Polite Dissent

The areas where I have seen the biggest influence of prescription drug advertisements has been in arthritis pain medications and stomach/heartburn medications. Both of these diagnoses cause significant pain, so it’s easy to understand why patients would want quick relief and why advertisements would catch their eye. In both these cases, however, there are over-the-counter (OTC) or generic drugs that work just as well, if not better. These are also some very expensive drugs. Insurance companies provide limited formularies, with only one or two of these expensive drugs on them, and even then you have to jump through hoops to prescribe them. I have to routinely tell patients who want a particular arthritis pain medication that they must first have tried, and failed, two other pain medications before they can get the ones they want. That’s two months of waiting, and most patients are very unhappy with that.

I have a fair number of patients who come in seeking allergy relief after seeing ads. Again, prescription allergy medications are expensive drugs. In this case though, there are no really good OTC or generic equivalents. There are still insurance restrictions, but not as strict as those for arthritis and stomach medications.

Occasionally, I’ll see a patient who comes in inquiring about an anti-depressant after seeing advertisements. This is the area where I actually see some benefit from ads. Many people have depression, but don’t realize they have it, aren’t sure it can be treated, or are embarrassed to admit that they are depressed. The ads help reassure patients and remove some of the stigma of being on anti-depressants.

Finally, I have seen absolutely no changes in my practice due to advertisements for high blood pressure or cholesterol medications. This makes perfect sense. Neither high blood pressure of high cholesterol have specific symptoms, so patient are not going to go out of their way to seek treatment.

In a given week, about 10-15% of my patients are clearly influenced by advertisements, while at least another 30-50% show are familiar with the ads. I generally dislike the idea of having prescription drugs advertised nationally, with the possible exception of anti-depressants. However, I prefer well-regulated prescription drug advertisements to the misleading and sometimes dangerous advertisements and infomercials for “nutritional supplements”, alternative “medications” and diet aids. But that is a rant for another day.