Hey Pharma, if you want our attention, give us the facts we need.
Do you think that everyone, or even most people, ask their doctors about the drugs they see Drug Ads on TV? Think again.
An industry survey shows that only 7% of TV viewers do what the ad asks and “talk to your doctor about…” That’s down from more than 21% of viewers last year. The pharmaceutical industry is asking why, and I’ll answer: We don’t get useful information. There’s info we want, and we suspect you’re hiding it from us. If you tell us what we want to know, maybe we’ll pay attention again.
What is the information we want and don’t have? DTC ads don’t disclose if the drug is more effective or more safe than other drugs already on the market. Here I blame the FDA for allowing drug companies to test nearly all new drugs against a placebo rather than against the standard-of-care drug. The “better than a placebo” standard allows meds to come on the market that are not as effective, are less safe and might be more expensive than existing meds. But how are we to know that?
Facts We Need to Know
All DTC drug ads should be required to include the following information:
- In drug trials, did this medicine outperform other drugs for managing or curing a symptom or disease? How did the side effects compare to similar drugs?
- How long are you likely to be on this drug? Even more clear, how long is the actual average patient on this drug? We should know before we start that we could be taking a drug for years.
- Is there a rebound effect? I’m looking at you, PPIs: These drugs, that are meant to calm stomach upset, actually interrupt your stomach’s own ability to calm itself. So you need the drug more and more often.
- Can you stop taking the drug on your own, or does a doctor need to manage the process? Some sleep aids, many antidepressants and other drugs can cause severe reactions if stopped too quickly. Let’s face it, they trigger addiction.
- Are there side effects that are significant enough that patients often need a second drug to manage it? Opioids, for example, so frequently lead to constipation that some drugs are advertised just for that.
- How long has the drug been on the market? Significant adverse events and side effects often aren’t clear until the the drug has been on the market 3-5 years or more.
What would change if this information was available? Perhaps your decisions. I know of 2 teams that have created new formats for the Drug Facts box. In Lisa Schwartz and Steve Woloshin’s sample, pictured here, one quickly finds that Abilify improved depression symptoms by 9 points as compared to 6 points for a placebo, on a scale of 60. (Click the image to go to the full-size verison.)
Richard Friedman’s version was just published as an OpEd piece in the New York Times. (Click the image to go to the story and full-size image.) He compares cost to Number Needed to Benefit — a measurement used in medical research to indicate how many people would need to take a medicine for one person to benefit or avoid a bad outcome.
Take a look at these 2 boxes. We could have them if we demanded them.
