by Judy Sloss

You’ve probably seen some of the dozens of TV ads for prescription drugs – meds that require a prescription – for conditions like Crohn’s disease, rheumatoid arthritis, psoriasis, depression, diabetes and more. I chuckle at parts of them, like ads that say, “Tell your doctor if you have an infection.” Excuse me – what? Shouldn’t my doctor be telling me that? Another good one, “Tell your doctor if you’ve had a vaccination.” Like when? Ever? I get a flu vaccination every year. Or “Tell your doctor if you’ve been to a place where fungal infections are common.” How would I know that? Ask the hotel concierge?

Then there’s the “medicalize” jargon that consumers can’t understand – the 20-plus complicated side effects, contraindications, comorbidities – things that pharma should be telling doctors, not consumers. Sure I could discuss them with my doctor, but I can’t write that fast to list them all, assuming I could spell some of them.

All these ads say, “Talk to your doctor about our drug.” But even if I did that, there’s no guarantee that the drug will be prescribed for me. My doctor knows my medical condition and pharmaceutical needs, and is guided by that and what they’ve learned from medical journals or references such as the Physicians’ Desk Reference and from pharmaceutical reps who visit doctor’s offices regularly to tout their company’s products. My doctor isn’t going to prescribe something just because I saw a TV ad for it.

Now, let’s talk about the scary part of these ads. First, it costs millions of dollars to air a TV ad. According to USA Today, directto-consumer (DTC) ad spend for prescription drugs is up 62% since 2012. So, how does big pharma recoup some of those costs? Some may be a tax write-off – there’s no way to know that. Another way is by charging consumers exorbitant prices. And consumer out-of-pocket costs for prescription meds over the last 20 years went from $16.5 billion to $328.6 billion. Here are just a few comparisons of TV ad spend versus consumer costs for medications requiring lifelong use:

According to FiercePharma, the number one advertiser is AbbVie, whose TV ad spend for Humira for Crohn’s disease, ulcerative colitis, psoriasis and arthritis was $184 million for the first six months of 2018. Consumer cost was $1,800 to $2,400 monthly, or potentially over $28,000 a year.

Eli Lilly also ranked high with a spend of $19.9 million for the month of June 2018 for just two ads for Trulicity for Type 2 Diabetes. The drug comes in a four-pack of pre-filled pens. The contents of one pen is injected weekly. Consumer cost per pack is about $800 or over $10,000 a year.

TV ad spend for Pfizer’s Xeljanz XR to treat rheumatoid and psoriatic arthritis was $25.5 million in July 2018 for just three ads. Consumer cost for a 30-day supply – $4,284.00. That’s over $51,000 a year – more than the annual salary of a minimum wage worker. And the list goes on.

I asked three different doctors I know what they thought about these ads. They all said big pharma is just trying to keep their product “top of mind” to consumers. But to what end? You or I can’t just walk up to a pharmacy counter and say, “Hi! I’d like some Xeljanz, please.” When did big pharma start marketing to us?

In the late 1990s, the FDA began allowing these TV ads in the U.S. – the only country other than New Zealand to do so. These ads are for FDA-licensed brand name drugs – no generic ones available. The manufacturer may offer a discount program, but only if you qualify. A patient might have insurance, but even then, the drug may not be on the insurer’s formulary, or the copay may be very high due to the manufacturer’s price. Consumers are essentially at the mercy of big pharma. It’s time to stop this pointless consumer advertising so patients can get needed medication without sacrificing things like food or housing. Pharma should be talking directly and only to medical professionals, not consumers.

Now that the FDA has opened the door for these ads, it’ll be difficult to stop them since, legally, they fall under freedom of speech in our First Amendment. But an article in MEDPage Today proposed mandating that each ad include the actual cost for that drug. That might make this DTC advertising less appealing for big pharma. I don’t know if that’s the answer, but I hope it helps.

Judy Sloss is a freelance writer from Glenside, Pennsylvania with a 20-year career as a marketing communications manager for a privately owned mail service pharmacy, subsequently bought by SmithKline Beecham and ultimately by Cigna.

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