If you’re a person with RA, you’ve no doubt bared witness to the litany of commercials that advertise RA meds. Heck, even if you don’t have RA, you’ve seen these commercials.
And if you’re like me, as a patient, it’s a bit distressing to be going about my daily tasks, only to be stopped in my tracks by a Humira commercial. In my head, the commentary rolls, I’m on that. Do I really want to be on that? as the fresh-faced woman on the commercial joyfully rattles off the potential side-effects.
While as a patient, I’m caught off-guard, as a sociologist, I am extremely interested in this phenomenon of direct-to-consumer advertising, because it is a key “engine” in medicalization (Conrad 2004).
Medicalization is a process “when previously non-medical problems are defined and treated as medical problems, usually in terms of illnesses or disorders” (Conrad and Leiter 2004: 158).
One way that medicalization occurs is by bringing to market drugs and other therapies to help treat or even cure illnesses.
While it is true that there has been an increased demand for treatments on the patient side of things, the reality is that there has been a rise in the ability of pharmaceutical companies to advertise their wears directly to the consumer market (Conrad and Leiter 2004).
In this day and age, direct-to-consumer advertising has become super common. Pharmaceutical companies advertise drugs for things that basically anyone could have. Restless Leg Syndrome. Seasonal Affective Disorder. Conrad and Leiter (2004) specifically focus on Paxil, Viagra, and the movement of Attention Deficit Hyperactivity Disorder (ADHD) from a disorder only seen in children to a disorder seen in adults, as well. The list goes on and on.
But the reason these things are money makers is because you can be watching Jeopardy and then hear an advertisement for a medication that treats a problem that you think you could have.
The key is that you will hear or see a commercial, suspect you have a problem, and then go to the doctor, asking to be prescribed the medication that you’ve seen on TV.
With some of the conditions mentioned above, like Restless Leg Syndrome, this is exactly the goal of the pharmaceutical companies.
Just as there are Hallmark holidays, there are pharmaceutical company-created illnesses. And while this is not the case for RA, there is definitely something to be said when it seems like every other commercial is for a drug used to treat RA.
It is harder to imagine, though, that someone might watch a commercial for Humira and run to their doctor, suspecting they have RA.
And while I’m sure these commercials do play to a certain segment of our population – maybe those who have the least active forms of the illness – it is hard for me to imagine someone with moderate or severe RA going to the doctor and directly asking about one of these medications. For several reasons: 1) They probably already know about these treatments, themselves, or 2) They are trying to avoid them.
Another key component to medicalization and direct-to-consumer advertising, according to Conrad and Leiter (2004), is that information about off-label uses of drugs can be shared with both doctors and patients.
Enbrel was approved to treat RA in 1998, Juvenile Arthritis in 1999, Psoriatic Arthritis in 2002, Ankylosing Spondylitis in 2003, and Plaque Psoriasis in 2004.
Humira was originally discovered to treat RA in 2003, but was then also approved for Psoriatic Arthritis in 2005, and Crohn’s Disease in 2007. It has also been proven effective in Ankylosing Spondylitis, Ulcertive Colitis, and Juvenile Arthritis.
As we can see, the uses of these drugs have been expanding over time. This is not to say that this is a bad thing, it’s just that we have to question if the payoff is more for the patients or more for the pharmaceutical companies.
A key form of medicalization seen with these drugs is that they are advertised to be prescribed in combination with other drugs, such as Plaquenil and Methotrexate (i.e. Simponi).
And it’s not just the pharmaceutical companies that have a stake in winning the drug wars. It gets worse. It has become clear to me that my insurance company has sold my information. I am being flooded lately with mail about Benlysta. Mail that tells me there were be a nurse educator in my area.
It has all become a bit too big brother for me.
But the interesting thing is that Humira, Enbrel, and Orencia, another biologic for RA, are being plastered all over our TV screens. This is puzzling to me. While it is easy to imagine people thinking they may have Restless Leg Syndrome, it’s less believable to me that people are running in droves to their doctors’ offices, thinking that they may have RA.
Fibromyalgia is another story, because if you watch those commercials, it seems that anyone could have it with the symptoms they discuss.
So where does it end? Where does patient expertise begin and end? And for that matter, where does the expertise of medical professionals begin and end?
These days, there is a fine line between the two, and there are inherent tensions. Sure, some doctors are prescription hogs. They will prescribe anything to anyone. But how do these commercials play into that?
And are they making our society hyperaware? Are we all just one commercial away from becoming flaming hypochondriacs?
On the one hand, these commercials give patients more agency in their health management. But on the other, these medications are extremely expensive and come with a litany of side-effects, some still unknown.
This is a bit of a chicken and an egg thing. Which came first? The medication or the disease? In the case of RA, RA definitely came first. But for some of the other ailments that are treated b RA, one has to wonder.
Let me be clear here that it is great that we have drugs that work for treating RA, and new drugs coming to market all the time. This is a wonderful thing. But, while we do have these drugs, we still puzzle over a cure. So this is to say: Buyer beware.
When our health is at stake, we have to be smart consumers.
As fellow members of the RA community, what effect do these commercials have on you?
Conrad, Peter. (2004). The Shifting Engines of Medicalization. Journal of Health and Social Behavior, 46 (1): 3-14.
Conrad, Peter, and Valerie Leiter. (2004). Medicalization, Markets, and Consumers. Journal of Health and Social Behavior, 45 (1): 158-176.
Published On: June 26, 2012