Opinions: Ignoring the side effects

 by Josh Spivack
 published on Thursday, March 27, 2008

Turn on your television, and among the dizzying array of noise you're guaranteed to see, you're also likely to see an assortment of advertisements relating to prescription drugs, all appealing to those who may or may not be sick. Most of us observe this nonchalantly. I, for one, had trouble conceptualizing these advertisements — they just seem to fall into the gaps and become normal.

But they aren't normal, and their history, purpose and cause in American medicine is worth looking at: What roles do ads that promote drugs in which one must obtain a prescription for serve? For my research, I interviewed an experienced doctor who wished to remain nameless for this report, as well as researched various other resources including the FDA and the Center for Health Statistics.

My first concern was that these ads added to the concept of drug abuse in the United States, especially the current epidemic with prescription drug abuse. This correlation seemed important, however it was quickly dismissed as unfounded — the drugs that are advertised are almost always the kinds that serve a specific purpose, drugs that have no abuse potential. Given that there are no advertisements for drugs that contain opiates such as codeine, drug abuse does not directly stem from these commercials.

Despite this, we as a society are frequently on drugs. Our medical system fits in our capitalist society in that it allows any individual who feels in need of a drug to obtain one through means of a doctors' prescription: Last year alone, 204.8 million drugs were provided to patients.

When you include the fact that the only thing restricting pharmaceutical companies in their advertisements is the manner in which they present their drug to its intended uses, one shouldn't be surprised that our society consistently takes medicine and drugs. It's quite possible that Americans see these advertisements and think to themselves that they are indeed ill, or at least in need of medical attention.

When patients see an ad and is convinced that they are ill, they go to a doctor who orders a prescription incumbent upon a diagnosis. However, often a doctor's suggestion differs from what the patient has been advertised to want. And after pressure from the patient and from the pharmaceutical companies themselves.

The companies send representatives out in a process known as "drug detailing," in which representatives push the specific drug, and the doctor often must relent and order the desired prescription. So long as there is an ailment in need of fixing, the patient is entitled to whatever (legal) remedy they desire.

This is where advertisements become a serious problem. We aren't smart enough to prescribe ourselves medicine, yet these advertisers trick many of us into thinking that we are. These advertised prescription drugs are always more expensive then their generic counterpart. They are what are known as "on patent," which the FDA gives to products to protect them for a varying amount of specified time in which the drug is heavily advertised and more expensive to consumers, thus raising health care in general.

The change was tricking the casual viewer. It used to be that similar advertisements were restrained to medical journals for doctors to see, but about a decade ago, advertisements shifted into the mainstream public. Marketing towards the everyday Joe, they attempted to resonate in the same way other ads do but under a significantly different branch of moral codes.

In the end, the problem with these advertisements is that they shifted the responsibility to the consumer. That might seem natural but in medicine, it's not. The responsibility used to be on the doctors who now sometimes have their hands tied as money-hungry drug companies push products on one end and patients demand these products on the other.

What's caught in the middle is the medicinal process. Capitalism and medicine shouldn't mix so freely; as health care costs rise, so does the responsibility of a consistently ignorant consumer.

Josh can be reached by e-mail at: joshua.spivack@asu.edu.