Welcome Transparency

17 October 2018

 

Cogito Ergo Non Serviam

Trump Administration May Demand Price Information in Drug Ads

 

Alex M. Azar II, the secretary of health and human services, was delivering a speech at the National Academy of Medicine on Monday. In that speech, he said his department was going to make drug companies reveal the price of their drugs whenever they advertise. The Pharmaceutical Research and Manufacturers of America [PhRMA] would rather have the ads refer people to company websites for pricing information. The quibble is over whether the list price of a drug is misleading because of all the discounts, various insurance coverages and so on that affect the actual price of a drug. This journal is fine with either solution if advertising to the consumer is going to be allowed.

The United States and New Zealand are the only two developed nations that allow drug makers to advertise to consumers. On the face of it, TV ads telling patients the benefits of a drug they can only get if prescribed by a doctor is ridiculous. The doctor makes the decision about the drug, so that's where the marketing effort (if there is to be one) needs to take place. Instead, we have old buffers and people with chronic diseases second guessing their physicians because of something they say on TV. It's similar to advertising breakfast cereal to kids. They can nag mom and dad into buying Super Sugar Bombs, but they don't actually have the power to make the decision.

This journal objects to the idea of consumers, who do not understand biochemistry in most cases, getting a one-sided presentation of the benefits of a drug. While side effects must be disclosed, the images of sunshine and walks in the park with grandchildren and kittens and puppies put the spin on the ad. It's a raw appeal to emotion that is deceitful and manipulative. If one has metastatic breast cancer, people who have been to medical school and who have practiced oncology with some success ought to decide what drug to use. They don't need a patient who latches onto some ad campaign second-guessing their professional opinion.

If the nation is going to allow this stupidity, then transparency becomes much more important. "You buy a car every once in a while," Mr. Azar said. "But millions of American patients buy expensive drugs every month. And a year's worth of the most advertised drugs, mind you, can cost more than a car. The drug industry remains resistant to providing real transparency around their prices, including the sky-high list prices that many patients pay." He is not wrong.

PHRMA has a voluntary declaration that reads, "All direct-to-consumer television advertising that identifies a medicine by name should include direction as to where patients can find information about the cost of the medicine, such as a company-developed website, including the list price and average, estimated or typical patient out-of-pocket costs, or other context about the potential cost of the medicine."

Perhaps, as a modest proposal, the ads could be purchased at a discounted rate (the FCC can require this) and extended 30 seconds so that those pricing issues could be addressed in the ad itself. That would be the best of both worlds (but not as good as getting rid of TV prescription drug ads).

The law of unintended consequences may well kick in regardless of which direction the regulations go. It may be that Big Pharma decides it doesn't want more transparency, even hidden on a hard-to-navigate website. If that is the case, the losers here won't be consumers, medical practitioners even or the pharmaceutical makers. The people losing out here will be the broadcasters who air the ads. Fortunately, they can sell airtime to someone else. So, if the direct-to-consumer ads won't be banned, pricing requiremnets are in order.

© Copyright 2018 by The Kensington Review, Jeff Myhre, PhD, Editor. No part of this publication may be reproduced without written consent. Produced using Ubuntu Linux.

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