When mental illness meets Madison Avenue - (10/6/2020)

By Dr. Ron Gasbarro

Henry walked up to the pharmacy counter to pay for his antidepressant. As he handed his credit card to the pharmacist, he said, "Have you seen those TV ads for drugs to treat people with mental illness? They are very theatrical, but they all seem to end well." Indeed, the pharmacist had viewed many of these ubiquitous TV ads – these mini-dramas. For example, one ad depicts a birthday party with a yard full of happy kids. Meanwhile, the mom is sitting on the floor of a darkened bedroom weeping. What is wrong? Why, it's bipolar depression (BPD). And here's a drug that will make it better. The last scene is the mom and dad walking through a forest, hands entwined, ostensibly content with her medication results.  

The question is, how much can you know about this woman's condition in a 60-second blurb? Who diagnosed her? Had she been taking other medications before her miraculous cure? How long did the drug take to upright her life again? So, then why run a TV commercial during prime-time for a condition so esoteric like a woman with BPD? Because to the deep-pocketed pharmaceutical companies, the drug is just another product to hawk, like Kool-Aid™ and Cheerios™. Long live the kings of Madison Avenue!

Advertising prescription medications to the public is not new. Around 1950, print ads popped up with remedies for all sorts of maladies. For obesity, take an amphetamine. For insomnia, grab a potent hypnotic. For general agitation, here's a heapin' helpin' of Mother's Little Helper. The fact is that none of the aforementioned chemicals is used today for these problems. Yet, billions of new bucks are ripe for the picking! Life may still suck for you, but the pills are shiny and new. 

The pharmacist is not minimizing these afflictions. Good things about drug advertising exist. The ad may motivate a person with crippling symptoms to go to their doctor's office for help. Even in the 21st century, mental illness stigma is so intense that people self-medicate. A pharmaceutical remedy to simmer down the hell a person goes through may be less complicated than swilling a quart of gin a day to feel better. 

Yet, there are bad things about drug advertising. The person may not get the drug that s/he saw on the television machine. For example, upon arriving at a BPD diagnosis, the prescriber may opt for another more suitable drug. At this point, the kerfuffle begins. A 2020 survey found that most people were unhappy once they left their doctor's office. Of respondents who talked to a health care provider about a drug they saw advertised, only 16% said they received a prescription for that drug. The rest reported that they had a conflict with their prescriber when turned down, questioning the doctor's wisdom, and threatening to find a provider who would write for the drug. "I expect my doctor to give me what I want!" said Ms. Payne N. Butt. And you can already hear your insurance company cruelly laughing as you ask them to pay for that pricey panacea. 

If you think the once-vaunted US Food and Drug Administration (FDA) has given the okey-doke on these drug ads, then the pharmacist has a rickety bridge to sell you. Before an ad runs over the airwaves, many manufacturers willingly submit them for FDA clearance to avoid having to remove them later in case legal trouble ensues. However, this action is not mandatory. Hence, bogus info could reach your living room before it hits the FDA. But money is money, and one must get it while one can.

"Wow, that Madison Avenue way of thinking is brutal!" exclaimed Henry. "But business is business," replied the pharmacist as he casually closed his cash register with Henry's money safely inside. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.


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