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Pharmaceutical marketing raises wide range of concerns

Wondering what ails you and what medication you should take for it? Just plug into electronic or print media for a barrage of pharmaceutical marketing hawking a wide array of medications for many illnesses, some of which you may not have known existed.

Healthcare professionals try to maintain a balanced view of these advertisements.

“I see good and bad with it,” says Buddy Ogletree, who has a doctorate in pharmacy and is an instructor at the University of Mississippi Medical School (UMC). “Sometimes it helps people realize what’s going with them, and that it’s a medical condition that can be treated. On the other hand, some people will think they have a condition they don’t have.”

Ogletree also coordinates the drug information center at UMC where he is a resource for healthcare professionals throughout the state about drug side effects and interactions and new products. It bothers him when he sees misleading information put forth in advertising.

“There’s one pharmaceutical ad that says the product will heal a condition when it’s the body that heals it,” he says. “It’s misleading. The drug allows the body to heal itself. The people putting these ads together know what to do — which buttons to push.”

What about the physician/patient relationship when patients ask for a product they’ve seen advertised and the professional doesn’t agree? Ogletree thinks that happens quite a bit.

The Mississippi State Medical Association (MSMA) encourages physicians to maintain professional standards of informed consent when prescribing, engaging in a dialogue that will assess and enhance the patient’s understanding of the treatment.

“Although physicians shouldn’t be biased against drugs that are advertised, we can’t succumb to pressure to prescribe drugs that may not be indicated,” says Dwalia S. South, M.D., president of MSMA.

However, South understands the reality and time constraints of running a busy medical practice.

“I have to talk people out of a drug,” the Ripley family practitioner says. “I have to explain why something that costs $200 a month is not better than a generic that costs much less. Many times the easiest route is just to stay here and write the prescription because I may not have 15 minutes to discuss it.”

Time precious

Dr. Edward Hill of Tupelo says the stress physicians in Mississippi experience is due to the ratio of physicians to patients. “We’re inundated and pressured, but I still feel we have a tremendous responsibility to educate patients,” he says. “We don’t want to be a barrier to innovation and new pharmaceuticals, but we also want to make sure the public is not misled.”

Hill, a former president of MSMA and the American Medical Association (AMA), points out that drug companies have spent years and huge costs for research, development and innovation of products. “We must remember that before jumping on direct marketing to consumers,” he says. “Social advertising is a fact of life in America.”

South says it’s common for physicians to deny requests for inappropriate prescriptions. “Instead, we try to educate patients as to why certain advertised drugs may not be suitable treatment options, providing, when available, information on the cost effectiveness of different options,” she says. “Physicians also must remain vigilant to assure that direct-to-consumer advertising doesn’t promote false expectations.”

She adds that she finds some of the advertising disclaimers infuriating, and she cites one advertised product that can only be taken by infusion. “Why are they letting consumers go to their doctors and ask for something that is by IV only?” she wonders.

Driving costs?

All three professionals say pharmaceutical advertising is driving up healthcare costs. “The companies do it because it works and drives up costs of medications,” South says.

Ogletree says that while he hasn’t seen the books of drug companies, he knows they’re spending big budgets on advertising and there must be a reason.

“We also have to remember that some of the marketed drugs have had problems and been taken off the market,” he says. “Most of the problems have to do with the number of people in the clinical trials for the drugs. There aren’t a lot. Then, there are a lot of people using it from the advertising and problems arise.”

Hill says Americans want a pill for everything, but there is a responsibility. “First, the patient has a responsibility to want to become informed,” he says. “Then, the physician has an enormous responsibility to guide the patient from good research and evidence. We must have a balance. A well-informed patient is worth the investment of time.”

The MSMA stresses that positive health effects can occur for patients who speak with their physicians about ads they saw in the media. Studies have found that more direct-to-patient advertising leads to more requests for advertised medicines and more prescriptions.

“More prescriptions for patients generally means higher drug costs for the patient,” South says. “However, if the pharmaceutical ad leads a patient to their physician and the prescription is warranted, obviously it’s better for the patient to have sought treatment than to have ignored symptoms.”

She added that the medical profession has taken an active role in ensuring that proper advertising guidelines are enforced and that the care patients receive is not compromised as a result of advertising. The MSMA and the AMA have a policy on direct-to-consumer advertising.

“MSMA has a strong interest in working with the AMA and the Food and Drug Administration (FDA) to ensure that the FDA remains committed to advertising standards that protect patients’ health and safety,” South says.

Contact MBJ contributing writer Lynn Lofton at llofton656@aol.com.

About Lynn Lofton

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