Jan. 29, 2007 -- Television commercials for prescription drugs play on viewers' emotions, often lack solid information, and downplay the role of a healthy lifestyle, according to a new study.
But the pharmaceutical industry begs to differ; industry spokespeople saying the study is flawed because it relies on information gathered before new guidelines to improve the commercials took effect.
The impact of the drug commercials is important, both sides agree, because the typical American TV viewer sees up to 16 hours of these ads, called direct-to-consumer advertising, every year.
The ads are regulated by the FDA, but the regulations were relaxed in 1997, and a debate about the effectiveness of the ads has raged ever since.
"The educational value of the ads is pretty modest," says researcher Dominick L. Frosch, PhD, assistant professor of medicine at the University of California Los Angeles David Geffen School of Medicine.
Frosch and his colleagues recorded programming for four consecutive weeks from June 30, 2004, until July 27, 2004, capturing 38 pharmaceutical company ads.
Among the medicines advertised were Actonel for bone density problems, Cialis and Levitra for erectile dysfunction, Valtrex for genital herpes, Lipitor for high cholesterol, and Zoloft for depression and social anxiety.
Frosch's team conducted a content analysis of the commercials, evaluating factual information and the types of appeals to viewers, such as rational, emotional, humorous, fantasy appeal, sex appeal, or nostalgia.
They also noted how the ads portrayed the role of the drugs in the lives of the character in the ads and how or if the role of healthy lifestyles was represented.
"Ninety five percent of the ads are using positive emotional appeals -- people looking happy after taking the drugs," Frosch says. The commercials, he says, present "a very black and white portrait of the benefits of prescription drugs -- 'Take this drug and everything is going to be back in order.'"
For instance, one commercial pitching Valtrex for genital herpes shows a young woman first saying, "Living with genital herpes can be a hassle." After taking the drug, the final scene shows her kissing a partner in the surf, with Rio de Janeiro in the background.
"Lifestyle changes are sometimes mentioned as an adjunct [to taking the drug]," Frosch says, when in some cases changing behavior -- such as exercising more to reduce high cholesterol -- might actually prevent the need for the medication.
But they found that no commercials mentioned lifestyle change as an alternative to the medication.
Pharmaceutical Industry: New TV Drug Ad Guidelines
"The data is old data," says Diane Bieri, deputy general counsel for the Pharmaceutical Research and Manufacturers of America (PhRMA), an industry group.
"They used advertisements from the summer of 2004, and this was before the guiding principles of direct-to-consumer ads were even developed and announced, let alone effective," she says. "The guidelines were intended to address some of the concerns noted in the study."
The new PhRMA guidelines -- announced in January 2005 and effective in January 2006 -- are voluntary, but Bieri says all members of PhRMA who do TV commercials for their drugs have agreed to follow them.
Under the new guidelines, for instance, TV commercials for a prescription drug should state the name of the drug, condition it treats, and the risks as well as the benefits, Bieri says.
Commercials have improved since the guidelines took effect, Bieri and others say.
The industry promise to do a better of disclosing risks is "a step in the right direction," says Douglas Levy, JD, special assistant to the dean of the University of California San Francisco School of Medicine, who co-authored an editorial on the study with David A. Kessler, MD, a former FDA commissioner.
"But the drug companies still are condensing decades of research into 60-second commercials," Levy says. "TV ads never are going to be able to be truly complete, or tailored to an individual."
His advice to viewers? "Be aware that no TV commercial can take the place of a physician's evaluation of an individual's medical needs," he says. "Even the most responsible commercial cannot include all of the important information about a drug or a medical condition."
In many cases, Frosch adds, there may be other medication options, such as cheaper, generic versions of the drug advertised, and there may be lifestyle changes that could help the condition.
The study and editorial are published in the January-February issue of the Annals of Family Medicine.