Direct-to-Consumer Advertising of Medications is Wrong

“Ask your doctor if drug X is right for you."

I don’t like direct-to-consumer advertising of medications. It not the same as advertising for other things. There’s a difference between choosing which laundry detergent to buy and which drug is most appropriate.

On the one side, sometimes patients come in with vague requests. “You know that drug they keep advertising on TV? You know, the one that’s supposed to lower your a1c." Um, you just described every diabetes medication.  Other times they are very specific, “Can I take drug W for my diabetes”. 

Sometimes the answer is yes, but most of the time the answer is no, because a) you don’t need it, b) you are already on something identical to it, c) you tried something like it before and had a reaction to it, d) you cannot be on it because you have kidney/liver/heart/etc problems, or e) you said you can only take generic drugs due to cost (trust me, if it’s on TV, it’s expensive).  The bottom line is if I thought you should be on it, you’d be on it by now. 

Sometimes they are misled by the advertisement, or perhaps I should say, they misunderstand what is stated in the ad.  “I want to take the shot that’s just once a day” You are already on a shot you take once a day, that’s your long-acting insulin.  “But I need to take the other shot before each meal.”  Yes, that’s your mealtime insulin, which you will still need to take even if you switch to the one in the ad.  “But the ad says you only need to take it once a day.” That is true, you only need to take it once a day; you still need your mealtime insulin.

Let's face it, I think the ad is misleading, but that's my opinion.

Other times, since ads need to be “fair and balanced," patients say “I don’t want to take that drug, did you see the commercial? It says it can cause pain and bloating and infections and heart attacks and DEATH! Why would I take something that could cause death?”

Sometimes patients who are already on said drug come in in a panic because they saw the commercial.  And no explanation about relative and absolute risk can erase the recording in their heads “...can sometimes be fatal…”

Since patients cannot purchase drugs without a prescription nor do they have the depth of knowledge to understand the process of drug selection, I wish there were no direct to consumer ads for drugs.