The harm in “asking your doctor”

“Ask your doctor.”

This phrase is very common to anyone who lives in the United States. Almost all pharmaceutical advertisements end with these three words. Prompting patients to have a discussion with a doctor can be a good thing in a way, but this is also cause for concern. Several studies have shown that direct-to-consumer pharmaceutical advertising increases the amount that people will request certain medication from their doctors. One study by Berger et al. found that up to 30% of Americans will speak to their doctors about medication that they have seen advertised. It may seem that speaking to your doctor about a certain medication is harmless, but even subtle inquiries about a specific medication can have a large effect on doctors’ prescribing habits.

One study from 2014 found that asking about a medication significantly increased the rate at which doctors prescribed that drug. In the study, the researchers asked the patients to say the phrase, “I’ve seen ads for (drug name)… A woman I work with takes it and she said it really works for her.” They purposefully chose this wording because it is not an active request for the medication, but rather the patient just mentions the drug and that he or she has heard it is effective. Even this less direct form of medication request causes a change in doctors prescribing habits. The study found that not only does the request make the doctor more likely to prescribe that drug, but it also makes the doctor more likely to prescribe a drug in the same class. For example, patients who asked for oxycodone were significantly more likely to receive a prescription for a strong narcotic or opioid pain reliever. This is concerning considering that this type of medication has a very high potential for addiction and can be very dangerous if too much is taken or if combined with alcohol. Additionally, long term opioid prescriptions are one of the major contributors to the United States’ heroin problem. Many people will get a long term opioid prescription for pain relief and become dependent; heroin, then, provides a more accessible and affordable opioid alternative once the prescription ends. In a system where drugs of this class are only a question away, advertisements prompting you to ask your doctor for them pose an enormous threat to public health.

Only two countries in the world, New Zealand and the U.S., allow public advertisements for pharmaceuticals. You can’t help but wonder why almost every country in the world has banned these advertisements. Pharmaceutical companies try to justify their marketing by claiming that they educate and raise awareness of treatment options. But, as a business, pharmaceutical companies aren’t seeking to inform the public of all the options. They are seeking to inform the public of one option: their option. The problem is that these ads tend to drive the public to desire very expensive name brand drugs when other cheaper options exist with the same clinical effects. Pharmaceutical companies are known to create a lot of what is known as “me too” medications. These are drugs that are extremely similar to other drugs that are already on the market and they rely on advertising, both to consumers and doctors, in order to differentiate themselves and convince people that they are better than their market competitors. These medications tend to be very expensive compared to generic drugs that have nearly the same exact function and health benefits. It, also, makes those taking generic drugs feel that their medication and care is inferior, and therefore, could potentially affect the trust they have in their doctor.

It’s clear that pharmaceutical advertisements need to be regulated more strictly or potentially banned all together, but more research is needed in order to move the debate forward. Pharmaceutical companies fund research supporting their side of the argument, and therefore, hold a lot of power over public perception on this matter. This, unfortunately, slows the progression of this debate and will likely keep pharmaceutical advertisements around for a very long time.