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Perfect Drugs: Media Critiques

Media Critique by Jane Chang

Drugs, Money and Advertising

Ads for pharmaceutical drugs are everywhere. They are in magazines, on television and radio, on billboards, and on the little bags that you get from the pharmacist. These days it is difficult to get away from all the drug advertising. All these ads are for products that require a doctor's prescription. The goal of advertising is to increase profits. By advertising so heavily for drugs that the majority of the population does not need, pharmaceutical companies attempt to create as large a consumer base as they can. In advertising directly to the consumer, the drug companies accomplish two objectives. First, they get information directly to the consumer. Second, they promote the product and generate demand for their particular drug.

Whether this type of direct-to-consumer advertising is good or bad depends on your perspective. The controversy about drug advertisement lies in how drug companies use the money generated by ads and how they choose to advertise their products. Some argue that the pharmaceutical companies just pocket the profits generated by ads, while the companies themselves say that the money is needed for the research and development of new cutting-edge drugs. The information that the drug companies provide in the ads can be both informative and misleading. Deciding which side is right or wrong may be more difficult than we think, as both sides make good arguments for their case. More likely than not, the answer lies somewhere in between, with both sides being right and wrong.

Allergy drugs such as Claritin, Allegra, and Flonase have become very popular in recent years. In 2000, Claritin was fifteenth in the 200 most prescribed drugs in the US, while Allegra and Flonase were both in the top 60 (Scott-Levin, 2001). Pharmaceutical companies claim that these drugs have a low occurrence of side effects (Allegra, 2001). Doctors often prescribe these drugs to those who have allergy-like symptoms without checking for particular allergies (Francis, 2001; Swanson, 2001). With so many commercials that tout the drugs as relieving symptoms and causing few side effects, many people are lulled into thinking that no side effects exist. The public is bombarded by images of happy people in fun and relaxing situations. They show what life could be for those who take these drugs. Lulled into a false sense of security by all these marketing tactics, why wouldn't people go see their doctors and ask for these drugs?

Ken Sanes (2000) gives a detailed description of a Claritin commercial and talks about its symbolism. This particular ad featured a hot air balloon and people enjoying an elaborate picnic in a field, after which they took a ride in the balloon. The website describes the ad as contrasting "the feeling of being trapped and weighted down, . . . with a floating hot air balloon and an upbeat song about blue skies." Sanes also claims that the commercial goes beyond selling the image of the good life and suggests that, "by using the product we will achieve transcendence from the weighted down world of mundane life. After all, the qualities depicted in the commercial - clarity of vision, joy, a feeling of weightlessly escaping the hold of the material world." The commercial may not be blatantly trying to fool people into believing that Claritin will bring them transcendence from mundane life, but it does play on the good feelings that people associate with the images they see. Drugs that require prescriptions are controlled substances because there is the possibility that these drugs can cause more harm than good for those who take them. With so many commercials portraying prescription drugs in such an idealized manner, the consumer is more likely to associate the consumption of prescription drugs as an everyday occurrence. This type of association is not healthy, at least not to those consuming them; those producing the drugs are likely to advocate this association, as evidenced by the mass marketing of prescription drugs.

The associations that people make when seeing commercials or reading ads in magazines are what the companies want you to remember. Just last year the Schering-Plough Corporation (the maker of Claritin) was asked to pull some of the Claritin ads because they were highly misleading. One of the ads made the claim that the FAA had approved the use of Claritin by pilots (Hankin, 2000a). Thus the reader would make the association that because pilots used Claritin, it could not have any important side effects. The use of any drugs by pilots must be reviewed on an individual basis. The FAA also requires documentation by the prescribing physician that states the pilot suffers from no side effects from the drug. The ad only stated that the FAA approved use of the drug, not that approval was granted on an individual basis. Two other ads featuring Joan London were pulled due to misleading information as well (Hankin, 2000b). These were multiple page ads that were reminder/help-seeking in nature. The front page of the ad features Joan London asking readers if they asked their doctor about Claritin. The next few pages are "articles" by Joan London about seasonal allergies. One ad made a connection between the use of Claritin and the improvement of children's attention span in school, and the second emphasized the need for entire families to be on this drug. In both cases, information about risk and side effects was omitted. Such ads directly mislead the consumer into believing that not only is Claritin safe to use in all situations, but it would be stupid not to ask one's physician for the drug and parents would be negligent if they did not provide their children with it.

With all these ads for relatively few drugs, where does the money come from? The answer is that the consumer pays for the mass marketing. Claritin is a very popular drug, yet very expensive because only brand-name versions of the drug are available (at least here in the US). Claritin can cost as much as $2.66 a dose, whereas the medicine would cost 50 cents a dose or less if a generic version were available (Novak, 1999). In 1999, Claritin was generating over $5 million in revenue a day (Novak, 1999). With sales like these, it is little wonder that the pharmaceutical companies are reluctant to give up their monopoly on the market. Millions were spent by Schering-Plough in lobbying congress ($9.2 million in 1999) to extend the patent of Claritin (Public Citizen, 2000). Just last year the company was granted a six-month extension on its patent because it had come out with a child-safe version of the drug (Tidwell, 2000). Earlier this year Schering-Plough sued Alpharma Inc. to prevent the rival company from producing a generic form of Claritin (Voreacos, 2001).

Ads, lobbyists, and lawsuits all cost a good deal of money, money that is not going towards research and development. In 1999, Merck & Co. had a total revenue of $32.7 billion, yet only $2.68 billion went into research and development while marketing, general, and administrative expenses cost about $5.2 billion (Kleinberg, 2000). Merck was spending almost twice as much on selling its drugs as it did on developing new drugs. Not only do drug companies advertise heavily to the public, but they also provide doctors with perks when they prescribe large quantities of their particular drug (Kleinberg, 2000). The marketing directed towards physicians is enormous, yet not seen by the public. Companies spend millions "teaching" doctors about their drugs and how much "better" they are than the competition. This marketing tactic also produces results since doctors become more likely to recommend a certain drug over another (Kleinberg, 2000). By having doctors give out samples to patients, drug companies are more able to create product loyalty since a stronger association to the product is made than if the patient saw an advertisement on television.

Pharmaceuticals are big business, especially in the US where companies are given free rein to price drugs as they see fit and mass market their products with little restraint. More attention has been given to the issue of direct-to-consumer advertising in recent years because more and more patients ask their doctors for certain drugs and receive prescriptions for them (Hollon, 1999; secondwind, 2001). The pharmaceutical companies are in fact companies, which is to say that they are there to make money. "The pharmaceutical industry's interest in the bottom line is legitimate, the industry, which has made important medical contribution, exists because it is profitable" (Hollon, 1999). Heavy advertising generates large profits, which can then used to develop other drugs. Drug companies argue that without large profit margins they are not able to develop drugs as quickly as they are wanted. This argument is likely to be true to some extent, since research and development of a drug requires large numbers of people working years before a drug reaches its intended market.

When asking your doctor for a drug you've seen advertised, you should be wary of several things. First, pharmaceutical companies are for-profit corporations and must act as such to generate revenue. Second, any misleading information provided in the ad is likely to be skewed favorably towards the drug. Advertisement is about selling one product over another. Third, sometimes there could be cheaper and more effective options than the advertised drugs. For the most part, the drugs that are heavily advertised are ones that people could do without. They are not drugs that will save a person's life; they are for comfort and not survival. People need to understand that by asking their physicians for certain drugs, they change the doctor-patient relationship to one of doctor-consumer. Pharmaceutical companies advertise in order to promote their product, not to inform you of the best treatments available. As a consumer, you need to understand what it is you are buying. When talking to your physician about a drug treatment you wish to take, remember to also discuss the effects of the drug (both good and bad) and ask if there are other alternatives available.

Works Cited

Allegra (2001). Advertisement from Aventis Pharmaceuticals. Better Homes and Gardens. Nov. 2001, p 37-8.

Francis, Clayton. (2001). Personal Interview. 6 June 2001.

Hankin, J. (2000a). FDA warning letter. http://www.pharmcast.com/WarningLetters/May2000/Schering0500.htm. (7 Oct. 2001).

Hankin, J. (2000b). FDA warning letter. http://www.pharmcast.com/WarningLetters/August2000/Schering0800.htm. (7 Oct. 2001).

Hollon, Matthew F. (1999). Direct-to-Consumer Marketing of Prescription Drugs: Creating Consumer Demand. JAMA. Vol. 281, No. 4

Kleinberg, Howard. (21 July 2000). 'I want to sell you - again'. Cox News Service. http://www.coxnews.com/newsservice.columnists/h_kleinberg. (6 Oct. 2001).

Novak, V. (2000). The Claritin Case: How One Firm Played the Patent Game. Time Magazine. Vol. 154, No. 21

Public Citizen. (31 Aug. 2000). Schering-Plough Political Money Pushes Claritin Patent Extension and Distorts Report. Public Citizen. http://www.citizen.org/pressroom/release.cfm?ID=369. (7 Oct. 2001).

Sanes, K. (2000). The Fake Haven of Claritin. Popular Culture. http://www.transparencynow.com/claritin/claritin.htm. (7 Oct. 2001).

Scott-Levin (2001) The Top 200 Prescription for 2000 by Number of US Prescriptions Dispensed. http://www.rxlist.com/top200.htm. (6 Oct. 20001).

Secondwind (2001) Direct-to-Consumer Advertising. Second Wind. http://www.secondwindmagazine.org/issues/2001/spring/feature.html. (7 Oct. 2001).

Swanson, Jack. (2001). Personal Interview. 17 Aug 2001.

Tidwell, J. (31 Aug. 2000). Claritin Patent Gets Extension. Allergies. http://allergies.about.com/library/weekly/aa082100a.htm?once=true&. (7 Oct. 2001).