One Doctor's Opinion: Regarding a survey conducted by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health about how drug ads influence doctors in prescribing medications and the impact on cost.
Marketing prescription drugs to the public was popularized over a decade ago, by the makers of Claritin, a non-drowsy antihistamine (currently over the counter). I remember my first reaction to seeing one of the Claritin TV ads. I was shocked and annoyed by the prospect of a TV commercial marketing a medication that requires a doctor's order. I was concerned about a deluge of phone calls and visits from patients wanting to be started on Claritin, or to be switched from another similar medication to Claritin.
My concerns were never validated in that only a few patients asked to be started on, or switched to Claritin. Instead, many people simply wanted my opinion about the drug. I found myself spending a little more time explaining to patients and parents, how antihistamines and other allergy medications differ in their benefits and potential side effects. Interestingly, patients seemed more attentive to my discussion about allergy medication as well as allergy triggers after hearing about them in the media.
Regarding allergy medicine, many commercials colorfully illustrate the role of common environmental factors (pollens, mold, pet dander) in triggering nasal and eye symptoms. Such information actually reinforces an important part of allergy management, avoidance.
I think direct to consumer advertising has further alerted patients to the existence of potential adverse effects. More recent commercials have not only included benefits of a particular drug, but also possible side effects (although they are often very quickly announced at the end of the commercial). Patients already on the drug tend to seek further information when they hear about side effects. I think such dialogue is important even if first brought up by the patient or parent.
Of course, the impact of marketing prescription medications to the public is not all good. I suspect some patients have inappropriately stopped or cut back on medications as a result of some of these ads (after learning about possible side effects). The data on percentage of doctors prescribing medication after a request for an advertized drug (82%) is of minor concern to me. I am confident that doctors will generally not prescribe medications that are unnecessary, for the sake of pleasing the patient. Whether the influence of patient requests for a particular drug significantly increases health care cost is a matter of debate.
Changes in health care, especially managed care (HMOs, PPOs), with respect to covered medications (drugs that the insurance pays for), have more significantly impacted prescribing habits of physicians compared to drug ads. Patients often have to pay more for name brands of drugs when generic brands are available. In many, but not all cases, the generics are just as effective. When patients are made aware of this information they are often happy to get a medication that will cost them less money but work just as well as another one.
I welcome questions or even requests for medications discovered by patients through the media. It is a great segue for more discussion and clarification. I usually learn more about my patient's concerns, and perhaps unmet desires, regarding their medical management. The sharing of information, and explanation, can go a long way toward building an even stronger partnership in care with a patient and family. I may not prescribe the requested drug, but the patient will understand why, and in the process, be more informed about their medical problem.
Have you ever asked your doctor about a medication you saw on TV?
Have you had a different feeling about a medication you are taking after seeing it on TV?
Do you think prescription medications should not be advertized on TV?
Published On: March 05, 2008