Why Don’t Side Effects Scare Us?

The AMA has called for a ban on direct-to-consumer advertising, citing increasing pressure by patients for prescriptions they’ve seen on TV

I can’t quite let this topic of direct-to-consumer pharmaceutical advertising go. A couple of weeks ago I wrote about the Helen Mirren ad that did everything to skillfully distract viewers from the supposed message, don’t drink and drive.

Now, StatNews has published a great article that’s also about advertising and distraction, in this case about the side effects of drugs. Megan Thielking, a blogger for StatNews, wrote the piece, How Narrators Take the Scariness Out of Side Effects, which reveals the techniques that advertising directors use to call attention to the benefits of a drug, while making the risks seem as if they are from a different ad. For example: The narration in drug ads about the side effects and risks is spoken quickly, but in a soothing, monotone voice. Lulling music and more complex sentences make the information more difficult to absorb.

If you think that technique doesn’t work, try listening to an 8-year-old reading a list of side effects and gauge how your response changes.

Her full article is worth reading. But for those who’d rather listen, Thielking was interviewed for a segment of the radio show “Here & Now” on WBUR, the Boston NPR station. The segment’s called How Drug Ads help You Remember the Good, Forget the Bad.

DTC-Countries300Direct-to-consumer advertising is a largely American phenomenon (New Zealand is the only other country that also allows DTC advertising). The American Medical Association (AMA) called for a ban on DTC advertising in November 2015, citing increasing pressure on physicians, by their patients, to prescribe the drugs they’ve seen on TV, rather than less costly, more clinically effective alternatives.

The fact that (some) doctors succumb to a consumer’s demand for an inappropriate drug (as cited by the AMA) seems grounds for malpractice to me. Physicians go on to claim that patients will leave to find a doctor who will give them the prescription they demand. I’ve heard a lot about how overworked and how little time docs have in the day. Not to be flippant, but losing a few patients who want to be their own doctor might be a way of getting a little extra time to spend with the patients who prefer to draw on the doctor’s training and experience.

I’m walking a fine line here — I advocate for people to actively participate in their medical care and decisions. But by that I mean learn from the doctor the benefits and risks of a drug, and then make an informed decision. I encourage neither demanding a drug (or course of treatment), nor asking the doctor to make decisions on your behalf.

Banning DTC advertising would be great, but I think it’s unlikely. And banning it because it gives consumers too much information and makes them difficult patients is a lousy reason.

The AMA’s press release also calls for greater transparency in drug costs and for generic drugs to be approved more quickly by the FDA. Both proposals would work to balance the escalating costs of drugs. The AMA further points out that federal regulators need to do their part to encourage innovation and competition by halting the “manipulation of patent protections and abuse of regulatory exclusivity incentives” by pharmaceutical companies. Patents and extended exclusivities, which delay the entry of generics to the market, too often become rewards for far too little innovation, such as producing a pill in a slightly different formulation or dosing level.

When DTC TV commercials air, remember that the advertiser, a pharmaceutical company, isn’t a friend or a doctor. It’s a for-profit company that has a responsibility to develop and sell as much product, drugs, as they can. It’s our job to listen to the risks and weigh them against the benefits carefully, in our own best interests.


Suzanne B. Robotti

Suzanne Robotti founded MedShadow Foundation in 2012. Learn more about Su and her mission.


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