Are Patients Consumers?

As expected, the House has passed their bill reauthorizing the Prescription Drug User Fee Act. While a House-Senate conference committee will have to hammer out the differences from the Senate passed legislation in May, I found a provision in the House bill to be interesting.

The bill earmarks $6.25 million of the user fees each year for the next five years to go to reviewing publicly broadcast drug ads. It enables the FDA to hire 27 additional staffers in the expansion of its ad-review operation. First off, is this the best use of additional staff at the FDA? According to the GAO, the FDA received 4,600 ad materials in 2005, and had a review staff of four. So I can see where they might need some help. But, is the FDA the right group to review these ads - at least in the initial stage? 

My first reaction is that if any drug manufacturer wants to advertise during "National Bingo Night" (an actual ABC show) or "Age of Love" - more power to them. Of course, advertising on lame shows is not the issue.

Next, let's look at the naysayers to "medical" advertising. According to Peter Laurie, deputy director of the health research group at Public Citizen, a consumer watchdog, quoted in the article, "The most likely thing that will come out of a direct-to-consumer advertisement is that people will either take a drug that they would otherwise not need to take, or they will end up taking a drug that is unnecessarily dangerous or expensive." Really? Doesn't the Doctor have some kind of say in the decision?  It should be pointed out that the U.S. and New Zealand are the only two countries that allow direct-to-consumer (DTC) advertising. However, the European Commission is supporting the demand of the pharmaceutical industry to get direct influence on patients (i.e., allow advertising) and a legislative proposal is expected to be introduced by the Commission in September 2007. 

The International Society of Drug Bulletins (a world wide network of bulletins and journals on drugs and therapeutics that are financially and intellectually independent of pharmaceutical industry) warns against this legislation.

Their argument is:
  1. Advertisements from drug companies are mostly limited to those drugs with the highest profit.
  2. Efficacy is often exaggerated.
  3. Risks are usually obscured.
  4. It confuses patients when suggested another drug by their physicians.
  5. It forces physicians to use the advertised drug.
  6. Advertisements by drug companies lack comparison with drugs from other companies or other treatments, making it hard for consumers to compare different drugs or other treatment options.
Number 1 is a duh. And, doesn't advertising and profit go hand in hand? Numbers 2 and 3 are legitimate concerns. But doctors again, should be the reasoning authority. Number 5 doesn't make sense. 

Number 6 is the one that argues against what the ISDB believes in. They believe that "patients are not consumers." Well, if patients are not consumers, why do they have to compare different drugs or treatment methods? It should already be decided for you.

The medical industry in recent years has advocated taking control of your own health. It wants people to be proactive and ask your doctor questions. It seems to be working, since I recently read that more people are going to the doctor. This doesn't mean I support drug companies advertising haphazardly. There are already rules and regulations. Let the buyer beware. I know we are dealing with the health of people but advertising didn't give people arthritis to begin with (but using the remote control so often because of all the lame television on just might).  Bill Swichtenberg