PureInsight | May 30, 2006
Falun Dafa practitioners, we are well aware of the underlying causes
for what appears to be illness and also of the supreme role the mind
plays in governing the state of the body, both for good and ill. Since
our cultivation path involves continual efforts to improve our mind
natures, we may find the tendency we see in the society around us to
find quick and easy "solutions" to every problem dismaying.
Need to quit smoking? Put this patch on your skin and you won't want to
smoke any more. Don't ask about your heart rate on these or what
happens when you stop putting the patches on.
Need to lose weight? Never mind eating only what's good for the body
and doing more exercise. Just take these pills and you won't be hungry
any more. Don't ask what happens when you stop taking the pills.
Feeling depressed? Perhaps because of all the weight you gained when
you stopped taking those other pills? Just take these pills and you'll
be smiling through your days. Never mind getting at the underlying
cause and don't ask about the suicide rate among people who take these
And so on and so on. In recent years, the trend has been exaggerated by
direct-to-consumer television ads. People who perhaps weren't even
aware they had a problem are being recommended expensive prescription
drugs, some of which have very serious side effects, right during their
favorite TV and radio programs, and in the pages of their magazines and
newspapers. No need for a physician. Just take the word of your
favorite drug company and the best advertising minds money can buy.
Fortunately, there is at least one citizens' group in the United States
that has also noticed and taken steps to public recognize this alarming
As reported by Jessica Love of the Prescription Access Litigation
Project (PAL), winners of the 2006 Bitter Pill Awards from PAL were
announced on April 26, 2006 through a nationwide conference call
originating in Boston, MA. This year, Bitter Pill Awards were presented
in four categories to drug companies engaging in over-zealous and
questionable marketing practices. The drug industry's national lobbying
group, PhRMA, received two awards, and the remaining three awards were shared among makers of five of the nation's most well-known drugs: Lunesta, Ambien/AmbienCR, Lipitor, Crestor and Strattera.
The only national consumer coalition devoted solely to challenging high
drug prices, PAL is a coalition of 118 state, local and national
senior, labor and consumer health advocacy groups in 35 states fighting
to make prescription drugs affordable for everyone. Now in their second
year, PAL's Bitter Pill Awards are handed out to highlight the serious
problems caused by drug industry marketing, particularly
Direct-to-Consumer Advertising (DTCA) of prescription drugs. DTCA
includes television, radio, magazine and internet ads that target
consumers directly, rather than targeting doctors.
"Whether you're watching TV, reading a magazine, or browsing the web,
it's impossible to escape prescription drug advertisements," said Alex
Sugerman-Brozan, Director of PAL. "A lot of money is riding on drug
companies convincing consumers that they have insomnia, acid reflux,
high cholesterol, allergies, depression, toenail fungus and erectile
dysfunction, and that they need to have expensive brand-name drugs to
The drug industry spent $4.65 billion in 2005 advertising brand-name
prescription drugs to consumers, a 4.7% increase over 2004. For every
dollar that drug companies spend on consumer advertising, it is
estimated they earn anywhere from an additional $1.50 to $4.20 in
sales. Drug advertising over-promotes newer, more expensive brand-name
drugs over lifestyle changes (such as better diet and exercise) and
much cheaper generic drugs that are frequently just as effective as
brand-name prescriptions. Drug ads also expand the market for newer
drugs far beyond those patients that actually need them, interfere with
the doctor-patient relationship, and perpetuate the myth that "there's
a pill for every ill" and that "newer is better." While many doctors
and patients believe that drug ads are policed by the Food and Drug
Administration (FDA), that agency has far too few staff and resources
devoted to reviewing drug ads, lacks real enforcement powers, and has
relaxed the standards governing drug ads too far.
"As a physician, I have seen how the avalanche of direct-to-consumer
drug advertising infects the doctor-patient relationship, as patients
demand brand-name drugs they've seen promoted in magazines or on
television. This aggressive marketing can lead people to take expensive
drugs they may not need, driving up costs for consumers and the health
care system as a whole," said Dr. Jerry Avorn, professor of medicine at
Harvard Medical School and author of Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs.
While the Bitter Pill Awards were designed to the highlight serious
problems caused by prescription drug advertising, a positive "Real
Deal" award was also presented to call attention to MedVantx,
one company that is working to provide consumers with affordable
alternatives to expensive, brand-name drugs. A list of drug award names
and coinciding recipients follows.
The While You Were Sleeping Award: For Overmarketing Insomnia Medications to Anyone Who's Ever Had a Bad Night's Sleep
Presented to Lunesta (Sepracor) and Ambien/Ambien CR (Sanofi-Aventis)
Ads for insomnia medications are promising trouble-free sleep to an
increasingly stressed and sleepless nation. 43 million prescriptions
for sleeping pills were filled last year alone, and since 2004,
advertising spending on prescription sleep aids increased 60%.
"Lunesta's and Ambien/Ambien CR's advertisements give the impression
that a full night's trouble-free sleep is just a pill away, when in
fact these drugs don't meaningfully improve how long it takes most
people to fall asleep or how long they stay asleep," said
Sugerman-Brozan. "For many of the millions taking these drugs, changes
in behavior would be just as effective, without the side effects. But
these ads convince people these drugs are a cure-all."
Ambien's patent is set to expire in 2007. In October 2005, drugmaker
Sanofi-Aventis introduced Ambien CR, a drug promoted as being better
than Ambien at helping patients stay asleep. A review of clinical
trials for Ambien CR, however, showed only a slight increase in sleep
time opposed to the original Ambien. "Successor" versions of brand-name
drugs have become common practice for brand-name drugs trying to hold
on to their blockbuster profits in the face of imminent competition
An aggressive advertising campaign launched the arrival of Ambien CR,
offering coupons for "7 day free trials" that neglected to state what
the drug was used for. Last year, a $215 million advertising campaign
made Lunesta the reason that pharmaceutical company Sepracor had its
first profitable year ever. Sales of Lunesta earned the company $329.2
million â€“ signifying that enormous spending on insomnia medication
advertising is a trend that will likely continue.
Although Sepracor signed on to PhRMA's "Guiding Principles" on DTCA, it
has violated Principle #10, by running so-called "reminder ads," which
contain the name of the drug, but nothing about what the drug is for or
its side effects. "This fierce competition in the insomnia market
offers a perfect illustration of the effects of drug advertising and an
example of how self-imposed industry â€˜guidelines' are likely to go out
the window when competition gets tough," said Sugerman-Brozan.
The "Got Cholesterol?" Award: For Overpromoting Expensive Brand-Name Statins Presented to Lipitor (Pfizer) and Crestor (AstraZeneca)
Statins, drugs that treat high cholesterol and heart disease, are the
best selling drugs in the United States. They are so profitable that
statins have become one of the most widely-used and competitive classes
of drugs on the market, selling more than 140 million annual
prescriptions in the U.S. alone. While statins are important drugs for
people that have heart disease, marketing campaigns conducted for two
of the nation's most widely
prescribed and highest selling statins, Lipitor and Crestor, often lead
consumers to believe that anyone and everyone with high cholesterol
needs to be taking these brand-name drugs. In many cases, people with
high cholesterol can improve their condition first by making changes to
their lifestyle (diet and exercise), or by taking a much less expensive
generic statin if lifestyle changes aren't enough.
"Advertising campaigns for drugs like Lipitor and Crestor, do not
distinguish between those who actually need a brand-name statin, or
those who would do better on a generic drug or through lifestyle
changes," said Sugerman-Brozan. "This kind of marketing is an excellent
example of what's wrong with Direct-to-Consumer advertising, because
it's far more profitable for drug companies to sell expensive drugs to
a large group of people â€“ whether they need them or not â€“ than to sell
them only to those who really need them."
The over-marketing of statins is also starting to be noticed by the
FDA. In late 2004, Crestor received an enforcement letter from the FDA
that the drug's advertisements were downplaying rare but serious muscle
conditions it can cause. The manufacturer got a second FDA letter in
2005 for misleading claims in a television advertisement, which stated
that Crestor was a more effective drug than other statins â€“ a claim
that was not supported by medical evidence.
The Driven to Distraction Award: For Hawking an Attention Deficit drug by Distracting Consumers with ADHD.
Presented to Strattera (Eli Lilly)
In June 2005, the FDA sent a letter to Eli Lilly charging that a
television advertisement for its Attention Deficit Hyperactivity
Disorder (ADHD) drug Strattera was "false or misleading." The ad showed
a person maneuvering everyday activities as seen through the screen of
a videogame â€“ activities like leaving the house, walking to a car, and
looking at a watch. These activities were overlaid with video
game-style messages such as "Disorganized â€“ Penalty," "Distracted â€“
Penalty," and "Trouble Finishing Things â€“ Penalty." These flashy
visuals were presented at the same time Strattera's approved use and
side effects were being shown.
"In short, Strattera was hawking its product to consumers with ADHD by
distracting them. So egregious was this commercial, that the FDA
complained to Eli Lilly that the visuals and graphics â€˜[worked to]
undermine the consumer's ability to pay attention to and comprehend
risk information â€“ thereby minimizing these risks and misleadingly
suggesting that Strattera is safer than has been demonstrated',"
explained Sugerman-Brozan. "This ad displayed an extreme lack of
sensitivity towards the very population it was purporting to help, and
exploited the very condition it claimed to be trying to treat."
"Consumers cannot make an informed decision about a prescription drug
based on a thirty-second or one-minute advertisement," said Dr. Avorn,
adding: "This Strattera advertisement is an extreme example of one of
drug advertising's core problems: prescription drugs and the conditions
they treat are highly complicated matters that require a high level of
information and a high degree of understanding."
But by the time the FDA issued its letter, Eli Lilly's campaign using
the ad had already ended one month previously, illustrating the
ineffectiveness of the current regulatory system. Many ads only run for
several months, so in the rare case when the FDA does send a letter
concerning a false or misleading ad, it is not uncommon for the ad to
have already stopped running.
In September 2005, Eli Lilly received the dubious and ironic
distinction of winning an award for its Strattera campaign during the
Pharmaceutical Advertising and Marketing Awards (PhAME). The press
release announcing these awards stated that the PhAME Awards "recognize
the best [direct-to-consumer advertising] campaigns that positively
inform the consumers they touch."
The Fox Guarding the Hen House Award: For Pushing Toothless "Guiding Principles" on Drug Advertising
Presented to Pharmaceutical Research and Manufacturers of America (PhRMA)
In an initiative that many saw as an attempt to fend off Congressional
action to more closely regulate drug advertising, PhRMA released its Guiding Principles on Direct-to-Consumer Advertisements about Prescription Medicines
in August 2005. While PhRMA encouraged its member organizations to
adopt these principles, they remain purely voluntary and there is no
penalty or enforcement for failure to comply with them.
"Of PhRMA's fifteen guiding principles, most are extremely vague and
contain no measurable benchmarks to determine whether or not a
particular advertisement complies with them. Only a handful call for
change in behavior, and Sepracor's use of a Lunesta "reminder ad," in
violation of the principle calling for an end to such ads, demonstrates
how totally inadequate it is to rely on the industry to police itself,"
Because PhRMA's principles are voluntary, there are no enforceable
standards or requirements. As such, the current guiding principles do
little to address the fundamental problems caused by Direct-to-Consumer
"PhRMA's principles force the public to rely on the voluntary
compliance of drug companies â€“ an industry of which the public is
growing increasingly â€“ and justifiably â€“ suspicious. Now, more than
ever, is the time for real standards and real oversight," said
The Truth is Stranger Than Fiction Award: For Commissioning a Hackneyed Thriller to Scare Americans about Canadian Drugs
Presented to Pharmaceutical Research and Manufacturers of America (PhRMA)
Last summer saw the release of a popular film portraying a fictional drug company engaged in evil doings, The Constant Gardener. The film demonstrated the power of popular culture to shape public opinion about the prescription drug industry.
In 2005, PhRMA consultant Mark Barodness, proposed commissioning a
novel about terrorists poisoning Canadian drugs destined for the U.S.,
in a bizarre attempt to help the pharmaceutical industry scare
Americans â€“ particularly seniors â€“ away from purchasing cheaper
prescription drugs in Canada. Valerie Volpe, at the time PhRMA's deputy
vice president for federal and state affairs, agreed to a $300,000 deal
and gave Barodness $100,000 in PhRMA funds to underwrite the effort. A
publisher and ghostwriter were found, a manuscript was written, and
Jayson Blair, the former New York Times reporter who was publicly fired for fabricating news articles, was briefly on board as an editor.
Then the deal began to fall apart. As the Philadelphia Inquirer
reported, "In the first draft, the terrorists were Croatian
nationalists angry at America over the war in Bosnia-Herzegovina. But,
Spivak [the publisher] said, Barondess and Volpe wanted the terrorists
to be Muslims motivated by greed. He said they also had wanted the
female protagonist to be â€˜frillier,' with â€˜more shopping' in the story
to appeal to women, who buy more medicine."
The deal was eventually canceled, and the publisher was later offered
another $100,000 in exchange for promising never to criticize PhRMA or
the drug industry in public. The publisher refused, and made public
dozens of emails chronicling the episode on a web site for a revised
version of the book, The Karasik Conspiracy (karasikconspiracy.com).
The book that was eventually published features a pharmaceutical
company behind the plot to poison the Canadian drug supply, and trying
to blame it on terrorists.
The Real Deal Award: For Promoting Safe, Effective Generics and Countering Drug Industry Marketing
Presented to MedVantx
Generic drugs enter the market when a brand-name drug's patent expires
or is declared invalid. Within six months after its patent expiration,
the price of the brand-name drug typically drops 70-80% as generic
companies begin selling their own copies of the drug. Despite the low
cost, and the fact that generics make up more than half of all
prescriptions dispensed in the United States, generic drugs are still
significantly underutilized. Direct-to-Consumer Advertising contributes
to low generic sales by perpetuating the myth that newer is better,
prompting consumers to instead demand advertised, brand-name drugs.
One company working to solve the problems associated with drug
marketing is the California-based company, MedVantx. The company
contracts with health insurers to place in doctors' offices ATM-like
machines that distribute free 30-day "samples" of a number of generic
"By placing generic samples within easy reach of doctors as they write
prescriptions and providing an alternative to the samples of brand-name
medications that drug companies shower doctors with, MedVantx is
helping to educate consumers and physicians about generics and
counteract the imbalance of information that currently favors
expensive, over-marketed brand-name drugs," said Sugerman-Brozan.