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Have TV drug ads gone too far? - (11/27/2018)

By Dr. Ron Gasbarro

Mrs. Drake came into the pharmacy looking shaken. She relayed a story to the pharmacist to get his take on it. “My two children were watching TV. I heard my 15-year old son giggling. Then he said, ‘Ask Mom.’” So, my daughter, who is just 11, came into the kitchen and asked ‘What is a curved erection?’ Well, I almost fell face first into the lemon meringue pie I was making!” She continued, “It was 8:30 PM. And it wasn’t the Playboy Channel. It was a news station!”

The pharmacist had seen the ad. It was for Xiaflex®, a collagenase product used to treat Dupuytren’s contracture, which is a crooked finger, and Peyronie’s disease, which is an abnormally curved penis. Collagenase breaks down the collagen protein in damaged tissue and helps healthy tissue to grow. 

There are pros and cons to advertising medications on television. One con is that, unless you have that condition, you are going to be bored. The other con is that if one’s kids see the ad, you might have some explaining to do. The advantage of this particular TV ad is that if you have a crooked finger, it is obvious to the world and to your doctor. But a curved penis is usually something one keeps to oneself and suffers with it. By advertising the condition on television means that the problem is brought to light and the affected male now has an option to correct it. As the manufacturer of Xiaflex explains the rationale for advertising their product, “Because many men are too embarrassed to seek help for penile symptoms associated with Peyronie's disease, they often go undiagnosed.”

This reasoning is why advertising medical conditions can assist those who do not know what is going on with their bodies so they can get help. The US Food and Drug Administration (FDA) approved direct-to-consumer (DTC) advertising in 1997. Depression was one of the first conditions to hit the airwaves following the FDA green light. In one sense, targeting depression through advertising was an option that patients had, rather than self-medicating themselves with alcohol or illicit drugs. Conversely, positioning antidepressants as safe opportunities to bolster a patient’s sense of self with the latest science has received greater public and regulatory scrutiny, from controversies over their questionable efficacy to the possible increased risk of suicide from their use. Yet, banning such ads would deprive patients of that option and positive clinical outcomes would be lost. 

Since then, we have seen TV ads for Truvada®, an antiretroviral product used to treat AIDS, now advertised to keep people who are HIV-negative from acquiring the virus via sex, a regimen called PrEP (pre-exposure prophylaxis). The manufacturer’s marketing message is “designed to encourage candid conversations around sexual health and promote public awareness of HIV prevention.” Also, through the magic of TV, we learn the problems blind people have in“Non-24”, a circadian rhythm disorder. Your master body clock controls circadian rhythms that tell you when to sleep, wake, and eat, among other things. Sightless people do not have this control and their quality of life is eroded by Non-24. Yes, there is a drug for it, but as the ad says, “Ask your doctor.” And we have all been hardened by ads for drugs that reverse erectile dysfunction, such as Viagra®. Currently, 128 TV drug ads are running. They are heavy on emotion, and light on facts. Side effects are trivialized. Yet, they can provoke conversations at the doctor’s office and around the dinner table. Mrs. Drake and her daughter will have that chat. There are no more boundaries. And that should give us all pause. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com 

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