Andrea Frydl cautions Canadians about the harms of direct-to-consumer advertising for pharmaceuticals and offers advice for health care providers and policy makers.

__________________________________________

Recently, the Trump Administration announced plans to introduce legislation requiring pharmaceutical companies to disclose information on drug costs in their television ads. This may seem like a good idea given that, as President Trump likes to say, drug prices in the United States are “out of control.” But this action does not address the ethical concerns associated with direct-to-consumer advertising. In my opinion, this type of advertising is detrimental to human health.

The United States is one of only two countries worldwide that directly advertises pharmaceutical drugs – including cancer drugs – to consumers. The other is New Zealand. The number of direct-to-consumer ads greatly expanded under the Clinton Administration at a time when the United States Food and Drug Administration issued a series of guidances on this topic. Since then, the pharmaceutical industry has become an extremely profitable industry and a huge lobbying force on Capitol Hill.

ttps://impactethics.files.wordpress.com/2018/07/pharma.jpg”> Image Description: Two bar stools shaped like pills in front of a counter decorated with images of assorted pills. Pharmacy-themed restaurant. Damian Hirst Exhibit, London U.K. Newport Street Gallery. Photo Credit: Francoise Baylis, November 2017

[/caption]In the United States direct to consumer ads are commonplace. Anytime there is a sporting event, there is an erectile dysfunction ad (or so it seems). And during prime-time, there is what I like to call the “big three” lineup – ads for cancer, diabetes, and heart disease. I am a new permanent resident in Canada. Since my arrival, I have not seen a single drug ad during commercial breaks on Canadian shows.

I very much enjoy my newfound drug-free advertising environment, and this moves me to caution Canada not to become complacent in its approach to drug advertising. So here are a few tips for policy makers and health care providers from someone who spent many years working at the Food and Drug Administration in the United States.

First, policy-makers should continue to ban pharmaceutical advertising to consumers. People cannot ask their health care providers to prescribe specific drugs if they are unaware of drug options. This allows doctors to only prescribe drugs to patients who actually need them based on their judgment and expertise. Generally, it is best not to be over-treated with drugs. Drugs come with side effects and costs. Without advertising prompting people to “ask” their doctor for certain medications, it is reasonable to expect there will be fewer drugs prescribed and fewer patients on costly drugs with side effects.

Second, healthcare providers should focus on prevention. If chronic diseases can be prevented, the need for drug treatments can be reduced. Campaigns to increase the quality of nutrition and physical activity will help to keep people from developing the “big three” diseases that we are all too familiar with nowadays.

Third, healthcare providers should prescribe non-pharmaceutical treatments. Drug advertising – along with other marketing tactics – misleads people into thinking that taking drugs is optimal treatment. This does not have to be the case. We should employ evidence-based approaches to treatment that don’t include drugs. For example, doctors at the Cleveland Clinic are treating their diabetic and heart-disease patients by prescribing a whole-foods, plant-based diet, and they are seeing phenomenal results. As documented in the highly-successful film Forks Over Knives, patients have actually seen full-blown diabetes and heart disease reverse itself.

Last, healthcare providers should prescribe well-established generic drugs. Typically, drugs that are advertised on television are new drugs with a more limited track record than well-established drugs that may be off-patent.

In summary, Trump can require pharmaceutical companies to flash a price tag at the end of a drug commercial, but this doesn’t really help with the distorted approach the United States has to using drugs in healthcare. All this does is make consumers more aware of drug costs. Canada can do better.

__________________________________________

Andrea Frydl is a Public Health Professional and current Volunteer at Dalhousie University’s Mood, Anxiety, and Addiction Co-morbidity Lab. @AFrydl