By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

In 1975, the Eagles recorded the hit Lyin’Eyes about dishonesty within a relationship. The song was written by Don Henley and Glenn Frey and recorded with Frey singing the solo lead. The band had its start when Don and Glenn were recruited for Linda Ronstadt’s band by her and manager John Boylan. The 2019 documentary Linda Ronstadt: The Sound of My Voice provided an excellent perspective on the relationship establishing the Eagles. The Eagles became one the best selling bands of all time and were inducted into the Roll and Roll Hall of Fame in 1998.  

Why a lead in with Lyin’ Eyes? 

The concern is the deception or misleading advertising that seems to be common with different media outlets. The pharmaceutical industry spent $5 billion on television ads in 2021 according to Fierce Pharma. These ads are referred to as direct-to-consumer (DTC) ads. The only two countries allowing DTC ads are the United States and New Zealand. Other countries have banned DTC ads similar to the 1970 ban of direct-to-consumer cigarette ads on radio and television.  

Prescription medications are regulated by the Food and Drug Administration (FDA). The FDA has a program aimed at healthcare professionals called the Bad Ad Program.  The FDA Office of Prescription Drug Promotions (OPDP) is responsible for the Bad Ad Program under the auspices of the Center for Drug Evaluation and Research. Anyone can report to the Bad Ad Program, but it is aimed at healthcare providers. Reports can be sent via email at [email protected] or phone at 855-RX-BADAD.  

Ads should be reported if they do not follow the rules for DTC ads. Those criteria include the ad should not be false or misleading and should reveal material facts. The ad should contain a balance of the effectiveness of the drug compared to the risks of the drug. The FDA has jurisdiction over ads on television, radio, print, internet and pharmaceutical company speaker programs.

DTC advertising has been documented to improve prescription sales. Multiple studies have recorded this fact over the last 30 years. If you watch television on a regular basis, you are probably familiar with drugs such as Skyrizi, Cosentyx, Otezla, Tremfya and Dupixent. While writing, I am watching 60 Minutes and there is a DTC ad for Jardiance. New drugs have emerged to treat plaque psoriasis and several of them are in the list above. The United States accounts for 45% of the global use of these drugs for psoriasis.  

Surveys of prescribers show many feel significant pressures from consumers to prescribe medications seen in advertisements even though 49% felt the therapy was inappropriate for the patient. Research indicates some of the drugs being advertised may have limited therapeutic benefit. The level and quality of evidence for supporting a drug's use is not a requirement of DTC ads. This is why it is important to have an honest conversation with your healthcare providers about various medications to get a broader and more expansive view about the drug.  

An advertisement could follow all of the rules established for DTC, but they still can use some subtle ways to influence consumers. Examples often evoking emotions. This can be accomplished by using certain colors or images that our brain responds to with the ad. A 2021 study had consumers look at ads for psoriasis and wet macular degeneration.  The consumers looked at ads with no image, accurate images and exaggerated images such as glass shards protruding from one’s skin.  The study found exaggerated images worked to improve recall of ads and the consumers felt the drug worked better.

A recent concern with DTC advertising is the loopholes brought on by new technology and media changing from traditional television, radio and magazines.  These new online health services use advertising on the internet as well as platforms such as TikTok and Facebook.  These services can easily be found on an internet search and provide access to prescribers to diagnose and treat online. These clinics offer services for things such as mental health, attention deficit disorder, sexual dysfunction, weight loss and hair growth.  Millions of consumers are being influenced by these online services.

Prescription medications are not the only concern since the FDA does not regulate over the counter (OTC) medications. Most television ads are regulated by the Federal Trade Commission (FTC) including over the counter medications, dietary and herbal supplements, and just about any other product. Many OTC ads do not provide a balanced or fair representation of their products. Companies may find celebrities to support their products who have no medical training, but gain the confidence of consumers to use a particular product. They often will refer to clinical studies proving their benefit, but these studies may not be published in a peer reviewed professional journal. Always look for the fine print stating that these statements have not been evaluated by the FDA!

Don’t let the lyin’ eyes fool you. Talk to your pharmacist or healthcare professional to get sound advice.

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