Don SCHILLING, a Los Angeles public relations consultant, is a savvy consumer of marketing ploys and, at 57, a man growing more attuned to the allures of pills and potions that promise to boost his health. For drug makers pitching their prescription medications directly to American consumers, Schilling, a retired Army officer, refers to himself as a "high-value" target.
They haven't captured him yet. But the drug makers keep pounding away with their ads, and Schilling admits to more than a few moments of surrender.
"I look at these [drug advertisements] and I don't know how much to believe," said Schilling. "I know it's just a blatant ad. But they're fun to watch.... These twentysomethings that put these things together, they know the hot buttons to push."
Schilling is not alone in his wary fascination. Americans who watch TV, listen to the radio or flip through a magazine these days are bombarded with advertisements designed to pique interest in a most unlikely consumer product: prescription drugs.
For The Record
Los Angeles Times Tuesday June 21, 2005 Home Edition Main News Part A Page 2 National Desk 2 inches; 79 words Type of Material: Correction
Drug ads -- An article in Monday's Health section on prescription drug advertising said that legislation proposed by Sen. Ron Wyden (D-Ore.) would strip drug companies of the tax deduction for advertising directly to the public. Wyden's bill would not affect the tax break for advertising. Instead, the legislation would require government programs such as Medicaid to pay less for advertised drugs, through discounts that eliminate advertising costs passed on by pharmaceutical companies as part of a drug's price.
For The Record
Los Angeles Times Monday June 27, 2005 Home Edition Health Part F Page 4 Features Desk 2 inches; 80 words Type of Material: Correction
Drug ads -- An article in last week's Health section on prescription drug advertising said that legislation proposed by Sen. Ron Wyden (D-Ore.) would strip drug companies of the tax deduction for advertising directly to the public. Wyden's bill would not affect the tax break for advertising. Instead, the legislation would require government programs such as Medicaid to pay less for advertised drugs, through discounts that eliminate advertising costs passed on by pharmaceutical companies as part of a drug's price.
But at a time when the safety and cost of such medications have become hot-button political issues, politicians, patients and those who tend to the nation's health are viewing these ads with a new wariness. The result is a simmering national debate over how, when and even whether drug makers should appeal directly to American consumers.
As lawmakers plot new restrictions on the practice, the drug industry, in a bid to preempt, is scrambling to voluntarily reform itself.
Just last week, Bristol-Myers Squibb Co. announced that it would not promote any of its new drugs directly to the public for at least one year.
Michael Guarini, a partner with the advertising leader Ogilvy & Mather Worldwide, calls this "the perfect storm" in drug advertising, as many forces gather to reform the young industry. Guarini acknowledged that much prescription drug advertising has left its sponsors open to attack.
"I hate to use the word 'slick,' but [they've become] a bit too consumerized," said Guarini. "There's not enough balance between risk and result."
Peter Pitts, a former associate commissioner of the Food and Drug Administration, goes further. "People need to see that pharmaceutical companies are not only hucksters trying to sell you pills but also squarely in the public health business."
The debate over prescription drug advertising has gained new momentum since the popular arthritis drug Vioxx was withdrawn from the market in September 2004 over safety concerns. For several years, Vioxx was the most aggressively promoted drug on the market, with direct-to-consumer advertising spending reaching almost $300 million between 2000 and 2001.
Celebrex, which came under scrutiny by the FDA and is being marketed now with stronger warning labels, was a close second in its promotional budget. The evidence that advertising had caused a rapid nationwide shift to the new drugs led the Journal of the American Medical Assnto warn in December 2004 that "the combination of mass promotion of a medicine with an unknown and suspect safety profile cannot be tolerated in the future."
Until the late 1990s, physicians were virtually the only members of the public who heard drug companies' pitches. But in 1997 the FDA -- which regulates the claims that can be made about prescription drugs -- issued new, more relaxed guidelines for advertisements aimed at the public. Suddenly a new form of commercial appeal -- the direct-to-consumer drug ad -- became the fastest-growing segment of the advertising business and a staple of daytime TV, talk radio and glossy magazines.
Today the direct-to-consumer advertising of prescription drugs is a $4.5-billion industry, with its own creative gurus, Internet bloggers and federal regulators hanging on every 30- and 60-second spot. Since 1997, drug makers have increased their spending on advertising almost fivefold, with television advertisements leading the way.
These ads appear to work too: A Kaiser Family Foundation survey in 2001 found that 30% of Americans had spoken to a physician about a specific medication they had seen advertised. And 44% of those -- about 13% of the American public -- reported that they came away with the prescription they asked about.
Drug advertising has succeeded in doing many things, arguably both good and bad. Studies have demonstrated that direct-to-consumer advertising boosts the sale of advertised drugs and drives overall healthcare costs upward.
Other studies suggest that it enhances communication between patients and their physicians, that it increases the diagnosis of many serious conditions, and that it has helped remove the stigma of many illnesses, such as depression and erectile dysfunction. It may even help patients who are already on medication regimes stay on them.