I’ve written several posts in the past months in which I’ve highlighted the dramatic rise in diagnoses of mental illness in North America in the last 30 years. In addition to the rise in diagnoses, there are other related happenings that have been growing in significance, and I’ve also featured some of these in my posts. They include such things as the insurance payment structure in America lending itself to drug treatment over talk therapy and the growing list of disorders that is included with each new revision of the Diagnostic and Statistics Manual (DSM).
Pinning down exactly how these things (directly or indirectly) have a connection to the increase in mental illness diagnoses is undeniably complicated—perhaps impossible to prove—but I absolutely believe they are interrelated. There are even more factors in play than those about which I’ve written, and this post will touch on another: drug advertising.
Only two countries in the world allow direct-to-consumer advertising (DTC) for prescription drugs: New Zealand and the United States. Ads began in the U.S. in the 80s, but early FDA regulations stated that a drug company couldn’t state what the drug was for. Does anyone remember the old commercial that urged TV watchers to ‘ask your doctor if the purple pill is right for you’? The ad neither specified the ailment that the purple pill was intended to treat nor did it name the drug (answers: acid reflux and Nexium.) It was absurd! At the time, there were only a small number of TV ads and they were aimed at prescribers. Regulations changed in the late 90s and while the ads (thankfully) became less absurd, they exploded across our television screens and in print. Ads for antidepressants are no exception.
Drug companies advertise because it increases their bottom-line: every $1.00 spent advertising prescription drugs is estimated to increase their retail sales by $4.20 because consumers then go to their doctors and ask for those medications by name. Ethical considerations aside, it’s the customer who pays for the marketing, and drug prices in the United States are the most expensive in the world.
And then there are the ethical considerations. If a car commercial influences my car purchase decision (as Toyota did in the late 1990s with its use of the Todd Rundgren song Bang the Drum All Day in the RAV4 ad), and the car turns out to suck—which the RAV4 didn’t— that’s a lot different than a drug commercial potentially influencing my pursuit of medication.
A good start to a list of the pros and cons of drug advertising, including the ethical considerations, can be found on the ProCon.org Web site.
To me, one of the most interesting aspects of this issue is that only two countries in the world allow this kind of DTC advertising. Perhaps it’s not a red flag, but it’s a flag—purple, paisley or otherwise. (If I tell you that I think sometimes the U.S. Supreme Court’s rulings in favor of the Constitutional right to free speech don’t provide the necessary protections to its citizens will you think I’m a pinko Communist?)
A 2009 World Health Organization article states that pharmaceuticals have been under some pressure to rein in their U.S. advertising, and the FDA has felt similar pressure to strengthen its regulation. As a human being who is susceptible to advertising, I would like to see DTC advertising for prescription drugs go away altogether. The pharmaceutical companies already wield enough influence in this country. They don’t need a platform that gives them access to the hearts, minds and pocketbooks of consumers. Besides, I’m saving up for a set of Ginsu knives.