Americans love their pills. We’re taking more medicine now than ever before. Are we taking too many pills?
Just watch the evening news or a prime-time television show and you will likely see a variety of prescription drug commercials. In addition to the ever-present ED drug ads for Viagra or Cialis, there are expensive, highly produced spots for drugs like Xifaxan for irritable bowel syndrome (IBS). The cartoon character represents intestines tied in knots, but as the voice-over lists frightening side effects, the Xifaxan mascot is having fun in a restaurant. The humans who show up on the screen are also enjoying themselves, smiling and taking selfies.
An ad for Opdivo features a city with a giant message crawling across skyscrapers: “A CHANCE TO LIVE LONGER.” The commercial is about a new immunotherapy for lung cancer and emphasizes longer life for desperate patients. What the commercial does not mention is how much longer. A study in the New England Journal of Medicine (July 9, 2015) describes median overall survival on Opdivo for lung cancer was 9.2 months compared to 6 months on chemotherapy.
The Cost of Advertised Prescription Drugs:
TV commercials never mention the cost of medicines they are advertising. A two-week course of treatment with Xifaxan costs over $1,000. If someone were fortunate enough to live a year while taking Opdivo, the cost has been projected at $150,000.
Whether the condition is erectile dysfunction, psoriasis, rheumatoid arthritis or cancer, the message is that there is a pill for this ill. Americans have swallowed the story.
A study published in JAMA (Nov. 3, 2015) shows that almost 60 percent of adults were taking at least one prescription medication in the 2011-2012 survey year. That is a significant increase from just over 50 percent about a decade earlier.
Polypharmacy: Too Many Pills!
In addition, the study shows that more people are taking several medicines at once. Polypharmacy, the use of at least five prescription medications, nearly doubled, going from 8 percent in 1999-2000 to 15 percent in 2011-2012.
The authors of this study don’t tell us why people are taking so many more drugs. Perhaps it is because the American population is aging and older adults are more likely to have chronic conditions that require treatment. Although that may be an important factor, it is not the whole story, according to the authors. They write: “These increases persisted after accounting for changes in the age distribution of the population.”
Categories where drug use increased included blood pressure pills, statins, antidepressants, acid-suppressing proton pump inhibitors and asthma inhalers. The authors point out that direct-to-consumer advertising may be contributing to increased drug use, although it is not the only influence.
The increase in polypharmacy is worrisome because with each additional medication the chance for side effects and drug interactions increases substantially. Too many pills leading to drug interactions are a significant cause of illness and death.
The FDA cannot stop direct-to-consumer advertising without an act of Congress. Perhaps it is time for both doctors and patients to let their legislators know that prescription drug ads are no longer acceptable.
Are You Sick and Tired of Prescription Drug Ads on TV?
If you have had it with all those prescription drug ads why not let your Congressman know that you are sick and tired of it. The United States and New Zealand are the only two major countries to allow this sort of thing. You will not see such commercials in Germany, France, Italy or Australia. Why should Americans have to be exposed to this sort of promotion?
Perhaps physicians and pharmacists should also get involved in the protest. If enough health professionals told their organizations that enough is enough we might persuade Congress to put an end to this practice.
