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The Nurse Card

Buyer Beware!: Practicing Caution with Pharmaceutical Ads

Published November 8, 2016 9:18 AM by Diane Goodman

If you spend any time watching your favorite televised programs or leafing through a popular magazine, you may be surprised by the increased number of pharmaceutical advertisements targeted at consumers with chronic conditions. The "patients" are generally smiling and engaged in lively outdoor activities. They appear to be fully involved in life by the assistance of whatever medication(s) is heralded as the "next big thing."

Crohn's disease? Diabetes? Psoriatic arthritis? End-stage lung cancer? Chronic IBS? They're not slowing these people down! Patients can't wait for a chance to talk to their physician about initiating one of these life-altering/life-extending medications. It almost seems too good to be true.

It is.

Direct-to-consumer (DTC) marketing is utilized by only two developed countries in the world: the United States and New Zealand. Physicians often frown upon the continued use of this type of marketing as the ads are scarcely regulated by the FDA. Additionally, patients may ask for medications without knowing the full scope of the medication's indication, possible side effects, cost, and drug interactions. A medication may or may not be appropriate for the consumer. Because the advertisements are minimally regulated by the FDA, they may not even be screened for content prior to being viewed by consumers. Cost is a huge factor. Usually, the newest and most expensive medication is marketed without any mention of cheaper or non-pharmaceutical alternatives. One of the primary issues for uninformed patients can be cost.

As an example, a relatively unassuming medication to treat toenail fungus was marketed to consumers via direct-to-consumer ads. You may remember the product. It was sold by an attractive, heavily-dimpled celebrity. Medicare patients had no idea what the actual cost of the medication entailed, and neither did their physicians, as pharmacies billed Medicare directly. It was only when these same Medicare patients fell into the "donut hole" of their policies that panic began to erupt, as they were billed $400-600 for the same 4mL container of antifungal liquid at their pharmacy. Mass hysteria ensued.

Eventually, coupons were printed by the pharmaceutical company for reduced pricing, but the product was still out of reach for many senior citizens and those without insurance and/or high insurance deductibles.

Hepatitis C is another area for massive potential profit, with one of every 30 baby boomers potentially testing positive for the virus. With the cost of one pill of a newer medication averaging ~ $1000, you can imagine the revenue. In the year 2015, the United States spent $9 billion treating Medicare patients for hepatitis C. "Are you ready for Harvoni?" the televised commercial asked consumers. Apparently, many of those watching desired treatment. It was unfortunate that only a year later a warning was issued that these drugs may cause dormant hepatitis B to emerge, requiring careful screening of patients prior to treatment. This may have been missed if groups had been previously treated.

Ultimately, reaching consumers with chronic disease is great, especially if they can be encouraged to seek more active lives and be more fully engaged in their own care. However, with DTC advertisement, healthcare seems to be taking a backseat to profit. Before patients can be smiling, riding bikes, jumping around, and taking grandchildren fishing, they should proceed with caution on a note of "buyer beware."

These ads are televised to sell medications, not necessarily safety. Profit appears to be important, not patient care. Those are models, celebrities, or actors in the commercial, and they may look like you, but they're not. I doubt there is a decent toenail fungus in the bunch.

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About this Blog


    Diane M. Goodman, APRN, BC, CCRN, CNRN
    Occupation: Clinical Educator
    Setting: Advocate Condell Medical Center, Libertyville, Ill

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