You could say that ads for prescription drugs were the camel’s nose under the tent. Once you start advertising prescription drugs like they’re shampoo or fabric softener, what’s next? How about medical devices? Or even surgical procedures? Heck, why NOT? If you’re going to turn medical treatments into a consumer commodity, why not go whole hog, as it were?
Well, because, of course, it’s a terrible idea. Medical treatments, be they pills, devices or procedures, are not consumer goods, and we shouldn’t treat them like consumer goods. It minimizes their importance, causes people to use them when they shouldn’t, and most fundamentally, promotes the notion that health care is a “product” that we “consume.” It is a triumph of marketing over medicine that we now consider ourselves health care “consumers” rather than “patients.”
Some might argue that this can be a good thing, given people’s interest in being informed, empowered consumers; that it’s a further shift from the old “doctor knows best” days when we were passive recipients of whatever our doctors deemed was in our interest. But medical marketing doesn’t necessarily turn us into empowered consumers — it just as easily turns us into the unpaid sales force for drug and device companies — and the target we’re trying to sell to, ironically, is ourselves, and our doctors.
As the Wall Street Journal reported in April 2007, (New Medical-Device Ads; Old Concernsm, subscription required),
Now a new frontier is opening in health-care advertising that may be even trickier to evaluate: ads for medical devices and procedures. A raft of ads for everything from hip replacements to radioactive seeds to treat prostate cancer has hit the airwaves over the past couple of years, as companies tap the aging population to boost sales. And like most commercials, the ads don’t pull any punches. A spot that launched in January for Medtronic’s implantable defibrillator, used to revive someone who’s suffered cardiac arrest, promises a longer life for patients. “If you’ve had a heart attack or have heart failure, inside this little device, you just might find 10,000 more kisses, snow, 200 more football wins…
We here at PAL frequently argue that drug ads are on balance a bad thing, and in making this argument, we frequently pose the hypothetical of medical procedures being advertised. “Most people,” we like to say, “would think it a bad thing if they saw an ad for open heart surgery, or a coupon for 20% off your next colonoscopy.” Yet that’s exactly the type of promotion that the market is starting to move towards.
Here’s one example of a TV ad for a medical device:
One hot new gift item in this holiday season that just passed: Gift cards for botox and other cosmetic medical procedures. Alternet ran a story on December 18, All I Want for Christmas Is a Shot of Paralyzing Toxins to the Forehead. The story begins:
Want to give the breast holiday present ever? How about the gift that keeps on giving: Plastic surgery!
We’ve all heard about high schoolers begging for — and getting — nose jobs for graduation or sugar daddies funding their girlfriends’ lunchtime lipo, but now, just in time for Christmas, you can give the one you love a BOTOX® Cosmetic (Botulinum Toxin Type A) gift card. Just wait until you see the (lack of) expression on her face when she unwraps what she thinks is a $50 Bed, Bath & Beyond gift certificate but is actually the pathway to three-to-six months of eternal youth.
“Dear Journalist,” the press release addressed to me read, “For your Holiday Gift Guide, please consider a story about taking the stress out of finding the perfect holiday gift! A recent international survey found that 52% of women ‘of a certain age’ would like to receive cosmetic injectables as a gift, which begs the question … how do you wrap it?”
One question about ads for medical procedures and devices is whether they contain adequate information about risks and side effects. Obviously, a medical device has one key difference from a drug: You can stop taking a drug at any time, but you can’t just yank out a knee replacement, gastric band or cardiac defibrillator. If you have a problem with a medical device, or if new information about risks comes to light, you usually have to have surgery to remove it — which can take time, be costly, and have its own risks. Consumer Union, the publisher of Consumer Reports, recently petitioned the FDA to require that all ads for implantable devices warn consumers about the risk of hospital-acquired infections and the expected life span of the advertised device. Here’s an excerpt of the press release:
Advertisements for Medical Devices, Implants Should Carry Warnings of Dangerous Side Effects, Infections
Consumers Union petitions FDA to require clearer warnings on DTC device ads
(Washington, DC) – Consumers Union has filed a petition with the FDA requesting it require all advertisements for implantable devices – such as knee, hip and heart valve replacements, cosmetic implants and heart stents – carry a warning about the possibility of dangerous infections or failures of the devices once they are in the body.
Implantable device makers recently have launched a wave of direct-to-consumer advertisements for their products, and Consumers Union said a review of these ads show that most lack basic information about the possibility of severe or fatal side effects.
“There is no question that many of these devices can restore high quality-of-life in patients, but we are concerned that serious and possibly deadly side effects like infections are consistently understated in these device ads,” said Bill Vaughan, senior policy analyst for Consumers Union, publisher of Consumer Reports.
“We’re asking the FDA to require clear warnings about the dangers of infection during and following such surgery, and information about how long the devices are likely to last once they are in the body,” Vaughan said.
(The full Consumers Union FDA petition can be found here.)
All of this begs the larger question of whether advertising medical treatments — drugs, devices, procedures — at all is a good idea. Most countries don’t allow so-called “Direct-to-Consumer Advertising.” Yet the pharmaceutical industry alone spent more than $5 billion advertising prescription drugs in 2006, and that number has been growing steadily since 1997. The reason? It’s extremely profitable. Estimates vary, but on average every dollar spent on drug ads produces $1.50 to $4.20 in sales — quite a handsome return on investment. Other industries, particularly the medical device industry, are no doubt eager to hop on board this gravy train. But we rightly should ask whether it’s for our benefit… or their bottom line.