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Tuesday, February 19 , 2019, 9:26 am | Fair 52º


Harris Sherline: Pushing Drugs the Legal Way

If our drug culture is out of control, perhaps it has something to do with the mixed messages that are bombarding us.

If selling “illegal substances” is a crime, what about legal drug pushers? Pharmaceutical manufacturers, that is. In 1997, the drug companies turned to aggressively hawking their products directly to consumers, after generations of leaving the need for drugs and their selection to medical professionals.


TV commercials and print ads urge the public to tell their doctors they want the prescription medicines that are being pushed. Buy Nexium, “The Purple Pill,” they say. It will fix your heartburn. Only now it’s called “acid reflux disease,” with all the potential dangers implied by the new name for that ominous affliction. Or, a pill that can help with “bipolar disorder,” “deadly artery plaque,” or perhaps some new “syndrome.”

Watching TV at night, we easily see 10 or 20 commercials hustling drugs. All this aggressive marketing is perfectly legal. You can go to jail for smoking “weed,” but it’s OK to drug your children so they will behave themselves and, hopefully, learn, or take drugs yourself to deal with problems such as ED, prostate, artery plaque, arthritis, menopause, on and on ad infinitum.

But, watch out they tell us, droning on endlessly about the potential side effects of their products. Everything from gas to headaches to fainting to possible liver and kidney damage, on and on they warn — a veritable litany of the risks of taking their medications.

And, what has all this produced? An out-of-control drug culture, with mixed messages coming at us from every direction, confusing and misdirecting our attention, that’s what. "Don’t do drugs,” unless, of course, they happen to be the drugs of choice that the drug companies are hustling.

The reason is obvious: It’s about increasing sales.

And, it works.

From 1996 to 2005, the amount of money spent on advertising by drug companies increased to $29.9 billion from $11.4 billion, according to the New England Journal of Medicine. A study by Elizabeth Ann Almasi at Stanford University, “The Relationship between Direct-to-Consumer Prescription Drug Advertising and Prescription Rates,” included the following points:

• Prescriptions for the 50 most heavily advertised drugs grew at a rate six times greater (24.6 percent) than other drugs (4.3 percent) between 1999 and 2000.

• Besides prescriptions, DTCA (direct to consumer advertising) has also increased the demand for other forms of treatment. Fourteen percent of patients disclosed health concerns as a result of advertising.

• A study by Murray (2004) found that 24 percent of all people scheduled a visit with their physician specifically to talk about a prescription drug advertisement.

• Physicians granted 12 percent of ad-generated prescription drug requests in which they did not believe the therapy would be helpful.

• Of the patients who recalled seeing a DTC advertisement, 94 percent remember television promotions, 62 percent recall newspaper and journal advertisements, and 22 percent recall radio spots. (Kaiser Health Poll, 2005)

• Spending on DTC is highly concentrated on products that generally treat chronic conditions and have a low incidence of side effects. (Rosenthal et al, 2002)

“A survey of family physicians found that 71 percent felt DTC (direct to consumer) ads pressure doctors into prescribing drugs that they would not normally prescribe," Z Magazine noted. "And, according to a study by the Henry K. Kaiser Foundation, when patients request a specific drug, doctors prescribe it 44 percent of the time."

Z also concluded that “ads are often for unnecessary or ‘lifestyle’ drugs that fuel the belief that there is a ‘pill for every ill.’ Drugs for thinning hair, toenail fungus and other problems are heavily promoted while important inexpensive treatments, like water pills for high blood pressure, are ignored.”

The Department of Advertising at University of Texas at Austin, tells us, “…the First Amendment, places constraints on government repression of speech. Advertising is recognized by the courts as a form of ‘commercial speech.’ Commercial speech has been defined by the Court as speech ‘which does no more than propose a commercial transaction.’ Although the courts never have recognized it as being as valuable as some other forms of speech, commercial speech is protected by the First Amendment.”

So, what to do about all this? Should the government ban all direct to consumer advertising of drugs? Unfortunately, that’s not possible — because advertising is also considered free speech, and we can’t deprive the drug companies of their right to speak, that is, to advertise.

If DTC advertising can’t be banned, what can be done? Could the Food and Drug Administration counter the drug companies’ hype by educating the public to the fact that most of what is beamed our way is not intended to educate, so much as to scare potential customers? I don’t know, but my sense is, don’t count on it.

Nothing sells like fear, and marketing drugs directly to consumers is based on fear.

Meanwhile, click here for a cartoon that pretty much sums up the dilemma.

Harris R. Sherline is a retired CPA and former chairman and CEO of Santa Ynez Valley Hospital who has lived in Santa Barbara County for more than 30 years. He stays active writing opinion columns and his own blog, Opinionfest.com.

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