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Perfect Drugs: Media Critiques

Public Under Pfizer

Each day, anyone who so much as reads a periodical, watches television, or drives down a street is bombarded with messages attempting to influence his or her consumer behavior. Since our popular cultural is so intimately linked with advertising, which supports most of our mass media sources, we tend to accept advertising as part of our daily lives. Advertising, in return, drives us to consume all sorts of products we surely do not need. Since the size of our economy and high standard of living can be attributed in large part to over consumption, the purchase of unneeded products is usually not such a great evil. While no one is harmed by indulging in a soda or purchasing a new electronic device, the story is quite different when we are influenced to consume prescription drugs. And this is exactly what is happening. New legislation in recent years has allowed a large proportion of the ads to which we are exposed to market prescription drugs, products which society has determined are not safe enough to be consumed except on the advice of a medical professional. Drug manufacturers claim that their purpose in advertising directly to the consumer is to educate those who are suffering unnecessarily from medical conditions about the availability of treatment and to encourage them to seek the help of a physician. Drug marketing benefits society, the pharmaceutical companies maintain (Miller, 1998). While this sounds noble, advertising is, by its very nature, designed to influence, not to help or educate. Are the drug ads perhaps different? The very reason behind prescriptions is that an individual without medical training cannot make an informed choice about whether to consume a prescription medication. Yet drug companies pour billions of dollars into exposing their products to the consumer. I have chosen to investigate pharmaceutical ads placed in three print media sources - Time, Newsweek, and Ladies Home Journal - which represent two distinct readership demographics, to analyze the messages conveyed to the reader. Issues of Time, Newsweek from October, 2001 and Ladies Home Journal from September, 2001 yielded thirteen advertisements marketing pharmacological agents. I have grouped these ads into three categories based on the general techniques used to influence the consumer - exploitation of fears, appeals to emotion, and promises of life improvement. This discussion will focus on four representative ads. Four of the thirteen ads obtained appeal to fears about declining health. An ad for Bristol-Myers Squibb's cholesterol lowering drug Pravachol asks the reader, "Will a heart attack make your life run out before your grandson tastes his first ice cream?" The add might well read "If you don't take Pravachol, you will die unexpectedly," as this is clearly the message. It targets older Americans confronting their declining health. The add continues to note that Pravachol is proven to help prevent heart attacks, strokes, and bypass surgery, suggesting that one might have a heart attack or stroke, or suddenly be ambushed by a cardiac surgeon if he or she does not take Pravachol. These claims appear to be quite shaky upon consideration. It is a basic tenet of science that nothing is ever 'proven.' Still, the claim sounds impressive. The assertion that this drug will 'help' prevent heart attacks is confusingly vague. Does the drug actually prevent heart attacks, or will it merely help? Drugs are not needed to help prevent heart attacks; switching to a lower cholesterol diet or increasing one's level of exercise will accomplish this. While containing no concrete information, the ad creates, to the reader who merely glances at it while perusing a magazine, the impression that Pravachol is undoubtedly a lifesaving drug. At the bottom of the ad, text subtly suggests that this drug can be used as a substitute for diet and exercise, stating "If you have high cholesterol, and diet and exercise still aren't enough, adding Pravachol can make a difference." While it is true that a small minority of the population have a genetic disposition to high cholesterol that cannot be overcome by even the strictest diets and exercise plans, this is not the case for the majority of Newsweek readers, since half of Americans have borderline-high cholesterol caused primarily by improper diet and exercise (www.idph.state.ia.us/). While fears of high cholesterol may not be great enough to prompt a lifestyle change, they might spur one to take a pill, a fact of which these advertisers are presumably well aware. A similar technique is employed by an ad for Pfizer's cholesterol lowering medication. The drug, Lipitor, is not mentioned in the ad, creating the impression that it is a public service ad rather than a marketing ploy. The advertisement reads, "One in five people has high cholesterol. Like your odds?" implying that not having your cholesterol checked is tantamount to risking your life. Perhaps it is; however, when people go see their doctor and have even moderately high cholesterol, they will likely receive a cholesterol-lowering drug. The ad pushes medication as a quick solution to a problem resulting primarily from an unhealthy lifestyle. The accompanying photo depicts people riding down an escalator labeled with their cholesterol levels. A tall lanky man is shown to have a cholesterol reading of 267, implying that one does not have to be obese to have high cholesterol. The text below informs the reader that "anyone can have cholesterol over 240, even you," and adds that, "cardiovascular disease claims a life every thirty-three seconds." These facts, like the question at the top, seek to scare people into visiting their doctors and presumably starting cholesterol-lowering drugs. A choice is implied between dying and taking cholesterol medication. Contradictorily, the ad seems to define only cholesterol over 240 as a problem. A false notion is thus created that people with cholesterol of 220 do not have a problem and should not worry about their health, when in fact they are defined as in the borderline-high range according to the National Heart, Blood, and Lung Institute (www.nhbli.nih.gov). These ads play on fears of a common health problem and are clearly trying to influence the many to medicate away cholesterol problems caused in large part by high-fat, low-exercise lifestyles. A second variety of ads recruits medication candidates by appealing to emotion. Whereas the fear-exploitation ads ran in Time and Newsweek, emotional appeal spots, which advertised acne and ADHD drugs, were found in Ladies' Home Journal and involve children. One ad features a photo of two very happy elementary school boys carrying books away from a school bus. A large caption over the photo reads "Another ADHD success story." You cannot tell which child is the ADHD success story, which is probably intentional: ADHD treatment normalizes children, the ad suggests. The depiction of active looking male children plants an association in the reader's mind between active boys and ADHD, as if to suggest that the normal high-activity level of boys is a component of ADHD. The paragraph below the photo suggests that ADHD treatment programs "may help your child overcome the obstacles to academic and social development during those challenging times." The reader is presented with the idea that ADHD drugs, rather than being reserved only for children with severe behavioral problems, can also be used to reduce the academic and social obstacles that are a normal part of childhood. The logical conclusion for a parent to draw is that, if her child has any social or academic difficulties, then medication is the answer. She is made to feel as if any loving parent would get her child treated immediately, and that if she does not "make the call that may make the difference" as the ad suggests, then she is somehow hindering her child. This ad exploits the desires of parents for their children to succeed academically and socially and frames the provision of amphetamines to children as a gesture of love. A third category of advertisements promises improvement to one's life. Ads for the allergy medication Allegra, the arthritis drug Vioxx, and the anti-anxiety medication Paxil fall into this category. The Paxil ad depicts an unhappy looking woman being encircled by symptoms - irritability, sleep problems, restlessness, anxiety, worry, and muscle tension - while a caption in front of her reads, "Millions suffer from chronic anxiety." This statement, coupled with a list of symptoms that are felt by everyone at some time or another, plants the idea in the reader's mind that he or she too may have an anxiety disorder and could thus be helped by this medication. Below the photo, the ad is more explicit: "Millions could be helped by Paxil," it claims. This ad, featured in Time, promises solutions to problems associated with the stresses of work, such as fatigue and muscle pain, which appeals to the magazine's largely white-collar audience. It claims that Paxil will allow you to "see someone you haven't seen in a while . . . Yourself." This statement implies that your natural state is one of happiness, and that if you have anxiety you are therefore not yourself and should be medicated back to your natural state. The face of the unhappy woman in the top photo is shown near the bottom of the ad, presumably following treatment with Paxil, smiling brightly, creating the false impression that Paxil causes happiness rather than simply eliminating anxiety. The product's motto "Your life is waiting," is a direct claim that this drug will improve one's life. The ad speaks to readers who are unhappy with the state of their lives and tries to convince them that common problems can be solved with this medication. The fact that irritability, fatigue, sleep problems and muscle tension, which are more than likely caused by factors other than an anxiety disorder, are listed as grounds for taking an SSRI is clear evidence that the ad seeks to influence and not merely inform the reader. There is also no mention that several of the listed symptoms - fatigue, irritability, sleep problems, and restlessness - can actually be caused by Paxil. While Paxil should only be prescribed for those with severe clinical anxiety and depression, the ad, as if to point out that its hidden intent is to generate unnecessary prescriptions, goes no further than to say, within a disclaimer buried in the text that, "Paxil is not for everyone." Careful examination of these advertisements, reveals that their purpose is not inform the consumer but to manipulate him or her into desiring prescription medications. While upon conscious analysis the messages and techniques of the ads are obviously preposterous, to the unwitting consumer who does not pause to consider their meaning but takes them at face value with but a few seconds glance, they can seem quite persuasive. It seems that the same forces driving America's over consumption of Coca-Cola have now turned toward our medical care. While it is unlikely that the pharmaceutical companies will voluntarily withdraw their enormously profitable marketing campaigns for the good of the public, these campaigns can exist only because they bring results. As consumers, we hold the power to improve the quality of our healthcare by refusing to be enticed by sly marketing tactics and instead making informed decisions in regard to the treatments we choose to pursue.

Sources:

Alza. Ladies' Home Journal. September, 2001.

Bristol-Myers Squibb. Pravachol. Ladies' Home Journal. September, 2001. GlaxoSmithKline.

Paxil. Time. October 8, 2001.

Iowa Department of Public Health website. www.idph.state.ia.us/. 2001.

Miller, Susan. "DTC ads provide the Right Prescription." Brandweek. June, 29, 1998.

National Heart, Lung, and Blood Institute website. www.nhlbi.nih.gov. 2001

Pfizer. Newsweek. October 15, 2001.