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"Generation Rx Some doctors argue that direct-to-consumer advertising has benefited their patients, that it has helped bring the sick into their offices, where they can receive needed medical care. But for many other physicians, drug advertising has changed their relationship with patients for the worse, often in precisely the ways predicted by the pharmaceutical executives who were writing to Congress back in the 1980s. Patients now routinely diagnose themselves with conditions and come to their doctors demanding the brand-name drugs they see advertised." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"One thing about direct-to-consumer advertising is not in question: since the advertising began in earnest in 1991 it has been a financial boon for the drug industry. Since 1991, when spending on DTC advertising was a mere $55 million, expenditures on drugs have increased at about four times the rate of expenditures on hospital or physician services. Melody Petersen reported in the New York Times that in 1998 the largest drug companies generated $22.50 in sales for every dollar spent on advertising to consumers and primary care doctors." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.) "Canadian patients made these requests less than half as often as American patients. direct-to-consumer advertising is not allowed in Canada, but some drug ads arrive in American magazines and over cable television.) A study done by Prevention magazine in 1999 showed that doctors prescribed requested prescription drugs 80 percent of the time. The drug industry would probably argue that these successful requests are evidence of their excellent consumer education, and that better-informed patients get better medical care. Doctors, however, have a different opinion." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.) "As explained by Alan Holmer, president of PhRMA, in a recent issue of JAMA, direct-to-consumer advertising "is an excellent way to meet the growing demand for medical information, empowering consumers by educating them about health conditions and possible treatments." Studies show, however, that drug ads usually stay away from the facts that count. Researchers from Dartmouth Medical School found that only 13 percent of drug ads in magazines used data to describe drug benefits; the remaining 87 percent relied on vague statements. Not a single ad in the study mentioned the cost of the drug." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.)

"The serotonin hypothesis of depression has been overplayed in the direct-to-consumer advertising as a way to link the "one pill to one chemical imbalance" idea. There never was much evidence that a deficiency of serotonin underlay depression, or that this deficiency could be fixed with a medication that boosts serotonin. If that were the case, then why don't you get better right away with an antidepressant, since it boosts serotonin right away? The academic psychiatry community never believed this hypothesis, although it never said much about it." - J. Douglas Bremner, Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health (Get the book.)

"Despite the barrage of direct-to-consumer advertising you are exposed to that seems to suggest drug companies are producing a steady stream of innovative medicines, the success of the industry's research and development efforts has been slowing down just as genomics and a variety of other approaches have come along with the promise of improving the efficiency of drug development." - Peter J. Whitehouse and Daniel George, The Myth of Alzheimer's: What You Aren't Being Told About Today's Most Dreaded Diagnosis (Get the book.)

"Holmer AF. Direct-to-consumer advertising: strengthening our health care system. N Engl J Med, 2002;346:526-8. Wolfe SM. Direct-to-consumer advertising: education or emotion promotion? N Engl J Med, 2002;346:524-6. 22 Whether or not pharmaceutical companies are involved in this avoidance of law and regulation, as the tobacco companies have proven to be with the illegal transport and distribution of cigarettes, remains an unanswered question. advertising through culture, long before it became fashionable to write novels at the behest of States, perfume houses and jewellers." - Martin J. Walker, HRT Licensed to Kill and Maim: The Unheard Voices of Women Damaged by Hormone Replacement Therapy (Get the book.)

"Once the FDA opened the door in 1997 to less-regulated direct-to-consumer advertising, says Elliott, "companies began hitting for the fences." They concentrated their efforts on potential blockbuster drugs for chronic illnesses that could be taken by millions of patients. A new antibiotic might save lives, but a new lifestyle drug—Prozac for depression, Clar-itin for allergies, or a drug like Lipitor that treats a risk factor like high cholesterol—could be taken every day by huge populations, sometimes for years on end." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"More than four out of five family doctors feel that direct-to-consumer advertising is not a good idea. Interestingly, although primary care doctors consistently express unfavorable opinions about the impact of DTC advertising on medical care, dermatologists have a positive view, perhaps reflecting the increase in visits generated by advertisements for skin products. At its best, the trust between doctor and patient creates the opportunity for open discussion of symptoms, fears, models of disease, life circumstances, and expectations." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.)

"A series of suits, culminating in a case heard before the Supreme Court in 1996, finally convinced the FDA that if pharmaceutical companies ever challenged its restrictions on direct-to-consumer advertising, the agency might well lose the case. In 1997, it issued a draft rule, finalized two years later, permitting companies to boil down the brief summary to a few seconds for broadcast advertisements, thus opening the gates to Zoloft cartoon ads during prime-time sitcoms and Ambien ads on the nightly news." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"It has legalized dangerous prescription drugs and supported the use of mind hacks by legalizing direct-to-consumer advertising in 1997. That's what allowed drug manufacturers to go out across the airwaves and reach consumers directly with bogus advertising claims. If it weren't for direct-to-consumer advertising, we never would have had the Vioxx scandal we are seeing today. We never would have had skyrocketing sales of Viagra, Bextra or Celebrex ?drugs that consumers are now demanding from their doctors. It is the FDA that has created an environment in which dangerous drugs can flourish." - Mike Adams, Spam Filters for Your Brain (Get the book.)

"As I discuss in chapter 9 and elsewhere, direct-to-consumer advertising transfers billions of dollars of pharmaceutical profits to print and broadcast media companies. There is an inherent conflict of interest in this arrangement. Without imputing malfeasance, it behooves the media companies to look askance, or choose other topics of interest, or practice circumlocution when it comes to being critical of the products of their advertisers. I believe that this is a subliminal dialectic most of the time. However, it need not be so subliminal." - Nortin M. Hadler MD, Worried Sick: A Prescription for Health in an Overtreated America (Get the book.)

"Had the company not valued sales over safety, a suitable trial could have been initiated rapidly at a fraction of the cost of Merck's direct-to-consumer advertising campaign.45 Writing from the "editorial desk" (which clearly gives the writer more authority than a "letter to the editor") of the New York Times, Topol estimated that COX-2 inhibitors were responsible for tens of thousands of heart attacks or strokes per annum. "Good riddance to a bad drug," he concluded, calling the entire story of COX-2 inhibitors "a debacle."46 That should have been the end of the story. Not so." - Gerald E. Markle and Frances B. McCrea, What If Medicine Disappeared? (Get the book.)

"Of course there are overreaching business practices that some pharmaceutical companies sometimes utilize, such as selling too hard, charging too much, or taking advantage of consumer ignorance with overstated direct-to-consumer advertising," wrote Howard Solomon, the chairman of Forest Laboratories, in a letter to shareholders in 2002. "And, of course, it is appropriate to criticize, and in a proper case, to take action against such excesses but, at the same time, to realize that all businesses have comparable excesses." - Melody Petersen, Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs (Get the book.)

"Other pressures are also behind the increase in antidepressant prescriptions. direct-to-consumer advertising in the U.S. is also driving up antidepressant usage. Interestingly, by making consumers more likely to talk to their doctors about going on a medication, when patients ask for an antidepressant, they get it 76% of the time compared to patients with the same symptoms who don't ask to go on antidepressants, who are given antidepressant prescriptions only 31 % of the time. Antidepressants are approved by the FDA for the treatment of several disorders in addition to depression." - J. Douglas Bremner, Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health (Get the book.)

"However, proponents argue that direct-to-consumer advertising, if done well, would be a form of health promotion (Hollon 2005) rather than an exercise in medicalization. It has been argued that treating physicians must assist their patients in interpreting the barrage of direct-to-consumer pharmaceutical marketing (Rosenthal et al. 2002). Sidney Wolfe (2002) has further argued, "The education of patients ?or physicians ?is too important to be left to the pharmaceutical industry, with its pseudoedu- cational campaigns designed, first and foremost, to promote drugs." - Nortin M. Hadler MD, Worried Sick: A Prescription for Health in an Overtreated America (Get the book.) "This is the impression one gets from the content of their numerous sponsored professional symposia, the dinner talks by "thought leaders," their advertising in professional journals, and their direct-to-consumer advertising. Direct-to-consumer (dtc) advertising has an interesting history. The Kefau-ver-Harris Amendments to the Food, Drug and Cosmetic Act in 1962 did more than mandate assessments of efficacy. The jurisdiction over prescription-drug advertising (not over-the-counter drug advertising) was transferred from the Federal Trade Commission to the fda." - Nortin M. Hadler MD, Worried Sick: A Prescription for Health in an Overtreated America (Get the book.) "Spending on direct-to-consumer advertising of prescription drugs has tripled between 1996 and 2000 to $2.5 billion (which is only 15 percent of the pharmaceutical marketing budget) and reached $4 billion by 2004. Vioxx led the charge. In short order Celebrex and Vioxx each accounted for revenues that exceeded $3 billion per year. Merck and Pfizer convinced consumers and prescribers that their coxibs are worth the considerable extra expense compared to inexpensive over-the-counter aspirin and other nsaids." - Nortin M. Hadler MD, Worried Sick: A Prescription for Health in an Overtreated America (Get the book.)

"No pushback For more than a decade, the drug industry has successfully used direct-to-consumer advertising to boost sales of brand-name drugs, so perhaps it should come as no surprise that the device industry has finally caught on to this marketing tool. After all, it's their job to sell as many of their machines as they can, and stimulating patient demand for imaging tests is one way to do that. What is surprising is the blinding speed at which many new, medical technologies, not just imaging equipment, are adopted by hospitals and physicians, regardless of their true utility or costs." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

"At any point, the FDA could have stopped Merck from using direct-to-consumer advertising, especially given the background concern that the cardiovascular toxicity was real and was receiving considerable confirmation in multiple studies conducted by investigators who were independent of Merck.15 His words drew attacks on his professional reputation. In November 2004, unfounded rumours tried to suggest a financial motivation to what he was saying. A month later, he was described as a luddite in the Wall Street Journal. " - Jacky Law, Big Pharma: Exposing the Global Healthcare Agenda (Get the book.)

"A friend of Davis's, William Castagnoli, had been chafing for years to try out direct-to-consumer advertising, but had made little headway. Castagnoli had made his bones at the old Frohlich Pharmaceutical Advertising Agency, which, under its founder, Arthur Frohlich, became a veritable monopoly for medical journal advertising. In the mid-1980s, at Medicus, the successor agency after Frohlich died, Castagnoli served as a senior executive overlooking the Merrill-Dow account. He had tried to get his superiors interested in DTC for prescription drugs." - Greg Critser, Generation Rx: How Prescription Drugs are Altering American Lives, Minds, and Bodies (Get the book.)

"In October 2002, at the request of members of Congress, the agency submitted a report called "Prescription Drugs, FDA Oversight of direct-to-consumer advertising Has Limitations." The report confirmed that drugs with high DTC spending were among the best-selling drugs. In 2000, 22 of the 50 drugs with the highest advertising spending were among the top 50 in sales, and sales of drugs with the highest DTC spending rose more quickly than sales of other drugs." - Craig Pepin-Donat, The Big Fat Health and Fitness Lie (Get the book.)

"Drug companies should be excluded from offering medical education. • direct-to-consumer advertising of prescription drugs should be banned. • Pharma's books should be open to the public because of the preferential tax breaks research attracts and the importance of its products to public health. • Drug pricing should not only be transparent but reasonable and as uniform as possible for all purchasers. She is the first to admit it is little more than a wish list." - Jacky Law, Big Pharma: Exposing the Global Healthcare Agenda (Get the book.) "The reasoning is that since the downside of the drug has been found to apply to the entire Cox-2 class (including Vioxx's rival Celebrex) and since the entire class has some important benefits for people who cannot take the alternatives, they should all be allowed as a prescribing option, albeit with heavy warnings and no direct-to-consumer advertising. But that is not the end of the story." - Jacky Law, Big Pharma: Exposing the Global Healthcare Agenda (Get the book.)

"On June 11, 2003 a joint study done by Harvard and MIT was released that revealed direct-to-consumer advertising by the pharmaceutical industry increased from $800 million in 1996 to $2.7 billion in 2001. Not only that, but with a return on investment of $4.20 in sales for every $1 spent on advertising, we can expect even more in the future." - Fred A. Baughman, Jr., M.D. and Craig Hovey, The ADHD Fraud: How Psychiatry Makes "Patients" of Normal Children (Get the book.)

"Other research also points to the power of direct-to-consumer advertising finding it is more effective than providing the physician free samples or even doing "detailing" (drug company representatives meeting and teaching physicians about the latest "research" on an antidepressant or whatever drug he or she is promoting on that visit).22 In fact, it appears that DTC advertising may be the single most effective way a drug company can increase the number of people who are diagnosed with depression and will then begin taking antidepressants." - Dr. Timothy Scott, America Fooled: The Truth About Antidepressants, Antipsychotics and How We've Been Deceived (Get the book.) "No dollars are more effectively spent than the direct-to-consumer advertising dollars. Advertising works! 5 "Advertising is a valuable economic factor because it is the cheapest way of selling goods, particularly if the goods are worthless." — Sinclair Lewis Nobel prize-winning author1 ANALYZING AN ANTIDEPRESSANT AD — Effexor® XR I recently made a visit to my physician's office. For want of anything else to read while waiting, I picked up a medical journal." - Dr. Timothy Scott, America Fooled: The Truth About Antidepressants, Antipsychotics and How We've Been Deceived (Get the book.)

"But there have been few, if any, large studies that rigorously investigate whether direct-to-consumer advertising causes unnecessary medical labeling or leads to inappropriate or harmful prescription of drugs. What is crystal clear, however, is that these ads boost drug sales. Industry executives argue that the most powerful case for direct-to-consumer advertising is evidence of underdiagnosis and undertreatment among those people with serious health problems, including high cholesterol, high blood pressure, depression and, presumably, PMDD." - Ray Moynihan and Alan Cassels, Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All into Patients (Get the book.)

"It was at Merrill that Ingram was exposed to the powerful potential of direct-to-consumer advertising and marketing. In 1983 he commissioned a study of five hundred viewers of Cable Health Network who saw a thirty-second commercial about the effects of cholesterol. The results: two weeks after seeing the ad, 22 percent had visited their doctors, and 46 percent of those asked to have their cholesterol checked. As the study authors told Ingram in an internal memo, "These results are nothing less than staggering." Ingram took the advice to heart." - Greg Critser, Generation Rx: How Prescription Drugs are Altering American Lives, Minds, and Bodies (Get the book.)

"When Congress approved direct-to-consumer advertising of pharmaceutical products, they subverted the time-proven doctor-patient relationship. With prescription pad in hand, and patients programmed by Madison Avenue ad executives, today's medical professionals are little more than middlemen, functioning as go-betweens for the pharmaceuticals. Since the role of the medical professional is instrumental in increasing corporate wealth, the pharmaceutical corporations amply reward these middlemen. The initials "M.D." may stand for "medical doctor." - Brent Hoadley, Ph.D., Too Profitable to Cure (Get the book.)

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