TV ads for drugs found wanting

Americans are asking for drugs they don't need based on vague TV commercial promises that are heavy on emotions but light on facts, according to a study published yesterday in the Annals of Family Medicine.

The charge, based on 30-month-old advertisements, has some pharmaceutical companies questioning the study's validity. AstraZeneca PLC, for example, acknowledges criticism of past advertising practices but said it has introduced new, more responsible campaigns.


"That was an old ad," AstraZeneca spokeswoman Michele B. Pelkowski said, referring to a summer 2004 commercial for its cholesterol medication Crestor, which the medical journal featured online.

"From that point and time, we've made incredible strides in how we educate patients. It's all about presenting the benefits and risks," Pelkowski said.


While most advertising by drugmakers is still directed toward doctors, dollars spent wooing consumers have ballooned during the past decade to $4.5 billion, compared with $260 million in 1995.

That's drawn the attention of lawmakers and watchdog groups who worry that the public will be duped into believing that they need to medicate the most minor conditions.

In response, trade groups and drug corporations have recently tightened their policies and adopted voluntary guidelines for responsible marketing.

The study acknowledges such efforts, but says the guidelines are "purposefully vague" and don't go far enough.

Many are predicting that such advertising, regulated by the Food and Drug Administration, will be a key focus area in Congress this year.

"We're seeing a dramatization of health problems [such as insomnia and high cholesterol] that many people used to manage without prescription drugs," said study author Dominick L. Frosch, an assistant professor in the Department of Medicine at the University of California, Los Angeles.

His study analyzed 31 drug commercials that made product claims to gauge their educational value and means of influence. It found that most drug ads - like most ads in general - use emotional appeals to draw people in. "[They] send the message that without medication, your life will be less enjoyable, more painful, and maybe even out of control," Frosch said.

In 2005, drug companies spent about a quarter of their consumer advertising budgets - nearly $1.2 billion - on television commercials, with a third of the money used to sell sleep aids.


More than 43 million sleeping pill prescriptions were filled that year - up 60 percent since 2000, according to the Prescription Access Litigation Group, which has criticized Sanofi Aventis for "overmarketing insomnia medications to anyone who's ever had a bad night's sleep."

Sanofi Aventis, which makes the popularly prescribed sleep aid Ambien, said its consumer ad campaign helps develop dialogues.

"We believe that it's an important way to help people identify their symptoms and discuss appropriate treatment options," said spokeswoman Melissa Feltmann, who added that the company's Ambien commercials should be viewed as "supplemental" to other patient education initiatives.

Sanofi Aventis has also said it supports voluntary advertising guidelines developed by the trade group PhRMA, which represents pharmaceutical and biotechnology companies.

The guidelines, available online, say advertising to consumers helps educate patients about diseases and treatment options, and suggest that ads make claims only based on "substantial evidence" and balance risk and benefit details.

"There is nothing wrong with pharmaceutical companies communicating directly with consumers," former FDA Commissioner Dr. David A. Kessler suggested in an accompanying editorial in the journal. "But they should adhere to the standards and ethics of medicine, not the standards and ethics of selling soap."


Drug Commerial Analysis

A study released yesterday analyzed the content of drug commercials from 2004 to gauge their selling methods. Here?s a breakdown of the information and techniques they often include:

COLUMNS: Content category ? Percentage of ads including it


Risk factors or cause of condition ? 26


Factual information, like symptoms ? 82

Condition prevalence ? 25

Biological nature of disease ? 54

Quality of life lesser before product ? 75

Quality of life improved after product ? 64

Offer lifestyle changes as an alternative to medication ? 0


Product enables recreational activities ? 56

Condition limits recreational activities ? 30

Condition causes loss of control ? 67

Product represents medical breakthrough ? 67

Humor ? 36

SOURCE: Annals of Family Medicine


? HED: ? SOURCE: Annals of Family Medicine

A study released yesterday in the Annals of Family Medicine analyzed more than 30 drug commercials aired in the summer of 2004 by coding their content, including this one for cholesterol medication Crestor, made by AstraZeneca.

The ad was critiqued by the U.S. Food and Drug Administration in 2005 for containing misleading statements, though AstraZeneca stood by its claims. Still, the company pulled the commercial and has since strengthened its advertising policy in response to the concerns, said spokeswoman Michele B. Pelkowski.

Ad Narrative (AN): ?Joe?s cholesterol was high, he was told, ?Get it low.? So he decided to move to the Land of No snacking, no slacking, avoid all the bad.?

53.9% of pharmaceutical ads show conditions causing distress

AN: ?He ate right and ran every chance that he had. That was how he should start, the right way to go. But many need more help to get that cholesterol low.?


21.3% of drug ads say lifestyle changes aren?t enough to control conditions.

AN: ?It?s OK,? said his doctor, add Crestor ? you should. With diet and Crestor you very well could cut bad cholesterol about half, while raising the good.?

100% of drug ads use rational appeals