An interesting article appeared in USA Today concerning the influence of pharmaceutical advertising on prescription practices by physicians. The survey performed by the Kaiser Family Foundation and the Harvard School of Public Health reported that prescription drug ads prompt nearly a third of Americans to ask their doctors about a specific advertised medicine. In turn, 82% of those who asked their physician eventually received a prescription. Furthermore, 44% of the physicians wrote a prescription for the asked drug while 54% recommended a different prescription. 30% recommended an over the counter medication.
Another interesting series of events occurred this past month involving Dr. Robert Jarvik, a pioneer of the artificial heart. Pfizer, the maker of the most popular selling statin Liptor, hired Dr. Jarvik 2 years ago at a price of over 1 million dollars to be a spokesperson for Lipitor. Since then, he has appeared in numerous ads depicting him performing some type of athletic activity such as rowing and ultimately ending the ads with an endorsement for the drug. Several issues were raised. Is it ethical for a celebrity physician to be hired by a private for-profit company to promote a product directly to patients/consumers? Dr. Jarvik is a physician but he is not a cardiologist, does not have a license to practice medicine, and cannot prescribe medication. Is it ethical for him to be promoting Lipitor? Dr. Jarvik also is not a rower and a body double was used for one of his ads. Is this false advertising? The ads were so controversial that the House Energy and Commerce Committee launched an investigation prompting Pfizer to cancel the ads one month later.
Although these events and the recent survey are disturbing, they should come as no surprise to the many of us who deal with the medical industry on a regular basis. I would imagine that most physicians and patients are aware that pharmaceutical companies' interests are not always the same with our personal interests. After all, pharmaceutical companies are just like most other businesses--they want to make money while providing a worthwhile product. The issue becomes which aspect of their business is more of a priority-- sales of the drug or the effect of the drug. The Kaiser survey revealed that only 47% of Americans have a favorable view of pharmaceutical companies with 70% believing that drug companies are too concerned about making a profit than with helping people.
On the flip side, given the reality of today's resources, we need pharmaceutical companies and private industry dollars to continue to develop new ways to diagnose and treat disease. The federal government (NIH/NHLBI) and non-profit organizations cannot fund an adequate number of drug research and development programs. We as a society have benefited tremendously from thousands of products that have come to market from for-profit companies. For example, the death rate from heart disease fell ~33% from 1994 to 2004 largely in part due to major advances in medical treatment. One huge advancement in that medical treatment was the development of statins by private industry.
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