But when time is short, more time can seem attractive - more time to spend with loved ones, to see beautiful places, and enjoy favorite past-times. Sadly, those end-of-life experiences are often clouded by pain and disability. My mother had difficulty working in her garden. Even the oxygen tank we toted out there didn’t allow her to do much more than examine the blooms. We would have jumped at anything to give her more strength and more time.
Pharmaceutical companies know this. They know that more than anything, people want to be strong and vital as they move through life. We want this whether we are at the end of life or have many years to live with chronic disease. This can be a good thing when it spurs solutions through research and development. But it can be a bad thing when the marketing team gets its hands on it.
If you watch television, you’ve seen pharmaceutical ads. They show people out fishing or hiking through a National Park. But when you look at what the drugs are for, you realize that these drugs and the conditions they treat have no connection to what the people in the ad are doing.
The commercial for cancer drug nivolumab stated it “significantly increased the chance of living longer versus chemotherapy” in patients with squamous cell lung cancer. But they glossed over the fact that it prolonged life just 3.2 months. And that it is indicated for stage four cancer only after standard chemotherapy has failed. And they didn’t even mention that it costs $157,000 per year.
Instead they mention a longer life and show relatively high-functioning people doing the things we all hope to do as the end of life approaches – walking the dog by the water, playing with grandkids, going to the ballpark. Trust me, this is not the typical final three months for someone with stage four lung cancer on chemotherapy.
This isn’t false advertising, necessarily. But it certainly isn’t grounded in truth.
The U.S. and New Zealand are the only two countries in the world that allow direct-to-consumer (DTC) advertising for pharmaceuticals. Individuals in these two countries take about 50 percent more prescription drugs than comparable countries. In the U.S., drug companies spend about $4.5 billion each year on advertising. And the amount rises every year. Pharmaceutical companies know advertising works.
At least once, it worked so well people died. After Vioxx was introduced in 2002, Merck went all out on the launch. They spent $160 million on DTC advertising for this pain medication that was easier on the stomach than most of the drugs out there like ibuprofen. Sales went through the roof.
Then doctors started noticing people on Vioxx were having heart attacks and strokes. This in itself isn’t unusual. Sometimes drug side effects don’t show up in clinical trials. It isn’t until they are more widely used that more unusual issues arise. But it turns out that marketing of the drug drove demand. Patients were specifically seeking it from their doctors. This vastly expanded the pool of people exposed to the dangerous side effects of the drug.
In 2004, the FDA pulled Vioxx from the market and decided DTC marketing was not okay for other drugs in the class. Which makes you wonder: If DTC marketing isn’t okay for those drugs, why is it okay for any drugs?
Pharmaceutical companies are motivated by profit. Period. I’m sure they are happy when a drug actually benefits people. But let’s be honest – nobody buys pharmaceutical stock because they want to help mankind. Stockholders want to make money. And the only reason drug companies engage in DTC marketing is because it helps them achieve that goal.
DTC marketing benefits pharmaceutical stockholders. But it doesn’t benefit us. It drives up the cost of drugs. It pushes the use of drugs in inappropriate cases. And it promotes expensive brand names over perfectly acceptable generics.
In the end, DTC marketing costs us a lot of money and hurts our health. The best way to decide if a prescription makes sense is to discuss your options with your physician, whose goal is to help you get better. The worst way is to let the profit motives of others drive your decisions.