NUR 421 D#1 In this post, I will discuss the impact of direct to customers advertising off medications. Only two countries allow drug companies to advertise directly to consumers and the United States is one of those countries (U.S. House of Representative, 2008 as cited in Ritter & Graham, 2017). So, what is the implication of this for the people in the United States and the way that they consume drugs? What are the implications for healthcare providers and those who prescribe drugs? The United States of America has been described as a culture of commerce (Ritter & Graham, 2017). This is because the commercial aspects of things are emphasized over the other implications. Medication is directly marketed to the general population even though they do not have the ability to purchase those medications without a doctor’s prescription. An example of the emphasis of commerce over the health of the population is that if a drug company violates the FDA regulations the mechanism for punishing that company is very cumbersome (Ritter & Graham, 2017). What effect does advertising directly to the general population have on the use of drugs in the United States? The decision to take any drugs should be based on consideration of risk versus benefits. In the many drug advertisements in the United States, things other than risks versus benefits are emphasized. The emotional appeal was almost universal with no ads mentioning lifestyle change as an alternative to the drug but only as an adjunct in some cases (Ritter & Graham, 2017). People often buy products that they do not need just because of advertising appeal. It stands to reason that people will buy drugs that they do not need if it is advertised to them. Companies understand the effectiveness of advertising which is why they spend billions of dollars each year on advertising. This can be seen in the fact that 95% of drugAds appeals to emotions instead of using facts and rationale as the main factor in the advertisement (Ritter & Graham). An alternative method would be for the drug companies to go directly to the prescribers and explained the benefit of prescribing their products versus prescribing another product. “A prospective mother can purchase calcium, iron and vitamin preparations by getting influenced by a picture showing breastfeeding mother and a chubby baby” (Khanwelkar et al., 2019, p. 58). For-profit drug companies are trying to increase their sales, and advertisement is an effective way to do so, as evident by the amount of money they invest in commercials. The effect that I have seen is that people will request that their doctor prescribes a certain medication even when there might be a better alternative. In my experience, even though doctors may not always prescribe a drug just because the patient asks for it, a patient’s request for a certain drug will strongly influence a choice between multiple options. At times, the patient seeing an advertisement of a drug will only lead to questions about that drug. A patient asking about a drug may not necessarily be a bad thing when it is filtered through a competent healthcare professional. A bigger problem may arise when patients use means other than a prescription from a healthcare provider to acquire a drug that is advertised to them. The fact that there is an overuse of drugs and an increase in polypharmacy, may be an indication that there needs to be some reform in the way that drugs are marketed in the United States. It may be beneficial to study other drug markets that do not allow direct marketing to the general population, to see how drugs are consumed differently. Stricter advertising regulations for medications, that require important information to be presented in a clear way to consumers, may have a positive effect. We cannot measure the precise effect of advertising on the consumption of medication, but we know that drug companies spend a lot of money on advertising their products because they believe advertising increases sales. Reference Khanwelkar, C., Phirke, V., Devi, P., Jadhav, S., & Thorat, V. (2019). Importance of Ethics in Drug Advertising. Global Bioethics Enquiry Journal, 7(2), 58. https://doi.org/10.38020/gbe.7.2.2019.57-60 Ritter, L.A., Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and Bartlett Learning. ISBN: 9781284021028 D#2 The Morality of Pharmaceutical Advertising The topic of direct-to-consumer advertising of prescription drugs is a complicated and unique situation in the United States. Certainly, there is an ethical component as well as a moral aspect as to whether prescription drugs should be advertised directly to their consumers.
Respond to direct-to-consumer advertising of prescription drugs. What impact have you observed in the populations you serve in your nursing practice? Comment on the ethics of this practice, in terms of autonomy, beneficence, non-maleficence, and justice. 500 words and 2 sources
Directto-consumer prescription ads (DTCPA) is defined as an effort usually via the media made by pharmaceutical companies to promote its prescription products directly to patients. The U.S. and New Zealand are the only countries that allow DTCPA that includes product claims (Ventola, 2011). Ethics and morality come into question when consumers are told about the general condition for which the drug is used but rarely given information about the average benefit achieved in clinical trials (Bohrer, 2020). Is it important to mention that if the DTCPA is found to be in violation of FDA regulations, they can issue warnings and place fines through administrative hearings (Ritter & Graham, 2017). Of course, DTCPA can only go so far into persuading a person into purchasing the medications. The patient still requires a prescription from a physician in order to begin treatment. The FDA found that 8% of physicians felt pressured and 20% felt somewhat pressured to prescribe the specific brand name drug when asked by the patient to do so (Ritter & Graham, 2017). This decision making infringes on the autonomy of the patient because now the patient has a predetermined attitude towards that specific medication. Few DTCPA described condition causes, risk factors, or prevalence (~26%) (Ritter & Graham, 2017). That certainly affects the beneficence and non-maleficence toward the patient. To be beneficent is to act kindly toward the patient and to be non-maleficent is do no harm towards the patient. A survey found that 19% of DTCPA never mentioned lifestyle change as an alternative to the product (Ritter & Graham, 2017). Leaving such a crucial area certainly presents ethical and moral question. It blurs the line between doing what is right and just for the patient and leading the patient into a “glossy promotional advertisement created by pharmaceutical companies and their ad agencies” (Bohrer, 2020). I understand that a company cannot explain everything that is important about the medication and therapy in a 30 second commercial however, leaving out parts of information on purpose is lying by omission. Just because they didn’t mention a side effect or explain the efficacy in clinical trials does not mean there does not exist questionable results or significant side effects. In my opinion, not only are the pharmaceutical ads immoral, they are clear violations of the First Amendment of the U.S. I believe this because these commercials provide pragmatic implications which is an important concept in marketing. Misleading individuals for monetary benefit is wrong on multiple fronts. Not only are they misleading patients into a false sense that the drug will cure their disease without providing real evidence, but they also can be detrimental to their health. I may have experienced some patients that have bias towards certain medications. I have experienced some patients name certain drugs by their popular brand names. That is likely because they see them on television more often and learn the brand names. That becomes a bias because when I mention the generic name of the same drug, they question its efficacy and safety. They don’t realize that the generic drug is the equivalent to the brand name in terms of molecular structure, function, and risk for side effects. I believe the burden should fall on primary care and nursing in this country to educate and inform patients about drug efficacy and safety. They should be transparent about risk factors and provide extensive research regarding the drugs clinical trials. That process is not only more beneficial for the patient in terms of education but it also gives full autonomy to the patient. They should feel comfortable about starting a new medication or treatment. References: BOHRER, R. A. (2020). Direct-To-Consumer Ads Are Misleading: Concise Statements of Effectiveness Should Be Required. Journal of Health Care Law & Policy, 22, 209–221. Ritter, L.A., Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and Bartlett Learning. Ventola C. L. (2011). Direct-to-Consumer Pharmaceutical Advertising: Therapeutic or Toxic?. P & T : a peer-reviewed journal for formulary management, 36(10), 669–684.
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