As a family physician in Duluth, it is my job to advocate for the health of our community. As such, I feel it necessary to draw attention to a growing concern of mine regarding the News Tribune’s advertising of pharmaceuticals and medical treatments.
The United States and New Zealand are the only countries in the world that allow such direct-to-consumer advertising. This means pharmaceutical companies can advertise their products directly to you via any media, whether radio, television, or newspapers.
This practice of direct-to-consumer advertising at one time was very heavily regulated by the U.S. Food and Drug Administration. That changed in 1997 when regulations regarding the listing of side effects were eased. In the decade that followed, spending for pharmaceutical advertising increased from $11 billion to $30 billion and has continued to boom in the last decade.
Why? Because it’s effective. Numerous studies show that direct-to-consumer advertising leads to the increased prescribing of expensive patented medicines rather than their generic alternatives and also leads to the increased use of “off-label” medicines.
I spend a lot of my time as a primary-care doctor talking through advertisements seen by patients. Common topics include “that shingles shot,” low testosterone, caloric supplements and multivitamins, and, recently, Hepatitis C screenings. To be clear, I love when my patients are informed, and I very much enjoy these conversations when the facts are clear. The problem, however, is, oftentimes, these advertisements lead to confusion and misinformation.
In mid-July I had a patient call my office near the end of the work day. He was frantic. He needed to get ahold of me immediately. He was at a stem cell education seminar and needed to know in the next few minutes if he should pay the thousands of dollars being requested for therapies that he was being told may help with his and his wife’s chronic diseases. I told him no.
The following day we were sitting in my office and he showed me a full-page “article” in the News Tribune titled, “Stem Cell Centers: Cutting Edge Treatments, Amazing Results.” I call it an “article” because nowhere on the page did I see it labeled as an “advertisement.” The article instructed the reader, in all capital letters, to “stop living with chronic pain.” It wondered if “you” are a candidate and beckoned readers to a “free” seminar.
Per my patient, the seminar was exactly what you would expect: a made-for-TV advertisement offering to harvest the patient's stem cells and reinject them into the patient for the low price of $4,000 per injection. But wait, if you buy two, there’s a $500 savings.
The truth about stem cells is that, while promising, they are largely unproven. That is, there is some very preliminary basic science research suggesting that stem cells may some day be beneficial in clinical medicine, but there are still no clinical trials that have shown any benefit. Nonetheless, companies stand to make a lot of money selling these uncertain therapies. States such as California and Florida are so fraught with stem cell clinics the FDA is weighing crackdowns. To be very clear, I would never advise a patient to undergo this treatment.
Physicians and medical societies, including the American Medical Association, have been calling for the FDA to crack down on direct-to-consumer advertising, as there is strong and mounting evidence that it leads to the increased costs of prescription medicines, the inappropriate “off-label” use of medicines, and, in some cases, the propagation of misinformation.
I suspect the FDA will make changes in the near future. In the meantime, our local news media has a responsibility here. There is an ethical and moral responsibility for the News Tribune to not let organizations like “Stem Cell Centers” prowl on our community.
The American Academy of Family Practice has recommendation guidelines for direct-to-consumer advertising: Advertisements must conform to applicable laws, including FDA and/or Federal Trade Commission guidelines (stem cell treatments are not FDA-approved); must be labeled as advertisements, unlike the ad in the News Tribune; should contain information that is accurate, balanced, objective, and complete, with no false or misleading statements; shouldn’t promote unhealthy or unsafe practices; should mention risks if benefits are mentioned; and should not promote the use of products that have addictive or abuse potential.
I’d urge the News Tribune to also insist that these advertisements recommend discussions with patients’ physicians. In the instance of “Stem Cell Centers,” my patient felt cornered and put on the spot for thousands of dollars.
Please, News Tribune, let’s be partners in taking care of our community’s health.
Dr. Timothy Kufahl is a family physician in downtown Duluth.