Drug Ads Work — On Doctors

Next time you turn on the tube and you see an ad for a certain kind of drug you might think you’re mentally strong enough to resist being greatly influenced by the advertising, and you might be right: you might not automatically embrace the drug just because you see it hyped on TV.

But your doctor MIGHT. If a patient asks a doctor for a heavily hyped drug he’s apt to get it — maybe even if he doesn’t really need it.


That’s the surprising finding of a new study that finds that drug advertising has a big impact on how drugs are prescribed by doctors. Reports the New Scientist:

Advertising drugs directly to patients has a “profound effect� on the way doctors prescribe, finds a new study in which actors posed as patients.

Drug companies have poured billions of dollars into direct-to-consumer (DTC) advertising in the US since the rules governing mass media advertising for prescription drugs were relaxed in 1997. Other countries – such as the UK, for example – do not permit advertising directly to patients.

But critics charge that DTC advertising can lead to over-prescribing which might be potentially harmful, while proponents say that giving patients knowledge about drugs can avert the under-use of effective treatments.

The findings have particularly great impact because the study appears to be solid and was done quite carefully. Some details from The Washington Post:

Actors pretending to be patients with symptoms of stress and fatigue were five times as likely to walk out of doctors’ offices with a prescription when they mentioned seeing an ad for the heavily promoted antidepressant Paxil, according an unusual study being published today.

The study employed an elaborate ruse — sending actors with fake symptoms into 152 doctors’ offices to see whether they would get prescriptions. Most who did not report symptoms of depression were not given medications, but when they asked for Paxil, 55 percent were given prescriptions, and 50 percent were diagnosed with depression.

The study adds fuel to the growing controversy over the estimated $4 billion a year the drug industry spends on such advertising. Many public health advocates have long complained about ads showing happy people whose lives were changed by a drug, and now voices in Congress, the Food and Drug Administration and even the pharmaceutical industry are asking whether things have gone too far.

The Post article notes that nearly every industrialized country bans this type of advertising, then includes this key quote:

“It is a haphazard approach to health promotion that is driven primarily by the pharmaceutical industry’s interest in turning a profit,” said Matthew F. Hollon, an internist at the University of Washington in Seattle, who wrote an editorial accompanying the study in today’s Journal of the American Medical Association. “The most overlooked problem in the health care system today is the extent to which it is permeated by avarice.”

Daily News Center also has an extensive piece, which includes a cautionary note at the bottom:

Doctors were significantly more likely to consider diagnosing depression, and recording that diagnosis, if the actor-patient made a request for medication compared with no request.

Although other studies have examined the effects of DTC advertising on consumer and clinician behavior, this was the first to examine the tendency to over-prescribe or under-prescribe a medication. The National Institute of Mental Health funded the project.

The researchers noted a few drawbacks to the study, however. Chiefly, they cannot determine whether DTC advertising actually produces the kinds of behaviors in real patients that were portrayed by the actors.

Yet, they write, the results “sound a cautionary note for DTC advertising and also highlight opportunities for improving care of depression (and perhaps other chronic conditions) by using public media channels to expand patient involvement in care.”