Friday, February 5, 2016

Turn the Volume Down on Drug Ads

Watching television these days means sitting through ads for drugs to ease pain, induce sleep, overcome sexual dysfunction, alleviate depression, ease urinary tract symptoms and more. Some patients say the ads are helpful, but many doctors warn that they are often misleading.

The American Medical Association’s House of Delegates voted this month in favor of a ban on direct-to-consumer advertising of prescription drugs and medical devices. Its officers argued that such advertising “inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”Only two nations in the world, the United States and New Zealand, allow consumer drug ads.

A survey by the Kaiser Family Foundation published in late October found that a whopping 89 percent of the public favors requiring the Food and Drug Administration to review prescription-drug ads for accuracy before they are broadcast. The F.D.A. currently does little to crack down on them, possibly fearing it would violate court rulings protecting commercial free-speech rights. It has never imposed civil fines on a company for a misleading ad or promotion.

Supporters of the ads say they educate and inform patients about drugs their doctors might not mention, encourage discussions between doctors and patients, and can help patients take more responsibility for their own health care. But they can also lead to patients’ demanding inappropriate drugs from their doctors. And they encourage the idea that there is a drug for every ill, even for conditions consumers might never have thought to treat.

Decades ago, most drug ads appeared in medical journals, on the assumption that only medical professionals could weigh the risks, benefits and appropriate uses. In 1962, a law was passed that barred the F.D.A. from requiring prior approval for the content of drug ads. The agency concluded, after various court decisions, that it was also limited in its ability to crack down on ads already on the market. By the mid-1990s, ads geared to consumers were on the rise.

Solutions other than an outright ban are being discussed, like proposals to tax the ads, which the courts might deem an infringement on commercial free speech. Another idea is to use public money to pay for evaluations by expert groups of the best ways to treat various conditions, which might emphasize dietary changes or exercise rather than drugs. That would provide unbiased information to counter the drug company ads. Or perhaps a television control device could allow consumers to block drug ads, if they want.

David Vladeck, a law professor at Georgetown and former director of the Bureau of Consumer Protection at the Federal Trade Commission, believes Congress should ban direct-to-consumer advertising for two years after a drug has been approved and put on the market. That would allow a brief period for adverse effects to be observed and might pass constitutional muster as a limited restriction to protect public health. Meanwhile, consumers need to be deeply skeptical of what they hear and read from drug companies.

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