You are probably familiar with drug commercials. There are all sorts of them showing people being active and smiling as they attend a birthday party, go biking, go surfing, or shopping at a flower shop. At some point they start listing some of the side effects and precautions, including some obvious and some scary statements. “Do not take this medication if you take nitrates for chest pain, do not take this medication if you do not suffer from a disease, or do not take his medication if you are allergic to this medication. Stop taking this medication if you experience headache, dizziness, sudden death, or body odor.”

If you think there are more of these commercials now than there used to be, you are correct. In 1997, the FDA relaxed some of the requirements such as listing all possible side effects, as long as they provide a phone number or website to obtain that information. Thus, direct to consumer advertisements have been on the rise ever since. Now, instead of focusing on the education of physicians and other prescribers, the drug companies have greatly increased their budgets on advertising and lobbying. Often they spend more on advertisements than they do on research and development, let alone the actual product. 

The research behind how these companies share this information is fascinating. For instance, they know it helps to “water down” bad side effects, such as stroke, with minor side effects, such as body odor. If the list of side effects ends with sudden death, it sounds worse than if it ends with flatulence, so they invest heavily in the research and psychology behind every word in the commercial. 

The benefits of direct to consumer advertisements may include increasing public awareness of diseases and treatments, empowering patients to know more about their options. However, these advertisements can lead to increased prescriptions of unnecessary medications, expensive medications, or the preference for an expensive medication over a cheaper one that may be comparable or better. This in turn increases health-care costs. Meanwhile, the high costs of these advertisements also end up being passed along to people in rising drug prices. Given these concerns, New Zealand and the United States are the only two industrialized nations which allow for direct to consumer marketing by the pharmaceutical industry. 

The goal of the weekly Prairie Doc Perspective and the Healing Words Foundation are to enhance health and diminish suffering by communicating useful information, based on honest science, provided in a respectful and compassionate manner. We do not accept any money from the pharmaceutical industry. When hearing about drugs, diets, supplements, or other health information, please consider the source, and talk to your doctor about the risks, benefits, and alternatives. 

Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® ® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook. Andrew Ellsworth, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota.