If you’ve ever sat through the commercials for an on-air television show, you’ve likely seen advertising for prescription drugs. The ads often tell the story of a person who suffered while enjoying a common American pastime only to be miraculously cured by whatever drug is being marketed.
You then hear the voiceover rush through an untold number of potential side effects, and you’re left pondering on your couch as to whether or not you should ask your doctor “if this prescription is right for you.”
Well, prior to 1997, these direct-to-consumer (DTC) advertisements were actually banned by the federal government. It was up to the patient to address any concerns with their doctors and rely on expert opinions and fully-trained professionals to give them the prescription they needed. But, the drug industry made a massive push for the approval of these DTC ads to the Clinton administration, arguing that consumers have a right to know and to be informed about the different drugs available to them.
In 1997, this type of advertising was approved for use by the pharmaceutical industry as long as they made mention to the medications’ side effects. Since receiving the FDA’s stamp of approval, the industry’s ad spend has skyrocketed; even research and development spend is lower than its marketing budget. In 2015 alone, drug companies spent $5.2 billion on direct-to-consumer marketing, an increase of 60% from four years prior.
Direct-to-consumer advertising shows no signs of slowing down, especially since heavy promotion encourages patients to request on-brand, and often more expensive, medications. Now up for consideration by the FDA is the expansion of DTC drug ads to include the promotion of off-label uses. But, researchers from Canada and the U.S. have found that patients who use drugs for off-label uses that haven’t been backed by solid scientific evidence are 54% more likely to suffer some sort of adverse side effect. It has also been argued that the off-label marketing of prescription drugs is what fueled the rise of the opioid crisis. Although sales tactics didn’t specifically involve DTC ads, physicians were encouraged to prescribe opioids for less severe forms of pain, spurring addiction.
It’s clear through DTC advertising and other sales tactics deployed by the pharmaceutical industry that its influence in American healthcare runs deep. As more states, cities, and counties file lawsuits against drug companies for their involvement in the opioid crisis, the question begs to be asked. Even with a massive payout, will the lawsuits have any effect on Big Pharma’s actions?
The sad reality is that drug companies play a role in so many aspects of healthcare that they view these payouts as just the cost of doing business.
In addition to its influence within the advertising sphere, drug companies are also allowed to fund clinical trials. A recent Johns Hopkins study found that the number of industry-sponsored trials have been on the rise. Between 2006 and 2014, this type of funding increased by 43%. On the opposite end of the spectrum, government-backed trials from entities such as the National Institute of Health decreased by 24% during the same time frame.
Although the provision of funding is great news for any attempt at bringing life-saving drugs to market, industry-sponsored trials equate to drug companies having financial interest in the outcomes. With profits at stake, results can favor positive outcomes while ignoring any adverse side effects the drug may cause.
This was the case for anticoagulant Pradaxa’s industry-funded clinical trial. Critics called out the study for generalizing the medication’s ideal population and for failing to remove the bias of a non-double blind study. With misrepresented trial results, Pradaxa was approved by the FDA in 2011 without an antidote to reduce its blood-thinning effects.
Disaster ensued when the medication contributed to over 1,000 deaths and severe internal bleeding complications. Although thousands of lawsuits against manufacturer Boehringer Ingelheim have been filed, Pradaxa is still on the market today as a practical anticoagulant option.
Then, there’s the issue of influence as it pertains to America’s lobbying efforts. The act of lobbying itself is defined as “seeking to influence (a politician or public official) on an issue.” And that’s exactly what Big Pharma does.
In fact, the Pharmaceutical & Health industry spends the most money out of any other industry on its lobbying efforts. It spent $10 million more in the first quarter of 2017 than it did in all of 2016, and total spend on lobbying efforts and the funding of Congressional members in the past decade is roughly $2.5 billion. It has been speculated that this lobbying spend successfully curbed legislation to limit opioid prescriptions, an action that may have lessened the severity of the crisis today.
Advertising, clinical trial funding, and lobbying are just three sectors of healthcare that reek of Big Pharma’s influence, and it will take more than the next wave of lawsuits to change drug companies’ behaviors for the betterment of the American public.
In the meantime, let us take matters into our own hands as consumers and as contributors to Big Pharma’s success to educate ourselves on the implications of medications that are available to us. We must be vigilant in our efforts to not be swayed by the actions of drug companies, no matter how deep their influence goes.