Surprise: Doctors and TV Viewers LIKE Ask-Your-Doctor Ads

A new study by ZoomRx found that many doctors and patients like ask-your-doctor ads. Patients said they had asked their doctors about a specific med––as the ads tell them to––and doctors said the ads can facilitate “helpful conversations.”

One doctor in the study even said the ads could inspire patients “to think about symptoms that may help with a diagnosis.” That is likely the reason that 194 countries––all but the US and New Zealand––ban such ads: they can “sell” a disease through flagging its symptoms and create hypochondria.

Direct-to-consumer (DTC) drug advertising began in the US in 1998 around the same time the Internet took hold. Both developments gave the public access, for the first time, to information only doctors once had –– the symptoms of diseases, preferred drugs to treat them and, of course, drug side effects.

DTC ads and their related online “symptom checkers” have been a heyday for drug makers––functioning as de facto drug reps. They have become a dominant ad revenue source for media outlets and TV shows. In addition to selling diseases and creating hypochondria, medical groups charge the ads promote expensive drugs over cheaper and just as effective ones and reduce doctors to mere “order takers” as patient “self-diagnose” on the basis of TV ads.

“Every time you turn on your television, open up a magazine, or head to WebMD during a hypochondriac episode, there they are,” read an opinion in the American Medical Association (AMA) Journal of Ethics. “[G]lossy advertisements for countless prescription drugs that promise the possibility of relief from whatever ails you.” All the ads, says the editorial, “drive home a single, uniform message: ‘If you suffer from [insert any condition], talk to your doctor about whether [insert any drug name] is right for you.’”

As someone who cut her teeth in the ad industry, I am not surprised that the high-budget ads with their music, actors and alluring stage sets work. But what is surprising is that the long list of dangerous risks does not “unsell” the drug. Brain bleeds? Coma? Death? Super infections?

“The list is, alternatively, horrifying, boring, concerning, and silly,” wrote cardiology expert Larry Husten in MedPage Today. “It is reasonable to wonder how these ads, with their interminable lists of side effects, lead to greater sales of the drugs they promote.”

Niro Sivanathan of the London Business School and Hemant Kakkars of the Indian School of Business write in the Scientific American that the recitation of minor side effects significantly dilutes the impact of more serious side effects in participants they studied. The minor side effects somehow take the sting out of the more severe risks and, perversely, boost the drug’s sales, they hypothesize.

Husten takes the hypothesis a step further. He suggests that the side effect list has the effect of “hypnotizing” viewers in a process sometimes called autonomous sensory meridian response (ASMR)—am experience sometimes linked to the Internet.

ASMR has been defined as a pleasurable feeling that originates in a person’s head and spreads to their spine and sometimes their limbs, he wrote. An ASMR experience can “lull or practically hypnotize viewers into a state of benign, uncritical acceptance.”

The “drug ads are themselves like drugs,” continued Husten. “It would not surprise me at all to learn that the advertising agencies that produce the drug ads are consciously using ASMR videos as a model.”

Ask-Your-Doctor Ads Work

Five years before DTC ads began, Americans took an average of seven prescription drugs per year and by 2007, after the ads began, that number had leaped to 12 per year. While many advertisers have fled broadcast to online marketing, according to the pharmaceutical industry outlet FiercePharma, drug makers have remained on TV, rich ground for sales of arthritis, diabetes and psoriasis drugs––some of the most lucrative products.

An area of DTC drug advertising that especially generates controversy is what the ad industry calls “unbranded ads”—ads that raise “awareness” about a disease without naming the actual drug that’s being sold or even appearing to sell a drug. Instead, the ads, often with accompanying online “symptom checkers,” can sound like public service announcements that serve the general good, such as “smoke detectors save lives.”

A hallmark of such unbranded advertising is the claim that a disease is more widespread and serious than people think and that sufferers could have a condition and not know it. The disease is often called “underdiagnosed,” “misdiagnosed,” and “underreported,” and TV viewers are told that “stigmas” and “barriers” can prevent them from getting the treatment they need.

Since the ads do not mention the drugs they are trying to create a demand for and sell, the list of scary side effects is absent. Is that good or bad?

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