Total spending on pharmaceutical promotion grew from $11.4 billion in 1996 to $29.9 billion in 2005. Although during that time spending on direct-to-consumer advertising increased by 330%, it made up only 14% of total promotional expenditures in 2005. Direct-to-consumer campaigns generally begin within a year after the approval of a product by the FDA.

Supporters of this form of advertising, which is banned in nearly almost all countries (excluding the United States and New Zealand) say it provides a real service to consumers, informing them of new drugs and alerting them to health problems they may be unaware of.

Critics feel this form of advertising promotes only the most expensive new blockbuster drugs, when older and cheaper versions of drugs might be just as effective, thus driving up overall health care costs, with much emphasis placed on the high costs of prescription drugs.

Aggressive promotion can pay off big time. Merck, maker of Vioxx, the most promoted drug, spent $161 million advertising it in 2000, and sales of Vioxx quadrupled to $1.5 billion.

In fact, Merck spent more advertising Vioxx, according to NIHCM (National Institute for Health Care Management Foundation), than the $125 million spent promoting Pepsi or the $146 million spent on Budweiser beer ads. It even came close to the $169 million spent promoting GM’s Saturn, the nation’s most advertised car.

The drug industry says its ads not only educate consumers but also prompt people who might otherwise go undiagnosed to see their doctors. Many doctors agree.

What’s your opinion as to whether or not prescription drug advertising costs are a direct reflection to the high costs of prescription drugs in the United States.

Advertising techniques are based on ‘rhetoric’ (emotional persuasion) rather than evidence and reason and I think that serious medication decisions should be based on evidence and reason rather than on rhetoric. The thing with advertising is that we aren’t even aware of how it effects us (studies have shown us that). Who would have thought that our choice of which brand of spaghetti sauce to buy was made on the basis of product placement. Who would have thought that our (or our doctors) choice of which medication to try was based on the cute puppy that looks just like the cute puppy that the wonderful neighbours down the road have!

The interpretation of the first amendment is controversial, I guess, though I hear you when you say there is precedent for regarding advertising to be protected “free speech”. What does it matter if medication decisions are based on cute puppies rather than evidence and reason? How is medication different from spaghetti sauce? What if the person with the urinary problem would spontaneously come right in 6 months without treatment whereas taking the treatment results in his experiencing a severe side-effect? How do we weigh whether it is better to treat another 100 people with the drug when (say) 5 of those people have serious side effects that they never would have had if the drug hadn’t been marketed?

The trouble I have is that advertisements DO have dubious claims that are undersupported by evidence. If someone says that ‘this brand of spaghetti sauce is America’s favourite brand’ then do they get in trouble if someone does a study whereby it is found not to be? Drug companies purposely didn’t ask people about sexual side effects for SSRI’s and they purposely kept the side effect estimate several magnitudes lower than they were found to be when people actually got around to doing the studies.

I think that health matters more than spaghetti sauce… And that freedom of speech has to be tempered with the effects of ones speech on others (e.g., you can’t yell bomb on the plane) and I really don’t think… You should pursuade people to make serious health decisions on the basis of emotion rather than evidence and reason.