Drug Ads A Bitter Pill For Doctors Patients Want Brand Names Seen On 30-Second TV Spots

In Lewisburg, Tenn., patients who never asked for a drug by name suddenly are demanding the cholesterol reducer Zocor from family doctor Clay Wilson. People with allergies ask Los Angeles Dr. John Brodhead for Claritin. In Dallas, psychiatrist Madhukar Trivedi is fending off depressed patients who “need” Prozac.

A surge in TV commercials for prescription medicines such as the herpes drug Valtrex and the contraceptive Depo-Provera has led to an increase in the number of patients demanding drugs by name. It also has led to a rise in doctors’ temperatures.

“What happens is that the physician not only has to defend what he’s going to prescribe, but he’s also got to defend what he’s not going to prescribe,” Wilson lamented.

Although drug makers say the ads put new patients in doctors’ waiting rooms, physicians complain that the ill-informed increasingly are demanding drugs they discovered during “Touched by an Angel” and “Suddenly Susan” - whether their doctor recommends them or not.

Last August, the Food and Drug Administration relaxed the rules governing TV drug commercials, and pharmaceutical companies and advertisers expect the television advertising blitz to increase.

“It’s out of control,” said Dr. Sidney Wolfe of consumer group Public Citizen. “The combination of the misinformed doctors and the misinformed patients leads to a rise in prescriptions being written which shouldn’t be written.”

Drug makers spent $277 million advertising prescription drugs on TV in the first nine months of 1997 - 52 percent more than they spent during the same period in 1996, according to Nielsen Media Research.

Many doctors don’t think 30-second ads are long enough to convey complex medical issues.

According to a recent survey of nearly 5,000 physicians by industry researcher IMS America and the Internet service Physicians Online, nine out of 10 doctors said the same number or more patients asked for specific brand-name drugs last year. More than 60 percent want drug makers to cut back or pull the plug on TV advertising.

Drug makers point out that the ads put patients in doctors’ waiting rooms. Merck & Co., the biggest buyer of TV commercials for prescription drugs during the first half of 1996 at $30.7 million, says its ads could prompt the 60 percent of heart disease sufferers who aren’t treated to get help.

“Physicians remain our most important audience, but they can’t treat people who don’t show up in their office,” said Julie Dean, spokeswoman for Glaxo Wellcome, the No. 3 spender at $19.8 million through June 1997. Glaxo’s ads vow to suppress genital herpes with Valtrex, “just once a day.”

Doctors concede the ads appear to bring in more patients. Besides, it’s the doctor, not the patient, who writes the prescription, said Brodhead, associate professor of medicine at USC University Hospital.

“If they are persistent enough, they’re going to find a doctor who prescribes what they desire, but no one puts a gun to your head and says, ‘Prescribe this drug,”’ he said.

Before the FDA relaxed the rules, TV spots had to explain side effects thoroughly if the ad mentioned both the product name and the ailment it was meant to treat.

As a result, Pharmacia & Upjohn ran 30-minute infomercials for its Rogaine baldness treatment, and scrolled a lengthy warning down the screen during its Depo-Provera ads.

But most drug makers who used TV simply skirted the rules by mentioning only the product name or an illness, but not both.

The ads left millions of Americans struggling to understand why the woman on their screen was windsurfing across a wheat field over the word “Allegra,” and why a mountain climber in a business suit was yelling “Zyrtec.” The ads didn’t mention that the drugs are allergy treatments.

Under the new FDA rules, companies need only mention significant side effects and refer viewers to magazine ads, toll-free numbers or Internet sites for details.

At the public relations office at the University of Texas Southwestern Medical Center, Ann Harrell conceded she nagged her doctor for a Merck cholesterol-lowerer until she got it.

“When I got it,” she said, “I celebrated.”