The resolution, approved by the AMA’s House of Delegates, has no immediate impact as only the Food and Drug Administration or Congress has the power to ban pharmaceutical advertising.
“Today’s vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices,” AMA board chair-elect Patrice A. Harris said in a statement Tuesday. “Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”
DTC ads offer “scientifically accurate information to patients so that they are better informed about their health care and treatment options,” Tina Stow of the trade group Pharmaceutical Research and Manufacturers of America told the Asssociated Press after the AMA’s decision. The ads lead to “important doctor-patient conversations about health that might otherwise not take place,” she said.
According to the AMA, as more people seek drugs they may not need from doctors who may not be willing to prescribe them, drug prices and the money spent on selling them is on the rise. The group reported an 30 percent uptick in the money spent on DTC ads in the past two years, now a total of $4.5 billion. Meanwhile, prescription drug prices rose nearly 5 percent this year. This leaves everyone worse off, some say.
“Physicians strive to provide the best possible care to their patients, but increases in drug prices can impact the ability of physicians to offer their patients the best drug treatments,” Harris said. “Patient care can be compromised and delayed when prescription drugs are unaffordable and subject to coverage limitations by the patient’s health plan. In a worst-case scenario, patients forego necessary treatments when drugs are too expensive.”
Though some forms of DTC drug advertising has been permitted for decades, regulatory changes the FDA made to guidelines in 1997 made such spots ubiquitous. Within a decade, the industry’s budget for DTC ads ballooned from little more than $300 million to more than $3 billion. Almost immediately, the AMA got nervous.
“When a patient comes to a physician with a request for a drug he or she has seen advertised, the physician and the patient should engage in a dialogue that would assess and enhance the patient’s understanding of the treatment,” the AMA advised in 1999. “Although physicians should not be biased against drugs that are advertised, physicians should resist commercially induced pressure to prescribe drugs that may not be indicated.”
Advertisers, however, turned up the heat. A market that had been cordoned off, albeit imperfectly, was now wide open.
“Nobody had ever thought that these drugs should be or could be advertised to the patients. It was just outside of people’s brains,” Joe Davis, an adman who pioneered DTC drug spots, told NPR in 2009. “They thought that only doctors could understand the products. They’re technical products. They’re scientific products.”
Such thinking soon proved quaint. DTC television ads — for Viagra, for Ambien, for the anti-toenail fungus Jublia, among many others — are now unavoidable. Even the terrifying list of many drugs’ side effects — a must in any ad by FDA mandate — doesn’t seem to dissuade consumers.
“Something like a third of consumers who’ve seen a drug ad have talked to their doctor about it,” Julie Donohue, a professor of public health at the University of Pittsburgh, told NPR. “About two-thirds of those have asked for a prescription. And the majority of people who ask for a prescription have that request honored.”
As some pointed out, the AMA’s vote — a resolution that can be ignored by legislators — may not mean much. Even if DTC ads are banned from, say, television, there’s always social media.
“In the old days, DTC was the one way they tried to reach consumers,” Steven Woloshin, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, told BuzzFeed. “Even if you got rid of all the magazine ads and TV ads, there’s still a tremendous platform to reach consumers.”