep up with the

torrent of newly approved drugs. As a result, the drug industry

correctly believes it can get away with more violative advertising

than in the past. The role of the U.S. Congress in pushing the FDA

into approving more drugs, and passing, with the FDA's reluctant

approval, legislation to further weaken the FDA's ability to protect

the public, cannot be overlooked.

Worst Pills Best Pills by Sidney M Wolfe MD and Larry D Sasich PharmD

MPH, page 10

 

Though broadcast advertising of prescription drugs has been legal for

years, guidelines released by the FDA in 1997 clarified the rules for

advertising directly to consumers. According to these guidelines, drug

companies can fulfill their obligations for informing consumers about

prescription drugs by referring in advertisements to four sources of

additional information: their doctor, a toll-free number, a magazine

or newspaper ad and a website.

Ephedra Fact And Fiction by Mike Fillon, page 77

 

Health care advocates were shocked by the decision of the Food and

Drug Administration (FDA) to allow drug makers to advertise

prescription drugs on television giving only minimal information about

the risks involved.

Under The Influence Modern Medicine by Terry A Rondberg DC, page 70

 

And for the first time in decades, pharmaceutical companies are

advertising heavily direct to the public. The 1962 Harris-Kefauver

Amendment to the Federal Food and Drug Act imposed strict regulations

on pharmaceutical company advertising. The requirements brought to a

halt the aggressive marketing of notorious drugs like amphetamine

antidepressants and barbiturates. But in the mid-1990s, the FDA

liberalized the requirements pharmaceutical companies have to meet.

The result has been a surge of advertising drugs direct to consumers.

Prozac Backlash by Joseph Glenmullen MD, page 231

 

Wilkes and a group of colleagues had earlier conducted a study of

prescription drug advertisements which showed " many claims prove to be

inaccurate or misleading. " The study was published in the June 1,1992

issue of the Annals of Internal Medicine. For the study, Wilkes' group

asked medical experts to review 109 advertisements from the country's

ten leading medical journals. Using the FDA's guidelines for

pharmaceutical company advertising, the reviewers " indicated that 92%

of advertisements were not in compliance in at least one area " of the

FDA's guidelines. Wilkes' group speculated " that the FDA is unable or

unwilling to enforce adequately its rules relating to drug advertising.

Prozac Backlash by Joseph Glenmullen MD, page 232

 

For years the pharmaceutical industry was allowed to market its drugs

only to doctors. It did this through medical journals, continuing

medical education, sponsored events, sales calls, and junk mail. Then,

in 1981, the drug industry proposed that the FDA allow advertising

directly to consumers, arguing that the public should not be denied

access to the " knowledge " that would be provided by such marketing.

Four years later, the pharmaceutical industry got its foot in the door

when the FDA agreed to allow " direct-to-consumer " (DTC) advertising.

But the rules were strict, and the content of the ads was, therefore,

limited: Drugs could be mentioned by name, but advertisements that

discussed the treatment of specific conditions were required to

include a lengthy list of side effects and contraindications

(situations in which the drug should not be used). As a result, the

ads were vague and unfocused, primarily brand-awareness campaigns

designed to smooth the way at the doctor's office.

Overdosed America by John Abramson MD, page 151

 

In the fall of 1971, the FDA also made a serious attempt to halt the

growth of the increasingly popular field of alternative medicine. By

defining all unorthodox medical treatments as " quackery, " which they

interpreted as " misinformation about health, " the FDA attempted to

prevent physicians, manufacturers, and consumers from practicing

alternative therapies. The federal government's war against quackery

was supported by the pharmaceutical companies and the AMA. In 1985 the

pharmaceutical Advertising Council and the FDA solicited funds from

the pharmaceutical industry to combat medical quackery; they also

issued a joint statement addressed to the presidents of advertising

and PR agencies nationwide, asking them to cooperate with the

anti-quackery campaign.

Innocent Casualties by Elaine Feuer, page 11

 

Although it is entirely legal for a doctor to use a drug off-label, it

is illegal for a drug company to advertise a drug for any purpose

other than the one or ones approved by the FDA. By recruiting

physicians to discuss off-label uses, therefore, the drug companies,

in essence, bypass official channels and create a potent marketing

force of physicians. One flagrant example of physicians aiding in

marketing came to light when a whistleblower charged that

Warner-Lambert had engaged in unlawful off-label marketing of the

anti-epilepsy drug, Neurontin. In May 2004, Pfizer pled guilty to

Medicaid fraud and agreed to pay fines of approximately $430 million.

On The Take by Jerome P Kassirer M.D., page 28

 

Government intervention is also warranted on industry-initiated and

industry-sponsored " front organizations. " These groups, often led by

financially conflicted physicians, sponsor ventures such as pamphlets,

brochures, pocket books, Web sites, and registries, and they have

gotten out of hand, often subtly recommending off-label drugs and

promoting expensive drugs. Although federal agencies have control over

drug advertising, these ventures apparently have escaped detection and

oversight. Nonetheless, they may have even more impact on the use and

misuse of drugs than pharmaceutical advertising in medical journals

and in the lay media. These publications masquerade as educational

materials, but many are largely marketing efforts that deserve as much

scrutiny as drug advertisements.

On The Take by Jerome P Kassirer M.D., page 207

 

Overview:

 

* The great direct-to-consumer prescription drug advertising con:

how patients and doctors alike are easily influenced to demand

dangerous drugs

 

Source: http://www.newstarget.com/010314.html