The Only Two Countries in the World That Allow Prescription Drug TV Ads (And Why Doctors Are Calling to Ban Them)

Direct-to-consumer advertising of these products sold under prescription It is banned in all countries in the world except the United States and New Zealand.

And it raises serious concerns about its impact on consumer behavior, doctors’ work and the price of drugs, which sometimes cost hundreds or even thousands of dollars.

We analyze how this system works and its double side.

Prescription drug commercials have not always been legal in the United States; in fact, they are a relatively recent phenomenon.

Until the 1990s, as in almost all countries in the world, pharmaceutical companies directed their advertising and marketing efforts exclusively to doctors.

But the paradigm changed in the last decade of the last century. Because?

“Other actors emerged in the health sector such as insurers, pharmaceutical companies became much more powerful and there was the rise of the ‘consumer movement’ that helped empower patients to make their own decisions,” researcher Jeanne Madden, a health systems expert at Northeastern University in Boston, explains to BBC Mundo.

The Food and Drug Administration (FDA) gradually relaxed restrictions until finally opening the doors – first in newspapers and magazines and later on radio and television – to advertisements for prescription drugs.

Under the new rules, drug companies’ advertising spending skyrocketed from about $1 billion in 1997 to more than US$4 billion in 2005according to data from the consulting firm IMS Health.

And from then until this decade the number has continued to grow.

Today, pharmaceutical companies spend between US$8 billion and US$12 billion annually on advertising, according to estimates from various sources, and a large part of the budget corresponds to television advertisements for prescription drugs.

The FDA imposes two limitations on any advertiser who wishes to promote their prescription drugs in the media.

Has to report the main side effects of the product – generally, pharmaceutical companies do it quickly in the last seconds of the advertising space – and cannot promise unfounded health benefits.

And what happens to those who break these rules? They first receive a warning letter and, if they repeat offenses, they would face a fine of US$250,000 for false or misleading advertising.

However, according to some experts, US authorities apply their regulations quite laxly.

“The FDA’s activity in this area has been mediocre in recent years,” says Robin Feldman, a specialist in intellectual property and pharmaceutical law at the University of California.

It alleges that the regulatory agency “tends to focus narrowly on details such as side effects rather than addressing broader issues of medical advertising.”

“In theory it requires that prescription drug advertisements communicate a fair balance of benefits and risks; But in practice, research suggests that pharmaceutical companies do not usually convey a balanced image of their product,” he explains to BBC Mundo.

And it specifies that, “despite the sharp increase in consumer advertising and evidence of problematic advertising, the FDA issued only five warning letters in 2020while in 2008 there had been 21.”

Jeanne Madden, for her part, believes that companies in the sector usually comply with regulations and that is why there are hardly any sanctions.

However, he claims that “There is pressure to allow corporations to have more and more ‘free speech’ and say what they want about what they sell, as well as a massive conservative movement to simply dismantle federal regulations across the board.”

Since prescription drug advertisements invade homes, an intense debate has raged in the United States about their convenience.

Critics argue that they stimulate demand for expensive and dispensable drugs, in addition to raise health care costs without necessarily improving patient health outcomes.

The American Medical Association (AMA) has repeatedly called for a ban on direct-to-consumer advertising.

This practice “inflates demand for new, more expensive drugseven when these medications may not be appropriate,” reads a statement issued in 2015 by the country’s main association of doctors and medical students.

Something that also worries professionals in the sector is that in many cases patients They go to their doctor’s office with the decision already made about what medication they need to treat themselves.

“Perhaps the doctor does not consider the medication to be appropriate, or there are important contraindications, and this puts the doctor in an uncomfortable position”explains Gary Young, director of the Center for Health Policy and Health Research at Northeastern University.

Young argues that, in these cases, doctors They may tend to accept the -wrong- request of their patient to prevent them from evaluating you negatively in the form after the consultation, which would affect your reputation and income.

Critics also allege that the ads promote the medicalization of conditions that are normal or minor, encouraging consumers to seek pharmaceutical interventions in situations that may not require medical treatment.

For many, however, prescription drug advertising also has a positive side.

Its defenders argue that educate consumers about diseases and available treatment options, increasing their knowledge and empowering them to actively participate in their health care.

And, by being more informed about treatment options and the benefits of maintaining a medical regimen, patients may be more likely to follow their prescribed treatments.

“This is consistent with our country’s perspective on health care and other issues, in that We put a lot of emphasis on individual decision making” indicates Young.

“We don’t want the government to say, ‘You can’t have this information.’ The American perspective is, ‘Yes, get the information, we hope you use it in the best way possible,’ without relying on the government to authorize it. Even if the doctor makes the final decision, you will be armed with that information,” he argues.

Those who defend their legality also believe that these ads encourage patients to consult their doctors about symptoms or conditions they might otherwise ignore, facilitating early diagnoses and appropriate medical intervention.

Finally, they state that encourages competition in the pharmaceutical market, encouraging companies to improve their products and develop innovative treatments.

New Zealand is the only other country in the world where direct-to-consumer advertising of prescription drugs is allowed, although there are some differences with the United States.

The New Zealand regulatory framework, overseen by the Ministry of Health, imposes stricter standards to ensure ads are accurate and balancedand prevent the spread of misleading information.

For example, the Therapeutic Advertising Prescreening System (TAPS) requires pre-approval of advertisements before its dissemination.

In contrast to the US approach, which does not require prior approval, the New Zealand model is considered somewhat less permissive towards drugmakers.

And the government agency Pharmac negotiates drug prices, making them more affordable.

According to experts, this also indirectly limits the need for aggressive marketing by pharmaceutical companies, which makes a difference in relation to the highly competitive and expensive environment in the US.

In any case, there is also a strong debate in New Zealand about the potential negative effects of prescription drug advertisements, with numerous opposing voices in the sector.

The New Zealand Medical Journal (NZMJ), the main scientific journal of the medical profession in the country, published an editorial in which it demanded that these advertisements be made illegal and blamed the fact that this has not yet happened. to the powerful pharmaceutical lobby and its close connection with the political elite.

“The available evidence indicates that banning direct-to-consumer advertising would help promote population health by reducing overdiagnosis, overtreatment, and iatrogenic harm,” they stated.