Early lawsuits against the makers of testosterone therapy drugs are claiming that the pharmaceutical makers of those drugs engaged in marketing pressure with potential to compromise patient’s safety.
One lawsuit claimed that, “Defendants coordinated a massive advertising campaign designed to convince men that they suffered from low testosterone.”
A new study sought to examine the impact of direct-to-consumer pharmaceutical advertising. The alarming findings of the study were that when patients made specific request for a certain medicine, it substantially affected the doctor’s prescribing-decisions, “despite the drawbacks of the requested medications.” The upshot from those millions of advertising dollars is they are not only swaying consumers, but they are swaying doctors as well.
The study, titled, “Effects of Patient Medication Requests on Physician Prescribing Behavior: Results of a Factorial Experiment,” was published in the April 2014 edition of the journal Medical Care. In an editorial in the same issue, the journal explained the background. They wrote that in 1997, the US Food and Drug Administration (FDA) relaxed the enforcement of its advertising regulations. Direct-to-consumer broadcast ads surged sharply soon after. Pharmaceutical ad buys for TV shot up to $3.3 billion by 2006. Due to the recession, it dropped to $2.4 billion in 2010.
The researchers said they launched their study on the effects of these ads on medical treatment:
“Because of internet searches, advice from friends, and pharmaceutical advertising, especially direct-to-consumer advertising, patients are increasingly activated to request medications during a physician encounter.”
They recruited 192 primary care physicians across six states and video-taped the exams. Two patient scenarios were presented: (1) an undiagnosed “patient” with symptoms strongly suggesting sciatica, and (2) a “patient” with already diagnosed chronic knee osteoarthritis. Half of the patients in each category requested a specific drug (oxycodone for sciatica and celebrex for arthritis), while the other half of each patient group simply requested something to help with pain.
The end result was that doctors were more likely to prescribe a brand name prescription medication when a patient requested the drug by name, even if the requested medication offered no benefits over less expensive alternatives.
- 20% of sciatica patients requesting oxycodone received it, compared with 1% of those who made no specific request;
- 53% of knee arthritis patients requesting celebrex received it, compared to 24% of patients who made no specific request.
The study found that, “No patient attributes, physician, or organizational factors influenced a physician’s willingness to accede to a patient’s medication request.”
In the case of testosterone therapies like Androgel and Testim, it can be argued that the drug companies spent millions of dollars on TV marketing to create a demand for those drugs, even among men who had no medical need for them.