As modern Western medicine has grown over the years, the tactics with which new ideas and findings are introduced to consumers have grown as well. One method that has sparked controversy across the country—even possibly the world—is that of Direct to Consumer (DTC) advertising. While this may not be an entirely new concept, it is one of the most rapidly growing and most heard of in the American prescription drug world. Instead of allowing consumers to find medicines and prescriptions solely through their doctors, drug companies have made it possible for them to play the role of their own ‘physician’, providing information with which consumers can essentially ‘diagnose’ themselves and find medicines on their own. As this entirely new step in the medical system is added, the rest of the world has not welcomed it with such open arms as the United States has. In fact, besides the U.S., New Zealand is the only other country in the world to work with this type of prescription drug advertising (Lo). This statistic has led many researchers to criticize the DTC movement as a whole, highlighting its negative effects on the medical system. While this specific kind of advertisement may not seem to warrant the scrutiny it has come under, the fact of the matter is that DTC advertising does negatively affect the country in a big way. Through researching various examples of how DTC advertising negatively affects patients, their relationships with their physicians, and the medical system as a whole, the conclusion can be reached that there must be an end to this sort of advertising in the United States. 

Since the late 1990s (Donahue), Direct to Consumer advertising has slowly been taking over U.S. television and website ads. No longer do consumers solely hear about different medicines by word of mouth or through doctor’s appointments, but they are now exposed to prescription drugs just about every time they turn on their televisions, computers, phones, and the like through ads. At their initial introduction, DTC ads were required to list every possible side effect and risk for consumers to clearly see. In 1997, however, the FDA released statements alleviating companies of much of these responsibilities, only requiring risks and side effects that companies deemed ‘major’ to be listed, with a source included for consumers to learn about others on their own (‘Background’). This opened an entirely new door for prescription drug companies, through which they were able to create advertisements in capacities that had never been seen before. From this, “expenditures on DTC ads nearly tripled between 1997 and 2001, and the percentage accounted for by television increased by 25 to 64 percent” (Angell), Marcia Angell, M.D. points out in her novel criticizing the DTC movement. While not a direct push to create an easier outlet for prescription drug advertisements, this move by the FDA is arguably one of the most crucial and influential in this epidemic. While there were still establishments in place to regulate these rapidly increasing advertisements, the Administration soon ran into a problem. The issue arose of there not being enough personnel to evaluate these ads, and Angell writes that the FDA ““only had thirty reviewers to cull through 34,000 DTC ads submitted to it in 2001” (Angell). Again, although there was not an intended advantage given to these companies, they were benefitted far more than what they could have asked for, simply due to a failing system. 

  

From said failing system came more advertisements of this kind than the world had ever seen, and doctors were suddenly flooded with patients who wanted the products they were being bombarded with on television. While some claim that this increased exposure could be for the better, the fact of the matter is that the Unites States is among the highest users of prescription drugs in the world. In 2000, not long after the new DTC advertisement regulations were released, “DTC advertising was responsible for 12% of the increase in prescription drug sales, or an additional $2.6 billion” (‘Impact’)—over $8.6 million a year. This sudden increase in sales so directly following the alleviated regulations can only lead to the inference that these advertisements directly and quickly affected how American consumers bought their drugs. 

There are some major downsides to how these ads affect consumer behavior, and it does not just involve them buying more drugs. For example, DTC advertisements can lead consumers to believe that normal bodily functions (thinning hair, low testosterone with age, etc.) are problems that need to be fixed by drugs, when that is not always the case (‘Prescription’).  This finding gives an almost direct reasoning behind the rapid increase of drug sales, and it is because consumers suddenly were told that potentially normal body activities prompted immediate drug use to ‘fix’ it. These advertisements not only encourage the use of drugs for ailments that may not require them, but they also misinform consumers. One survey conducted by the FDA revealed that sixty five percent of physicians surveyed “believe DTC ads confuse patients about the relative risks and benefits of prescription drugs” and that “about 75 percent of physicians surveyed believe that DTC ads cause patients to think that the drug works better than it does” (FDA). While they are not permitted to use false information in their advertisements, there are ways that drug companies get around having to tell the whole truth behind their products. For example, most consumers may not be aware that some drugs advertised are not 100% approved by the FDA due to their pending approval, yet are still able to be projected to the public. Although the companies may not state that their product is completely deemed as ‘safe’, consumers typically expect them to be since they are so frequently pushed on them, as a survey conducted in April 2013 suggests. The survey shows that “43% of consumers surveyed thought the [advertised] drug had to be 100% safe before being advertised” (‘Prescription’)—showing that consumers put more trust into drug advertisement companies than they should, which could lead to disastrous results. One example of said potential results is associated with the former arthritis drug, Vioxx. Advertised as an arthritis pain reliever, this drug was used by consumers from 1999 to 2004 before being pulled from the market for causing strokes and heart attacks. The lack of research done on this drug’s effects lead to over 4,000 deaths from 1999 to 2005 (‘Prescription’), a tragic but avoidable occurrence if better regulations had been put into place. 

Not only do these advertisements negatively affect consumers, but they affect the patient-doctor relationship, as well. One article written by a Dr. Kurt C. Stange points out that time spent explaining to a patient why a certain advertised medicine is not right for them is time wasted—time that could mean “that a mammogram is not ordered, an important health behavior not discussed, a deeper patient concern is never articulated” (Stange). Doctors are not able to do their jobs for their patients properly, and patients lose trust in their doctors because they do not believe they are being treated properly—because of the influx of drug advertisements that come their way every day. One study done in 2004 reported that “based on average viewing of television in the United States, an adult is exposed to 100 minutes of direct-to-consumer advertising for each minute they spend with their doctor each year” (Gellad). That is essentially saying that consumers are exposed to drug advertisements one hundred times more than they are with their doctors, the only people whose sole job it is to aid in their health. This then raises the question of how patients and doctors would have even a fraction of enough time to adequately advise them on certain drugs and to also do their normal job, and the answer is simply that they do not. From the influx of patients they see inquiring about DTC-advertised drugs to the pushing of pills by drug representatives and the like, doctors have come to feel pressured to prescribe things to patients that they may not have if these factors did not exist. In one survey conducted in 1999, “91% of the physicians who responded reported that they felt under pressure to prescribe products patients asked them about” (Spurgeon), and that 77% of said physicians “said that television advertisements were the most frequent source of their patients’ information” (Spurgeon). While doctors are usually seen as ‘holding the keys to the kingdom’ in the world of writing prescriptions, this study and many others like it have lead to the conclusion that DTC advertisements and the drug companies behind them are slowly becoming more powerful than the professionals when it comes to giving patients drugs. While some might argue that these advertisements advise patients better than their doctors, based on the previously mentioned fact that these ads are said by many to be confusing and misleading to patients disputes that argument altogether. 

As if misleading, pill-pushing advertisements were not bad enough as is, Direct to Consumer advertisements have also been found to push more expensive, less practical drugs for the financial gain of the drug companies. In an article by USA Today, the author reports that “critics say the [DTC] ads encourage patients to ask their doctors for expensive, often marginal—and sometimes inappropriate—drugs that are fueling spiraling health care spending” (Horovitz). This finding shows just how out of touch the drug companies and their advertisements are with the bettering of America’s health, and that they are a business first, not a health care provider. In a survey conducted in 2013, “37% of doctors said they often or sometimes prescribed brand name drugs because the patient requested [it] rather than prescribe the equivalent and cheaper generic drug” (‘Prescription’). Many consumers gravitate towards brand name drugs because of the familiarity of their names, but many also do not know that they cost “30 to 80% more than generic drugs” (‘Prescription’) because generic drugs are not advertised, therefore generic brands do not have to make up for advertisement costs with increased prices. This indirectly but heavily influences the cost of health care in America, which had an increase of over 180% from 1999 (shortly after regulations were lifted) to 2013 (Young). 

In comparison, one of the many subjects of controversy that has overtaken the United States in especially the last decade is that of marijuana legalization. The way that most adult figures and school specials talk about the plant that has been around for centuries would make people think that it causes severe problems for its consumers, when the real problem is the drugs that are legal. To put it into statistical terms, in a study done by the Center for Disease Control, over 18,000 people died in the United States from prescription drug overdose in 2014, while the number of people who died of marijuana overdose was, in fact, none (CDC). While one of these substances has been deemed that of delinquents and drug abusers, the one that now has a higher death rate than car crashes or shootings in the U.S. (Christensen) is not only legal, but is being pushed on citizens to consume and sell every day, and a higher price than they are worth. Drug companies have taken all of this into account, preying upon America’s growing prescription interest and, in some cases, addiction, and using it to further their success. Their agenda of pushing unnecessary, harmful pills onto American citizens has become more prevalent as years have passed. 

From these examples, the conclusion can be reached that drug companies are after one thing only: profit. There is little, if any, concern regarding the well-being of American citizens, as seen with the advertising of Vioxx, a drug that was not researched well enough and, in turn, had fatal results. Drug companies mislead, misinform, and take American people for granted when pushing their products, using overly-relatable and sometimes fear-inducing tactics to make their messages have a greater effect on consumers. These Direct to Consumer advertisements also effect physicians and their ability to do their jobs correctly, along with their relationships with their patients. The bond between healthcare provider and patient is one that has been seen as a trusting, professional environment, but that is now being tainted by the existence of DTC ads and their pill-pushing agenda. While some argue that these ads inform consumers of potential health risks they have or of medicine that may work more efficiently, they are simply advertising the drugs that will produce the largest profit for the company by using brand name drugs, affecting the medicines that patients inquire and ultimately increasing health care costs. As a whole, Direct to Consumer advertising has an overall negative effect on the American health care system and its people in general. These ads must be put to an end, and our healthcare professionals must take back the medical field that is rightfully theirs—with the well-being of the American people as their first and only priority. 
