Medicines advertising in the US – patient power gone mad?

Originally trained as a pharmacist, I have always kept an eye on the pharmaceutical industry and drug information for patients in general. For a while I worked on drug development for a major pharmaceutical company so I have a clear understanding of the costs involved in bringing a new drug to market. However during my recent visit to the US, I was, as always, bemused by the level of drug advertising on television.

In the UK, we only see TV adverts for over the counter medicines, and promotion of prescription-only medicines is confined to medical journals and specialist conferences.

There seems to be a push on diabetes in the US at the moment. Not surprising, considering there are 20 million diabetics there. This is also a growing problem in the UK, with approximately 5% of the population suffering from the condition as unhealthy lifestyles are bordering on pandemic.

I found it bizarre to hear the voice-over on the TV advert asking (in effect) – ‘could your diabetes be controlled better with insulin? Check with your doctor and discuss insulin treatment with him’

This unsettles me on so many levels. With my limited knowledge of diabetes, my understanding is that Type 1 is treated with insulin and type 2 is normally controlled by diet and tablets, with insulin therapy an option if the first line of treatment fails. Does this advertising suggest that a) patients are not being offered insulin when they should or b) physicians are being pressurised into prescribing a mallet to crack a nut? The thought that a patient would go to their doctor’s surgery and suggest that they be treated with a medication that may well be unnecessary and is normally avoided if possible seems extreme. And yet clearly this advertising works as I find it hard to believe that the drug company would invest in prime time slots to no avail.

It is interesting to note that the annual drug spend per person in the US in 2008 was £507 compared to £200 per person in the UK. (http://www.abpi.org.uk/)  Are drugs more expensive in the US than the UK? I don’t think so. Does excessive prescribing lead to increased costs in the US? Maybe.

Of course patients should question their doctors on any aspect of their treatment and of course they should be free to suggest options for drug regimes. I can also see the merit in the popular press in informing patients of innovative treatments as they become available. But who should be the driving force in planning treatment regimes?

We don’t have the luxury (or is it a curse?) of TV and popular press advertising for prescription only medicines here in the UK just yet. And I hope it will be a long time before we do.