The Strange Truth Behind those Drug Commercials
Want to hear a not-so-secret secret? A piece of industry lore that’s mostly been buried under decades of spin…” It’s about DTC advertising of pharmaceuticals, those pesky drug ads.
DTC pharmaceutical ads emerged because patients weren’t always hearing about all their options. Too often, loyalty to a product, company, or protocol—sometimes for reasons unrelated to outcomes—shaped what got prescribed.
We all watch them and comment on them. Sometimes we laugh, sometimes we are horrified, sometimes we ae stunned by the list of side effects. Rarely, even after hearing those, do we stop and think wow, maybe the condition they treat is really awful, but most times we don’t even think of that because it doesn’t affect us directly.
We all make fun of them, and we tune them out. And we occasionally whine about them when the topic comes us. But did you know pharmaceutical advertising to consumers wasn’t always a “thing”? Most advertising of drugs was done directly and only to doctors and healthcare professionals. There was a streamlined system of access and presentation, leaving the patients and public out of the discussion.
A side note to understand the context of the changes. While this was happening, the FDA was also cracking down on pharmaceutical “advertising” to the healthcare professionals. They effectively put an end to the overt wining and dining of doctors, essentially buying them for loyalty. Medical conferences were no longer comped, in exotic resort locations with added perks for the doctor and their families. Gone were the free flying lessons and concert tickets (mostly).
To put it simply, the FDA had it’s hands full.
But so did the doctors and healthcare professionals.
Doctors were put on the spot
- Now they had to know the products.
- They had to be aware of the side effects, because patients had access to information now, and they were asking questions.
- This was new.
Doctors had been afforded the de facto trust of their patients as the all informed experts, never knowing they were informed of the products they used most “for whatever reasons” (wink wink), and even then, didn’t know all the information. Now they were facing informed consumers. And their own loss of balance on their pedestals.
1985: FDA approves DTC drug ads
Then, in 1985, after years of debate, the FDA opened the door to consumer advertising—with strict rules requiring risk disclosures and proven benefits.(1) There were very very strict guidelines, and the advertising was only in places where the public might run across them, such as obscure, niche magazines one might find in a doctor’s office, or disguised as patient education pamphlets. Nothing really overt.
The DTC advertising wall was broken, though, and soon the advertising in general magazines and newspapers became common place. The FDA suddenly had its hands full cracking down on claims, as previously tracked products like make up and supplements began competing, in a sense, with the DTC pharmaceutical ads.
You’d think doctors would adapt—armed with data, conferences, scientists, and yes, those endless lunch-and-learns. But many resisted, dismissing consumer knowledge as noise.
1997: FDA allows DTC drugs ads across platforms
And then all hell broke loose. Television and radio were opened to DTC drug ads in 1997, and the internet soon amplified everything.
Nearly 50 years. So how’s it going? It’s fine, everything’s fine, it’s all fine. Healthcare providers have been widely accepting of societal and business change and have adapted to the “well informed consumer”, knowing they are a partner in their own healthcare. {sarcasm}.
Yeah, I know. It took many tries to type that out due to the typos from laughing so hard.
DTC drug ads introduced the age of informed patients
Doctors (ok, fine, #NotAllDoctors) are not fans of informed consumers. They rail against information patients bring to them, they push back saying it’s incomplete or outright wrong, not applicable. Yet they still don’t discuss what is. They still push for adherence, even 50 years and generations of professionals who have grown up in this environment. The FDA still watches, and pharmaceuticals now also include inevitable fines for overstepping in their marketing budgets, and they still crack down on buying loyalty, now for consumers AND doctors (pharmaceutical companies can’t even give out branded pens anymore!).
DTC advertising, while bizarre and often off-putting, has been a long journey to awareness and accountability. That example of shining a light on truth and facts in action, even if it’s taken nearly a half a century to get here. But we need to keep it moving forward. The FDA needs to still stand strong, and define facts and science as the reliable truths.
And the next time you see a drug ad or a commercial, listen to the side effects and risks, and then consider this … these are risks worth taking for many, given the effects of the condition they’re designed for.
Don’t mess with the FDA when it comes to Drug Ads
Here’s how sensitive the FDA is about claims: one client had to scrap an entire campaign because a background photo showed the Appian Way—deemed too strenuous a hike for the target audience of cancer patients. Walking in a picture was considered too much of a promise.
So next time you hear that long list of side effects during a commercial or see it in drug ads, pause. Think about the condition that makes those risks worth it. And remember: DTC advertising wasn’t born to annoy us—it was meant to keep doctors honest by giving patients a voice. (more to come on that)
References:
(1) FDA lifted moratorium and confirmed that DTC ads must meet the same “fair balance” and “brief summary” standards as those directed at doctors. https://pmc.ncbi.nlm.nih.gov/articles/PMC3278148/
(2) FDA eased broadcast rules, permitting TV/radio prescription drug ads with streamlined risk disclosure and alternate paths to full information. https://pmc.ncbi.nlm.nih.gov/articles/PMC4031617