You can't watch TV for long before seeing a commercial for a big pharma drug (with its comically long list of side effects). But the biggest medical organization in the U.S. would like that to change.
After wrestling with the issue for well over a decade, on Tuesday the American Medical Association (AMA) called for a ban on direct-to-consumer advertising of prescription drugs and medical devices.
The announcement came from members at an AMA meeting in Atlanta.
“We want to spend our time diagnosing and treating patients, not rebutting marketing claims," Michael Miller, a delegate of the Wisconsin Medical Society, argued at the meeting, according to Bloomberg.
“Drugs aren’t like everything else, people don’t need to be sold on the newest and brightest drug,” Lisa Schwartz, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, told BuzzFeed News. “People need to be educated on the benefits and harms, but that’s not what drug ads do.”
It's unclear how much effect this call will have, however, given that such a ban would require an act of Congress.
"It’s important that the AMA is adding its voice to this issue, but Congress has shown no real interest in taking up this topic," Aaron Kesselheim, director of the Program on Regulation, Therapeutics, and Law at Harvard Medical School, told BuzzFeed News by email.
"There are important First Amendment jurisprudence hurdles related to commercial speech that need to be considered before such a measure could be enforced," he added.
The United States is one of only two countries (the other is New Zealand) that allows direct-to-consumer advertising, such as TV and magazine spots, for prescription drugs. Drug companies spent $4.5 billion on consumer marketing in 2014. This investment, according to the AMA, fuels higher drug prices.
The FDA requires only that a new drug perform better than a placebo. The agency does not test whether a new drug is better than an older (and generally cheaper) drug.
To get doctors to write prescriptions for new drugs that cost more and don't necessarily make people healthier than the ones they're familiar with, drug companies try a lot of tactics. They run training courses to convince doctors to switch, they meet with doctors in their offices, and they run ads in journals and magazines that doctors are most likely to read.
But they also ramp up pressure by targeting patients directly. "Talk to your doctor" is a phrase that every American TV watcher is familiar with.
American consumers are also concerned about these pharma ads: A recent poll by the Kaiser Family Health Foundation found that 89% of respondents thought that the FDA should review prescription ads before they air. Currently, it's against federal law for the agency to do so; instead, it relies on consumer complaints after the ads have run.
The AMA has been wrestling with direct-to-consumer ads since at least 2001. Members called for a temporary moratorium in 2006, then voted against a ban in 2007 and 2008. The previous policy on consumer advertising outlined what the AMA considered an acceptable advertisement.
The new policy does not specifically address the rise of social media advertising, such as when Kim Kardashian got a warning letter from the FDA for running a morning sickness advertisement on her Instagram without proper safety information.
“In the old days, DTC was the one way they tried to reach consumers. Even if you got rid of all the magazine ads and TV ads, there’s still a tremendous platform to reach consumers” in social media, Steven Woloshin, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, told BuzzFeed News.
Critics at the meeting said that the ban would limit the free speech of drug companies and doctors, and that some advertising helps teach consumers about conditions they might not otherwise seek help for, such as depression, according to Bloomberg.
Others say that banning direct-to-consumer advertising isn't enough.
"It would have a much greater impact if it also went on to address promotion to physicians," Joel Lexchin, a professor in the School of Health Policy and Management at York University, told BuzzFeed News by email.
"In dollar figures the amount of money spent promoting drugs to doctors is 10 times more than the amount spent on [advertising]," Lexchin added. "And doctors are the ones who make the ultimate decision about what drugs to prescribe."
This post has been updated to include a comment from Aaron Kesselheim of Harvard.