- - Wednesday, February 8, 2017

It’s been 20 years since the Food and Drug Administration (FDA) permitted the advertising of prescription drugs on television. It was a dumb decision in 1997, and it’s dumber after two decades, with just one other nation, New Zealand, in agreement. The only individuals who can prescribe such drugs are physicians. And only doctors have the training about, and knowledge of, such drugs, as well as insight into their patients’ medical backgrounds that may or may not be appropriate for such medications.

Of course, the reasoning of the FDA was that the more information provided the patient the better, but the problem is that advertising in a 60-second or 30-second ad doesn’t provide adequate time to enumerate benefits and especially risks. And the FDA requires only that “major” risks are delineated, no matter that the determination of such issues is left entirely to the pharmaceutical company. In a typical one-minute ad, only a few seconds discuss risks — and at a rapid rate so as to perplex even the most gifted mind.

No doubt, often these TV ads refer viewers to magazines where the ads are similar to the inserts in the prescription drug packing. Fine print, lengthy medical jargon, even with chemical formulae and the like — but the likelihood of anyone reading the disclosure is slim.

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To be sure, TV ads are reviewed by the FDA, but its staff is inadequate to deal with the numerous ones that appear each day. A typical American TV viewer watches nine such ads a day, often in the prime-time spots of morning and nightly news. And not surprisingly, numerous ads follow from law firms engaged in class-action suits against companies producing drugs that adversely affected consumers.

Here’s the real zinger: The ads are slick. Individuals with chronic bowel disease, arthritis, diabetes, osteoporosis and other maladies look just fine. Even ads featuring psoriasis drugs appear to highlight people who have great skin. Not even the inkling of a zit. Nor do the ads for antifungal remedies, as an example, prominently indicate that usage is required for lengthy periods to achieve results. Nor does the good and bad of long-term usage of prescription drugs find a place in the glow of faces on TV ads.

Worse, anti-cancer drugs that allegedly extend life have to be read in fine print at the bottom of the screen. And the verdict is that only a few months of life are added in contrast to other therapies. Which brings up the matter of comparative advertising of prescription drugs — a perilous path because unlike comparing Ragu with Prego pasta sauce — switching of blood-thinning drugs may well be adverse to some patients. And the average consumer isn’t sophisticated enough to note what is a chronic medical condition as opposed to an inconvenience (as illustrated by drugs for erectile dysfunction).

Comparative advertising of consumer goods was first approved by the Federal Trade Commission in 1971, and although controversial, some advertising experts have argued that the practice has faded because the consumer gets confused and the product that is unfavorably compared gets free advertising in the process.

Once some prescription drugs become generic, the Federal Trade Commission takes over the supervision of advertising. And once again, the dilemma is that risks of using or overusing such medications are rarely touted in TV ads.

All this advertising costs big bucks and adds significantly to the cost of prescription drugs, which is one of the reasons that a few in Congress have proposed eliminating the tax deduction that pharmaceuticals can claim for these TV ads. But they’ve been met with a powerful lobby as well as waving of the flag of free speech by drug firms.

But there’s plenty of room for drug firms to exercise their First Amendment rights. They can resort to printed materials and inundate physicians with medical literature and free samples (which doctors can prudently monitor on select patients). And they can take heart that in the past, the federal government has curbed free speech. And Congress did so by dealing with one of the leading causes of death, lung cancer, by eliminating in 1971 ads for cigarettes on TV.

• Thomas V. DiBacco is professor emeritus at American University.

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