The Politics of Women's Health

Direct to Consumer Advertising

In the ad, a beautiful woman grins out at you. She wants to know: Mood swings? Irritability? Bloated feeling? Think it's PMS?

Think again, she says. And that's exactly what we need to do.

This happy, healthy young woman, a lovely advertising figment of pharmaceutical giant Eli Lilly, is trying to sell you something. She's trying to sell you a new illness. The illness is Premenstrual Dysphoric Disorder (PMDD), and guess what? She also just happens to be selling the cure.

She wants you to know that Sarafem is the first and only FDA - approved prescription drug to treat PMDD and "help you feel more in control."

What she doesn't tell you is that the American Psychiatric Association (APA) has been unable to agree that the mental disorder PMDD exists. She also doesn't mention that Sarafem is really the same drug as Prozac, renamed and repackaged in a feminine pink and lavender capsule.

Are millions of women really mentally ill for a week or two every month? Does Eli Lilly's unveiling of Sarafem have anything to do with the fact that their exclusive patent on Prozac expired in August 2001?

Sarafem is just one of the many prescription drugs that is being aggressively marketed to consumers. Everywhere you look -- on TV, billboards, and in magazines -- drug ads hyping happiness, contentment, and the good life leap out at you. It hasn't always been this way. Prior to 1997, prescription drugs were advertised mainly in medical journals aimed at health care providers. But in 1997 the Food and Drug Administration (FDA) loosened the restrictions on what is called direct-to-consumer (DTC) advertising, and since then pharmaceutical companies have spent billions of dollars advertising their drugs to a general audience. In 2005 alone they spent $4.2 billion on direct-to-consumer advertising.

The drug companies claim that DTC advertising is good for consumers because the ads educate the public and encourage people to be more involved in their medical choices. But drug companies have a serious conflict of interest when it comes to educating consumers: The more people take their drugs, the larger the drug company profits. Because of this vested interest, ads for prescription drugs are often misleading and sometimes unethical.

We’ve gathered together a series of articles that explore the impact and repercussions of direct-to-consumer advertising.

• Misleading Ads and How They Hurt Us, a commentary by OBOS executive director Judy Norsigian, looks at how drug companies profit by promoting anxiety about illness.
  
  
• "There's a lot of money to be made from telling healthy people they're sick. Some forms of medicalising ordinary life may now be better described as disease mongering: widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments." This insightful comment is one of many from "Selling Sickness: The Pharmaceutical Industry and Disease Mongering."
  
  
• "Prime Time Pushers," an online article from Mother Jones Magazine, provides an overview and history of the issue.
  
  
• Each year the Prescription Access Litigation Project, a national consumer coalition devoted to challenging high drug prices, bestows Bitter Pill Awards to drug companies that engage in over-zealous and questionable marketing practices. Read all about the 2006 winners.
  
  
• "Feminists Challenge Unethical Marketing by Prescription Drug Companies," written by OBOS founder and executive director Judy Norsigian, examines advertising campaigns directed at women and looks at how some women's groups have responded.
  
  
• In 1995 the National Women’s Health Network testified at a FDA (Food and Drug Administration) hearing about the risks inherent in advertising prescription drugs. Their main complaint --  that consumers bombarded by slick advertisements have little access to unbiased information on drugs -- continues to be relevant today.
  
  
• A Washington Post article, "Drug Ads Hyping Anxiety Make Some Uneasy," tells the story of how one drug company and one marketing agency "sold" and packaged a new anxiety disorder in order to promote their drug.  
  
  
• In her article "Hot Flash Cold Cash," Washington Monthly reporter Alicia Mundy examines the impact that accepting funding from drug companies has had on the Society for Women's Health Research, a supposedly independent women's health organization. 
  
  
• Advertising and promotion by drug companies has a tremendous influence not only on consumers but also on physicians and other health care providers. Healthy Skepticism is a nonprofit organization that works to improve health by reducing harm from misleading drug promotion.
  
  
• The Center for Medical Consumers has long pointed out that consumers lack the safety and efficacy information they need to make informed decisions. Their article "How To Read A Drug Ad" is  a practical guide about deciphering drug-company speak; "Rein in Those Deceptive Ads" is a wish list of recommendations to the FDA regarding DTC advertising.
  
  
• Commercial Alert, an education and advocacy organization, begins their Statement on Direct-to-Consumer Marketing of Prescription Drugs with this line: "In 2004, pharmaceutical companies spent more than $4 billion in an onslaught of advertising to promote prescription drugs." The statement has been signed by more than 200 professors from U.S. medical schools as well as health activists.
  
  
• Finally, we’ve posted a description of Prevention First, an organization founded by women’s health advocates to promote a view of public health that stresses prevention – healthy food, water, and air -- over narrowly focused risk reduction through pharmaceutical interventions.

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