Consumer-Oriented Ads Touting Rx Drugs Up, Frustrating Docs
By Otesa Middleton
WASHINGTON (Dow Jones)--Dr. Charles E. Cummings calls it dangerous that more of his patients come to him demanding Knoll Pharmaceuticals' new weight-loss drug Meridia.
"Patients put a lot of pressure on me to prescribe the drug," said Cummings, a Richmond, Va.-based family doctor and internist.
Cummings blames television ads touting the drug.
Knoll, a unit of Germany's BASF AG (BASFY), started its television campaign for Meridia in October.
"Everybody who is overweight wants it," the doctor said.
But Cummings said when patients hear the commercials, they ignore the explanations of side effects.
Cummings isn't the only doctor hearing specific requests from his patients.
Physicians saw a dramatic rise in the number of brand-name requests, according to a study released Monday by IMS Health, a company that tracks the pharmaceutical and healthcare industries.
The IMS survey said 48% of medical and pharmacy directors for managed care organizations said in the last year they had an increase in requests to approve drugs not on lists of accepted medicines their plan would pay for.
IMS said the top drugs benefitting from direct-to-consumer advertising are Schering-Plough Corp.'s (SGP) antihistamine Claritin, the most requested drug; Pfizer Inc.'s (PFE) impotence pill Viagra; and Hoechst-Marion Roussel's antihistamine Allegra.
Claritin had third-quarter sales of $635 million, up a whopping 42% compared to the same period last year. Viagra, just approved this year, had $141 million in third-quarter sales.
An earlier IMS report said pharmaceutical companies spent $2.5 billion the first half of 1998 advertising to doctors, up 19% compared to last year. The drug makers spent $631 million on consumer-oriented ads, up 16% compared to the first half of last year.
Neil Sweig, a phamaceutical analyst for Southeast Research Partners, said drugs that are more for general use like allergy and arthritis medication and "lifestyle" drugs like Viagra, hairloss treatments and anti-depressents are good for television ads.
"Drugs for congestive heart failure, AIDS and cancer are unlikely to be advertised in that fashion," Sweig said.
"TV is the mass medium," he said. "The ads propel a consumer to ask, request and demand the latest newly introduced drug usually at a premium price."
The American Medical Association has qualms about patients petitioning doctors for particular drugs. In October the group wrote the U.S. Food and Drug Adminstration about the issue.
"The physician members of the American Medical Association are concerned about the rapid growth in (direct to consumer advertising) and believe there is little credible information on the health and economic impact of advertising prescription drugs directly to consumers," the letter said.
Last summer, the FDA started allowing drug companies to promote drugs on television, with certain caveats.
Although the FDA doesn't approve the ads prior to publication or airing, the agency requires companies present copies of the ads at the same time they are scheduled to run, said Brad Stone, an FDA spokesman.
"We look for accuracy, balance and make sure the ads aren't making unsubstantiated claims," Stone said.
By balance Stone said as much time must be spent on negative side-effects as on benefits of a treatment.
The Pharmaceutical Research and Manufacturers of America, the drug company trade group, said advertising gives patients information, which is power.
"A growing number of patients have signaled that they want to know more about what their treatment choices are and they want to be a part of the decision-making process," said Jeffrey L. Trewhitt, a spokesman for the trade group.
Some doctors complain about the advertising, while other doctors appreciate it, Trewhitt said.
"We've heard some doctors say they hear about new drugs on the market from their patients," he said.
A July Prevention Magazine telephone survey of 1,200 adults found that 70% had seen a direct-to-consumer ad for a prescription drug. Of those who had seen such an ad, 33% talked to their doctor about the product they saw, while 13% said they talked to their physician about a condition for the first time.
But most consumers are overwhelmed by the ads, said Mary Rouleau, legislative director at the Consumer Federation of America.
"Part of the problem is consumers aren't given adequate information on side effects," Rouleau said. "A particular brand name drug may not be the best choice. This could lead to over-prescribing."
Gerald Wilson, executive director of Citizens for Public Action on Blood Pressure and Cholesterol, said ads are very helpful for certain drugs.
Because many people don't continue taking their cholesterol medicine, the ads may serve as a reminder, said Wilson, whose group is public interest advocacy orgnization.
Commercials might also get people into the doctor so they will be diagnosed, Wilson said.
"At least 15 million people in the U.S. have very high cholesterol," Wilson said. "Only seven milion to 10 million are being treated."
Cummings, the Richmond physician, said persistent patients will eventually find doctors who will write them prescriptions for medicines they've seen advertised.
"It's dangerous," Cummings said. "One of my patients called me set in my ways."
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