Roosevelt Institute | Cornell University

The Link Between Unnecessary Medication and Television

By Rachel ArmstrongPublished February 23, 2019

A man breaks a television, and medications fall out.
Elderly patients are often successfully persuaded by direct-to-consumer (DTC) advertising on television for prescription medication. Regulating or banning DTC advertisements would combat unnecessary medication, and improve patient-physician relations.

Billions of dollars are spent each year on advertising pharmaceutical drugs to consumers. In 1997, direct-to-consumer (DTC) advertising regulations were relaxed—with one measure allowing for only “major risks” to be provided in an advertisement, as opposed to all possible side effects. A rise in advertisements followed this deregulation, leading to pharmaceutical commercials being a normal part of older populations’ typical pastime: watching television. These advertisements are not ignored or insignificant: viewers of DTC advertisements were more likely to discuss an advertised drug with their physician, as well as request a prescription for a drug they had seen on television. While it is undoubtedly beneficial to promote discussions surrounding health issues and treatment options, DTC advertisements have proven to be too influential in promoting medications, especially towards the elderly.

One study found that physicians were unlikely to provide antidepressants unless they were requested by the patient, and prescription rates were highest when brand-specific requests were made. This suggests a relationship between DTC advertisements and increased prescriptions, since DTC advertisements can persuade patients to mention a specific drug they saw on television to their physicians. A different study found that physicians often feel pressured when patients mention they would like to be prescribed a drug they saw on DTC advertisements. This data also leads to the question of whether any of these prescriptions were necessary or even valid; either answer to this question paints a concerning picture of the state of prescribing medicine to the elderly in the United States. On one hand, if the prescriptions are found to be valid, then doctors are missing signs that patients are then forced to communicate to receive treatment for. On the other hand, if these prescriptions are found to be unnecessary, patients were being over-prescribed.

Over medication has been cited frequently for its numerous negative effects: antibiotic resistance, fueling the opioid crisis, and other adverse drug effects, including harmful interactions. Specifically, polypharmacy—the use of multiple drugs, or more than are necessary—is becoming increasingly common for the elderly, raising worries for unintended life-threatening consequences. Eleven Veteran’s Affairs Medical Centers found that approximately 44% of older and frail patients studied were using at least one unnecessary drug. The elderly are already more susceptible to health-related issues than other populations, making unwarranted medication even more dangerous. To avoid over medication, DTC advertisements should be regulated.

The United States and New Zealand are the only countries that allow DTC advertising of pharmaceuticals. Plenty of people in the United States believe there is no need for a ban of DTCs advertisements probably because they do not understand how they are created. In one survey, 50% of participants believed the advertisements had to be approved by the government, and 43% thought the medication had to be completely safe to be advertised, leading to undeserved trust in the advertisements and as an extension, the drugs. In acknowledging how the general public interprets these DTC advertisements, it is easier to see why people who are frequently exposed to the advertisements are inclined to try and persuade their physicians for a prescription. Not only are audiences misinterpreting DTC advertisements, the advertisements themselves are misrepresenting their drug under what little regulations are present. A 2018 Yale study found that few broadcast DTC advertisements fully met the requirements the FDA has set. Effectively, people who often watch television, i.e. the elderly, are regularly believing in the inaccurate information presented in noncompliant formats by FDA standards and then pressuring physicians to prescribe them medication.

As simple a solution as enforcing stricter regulations for DTC advertisements could lead to favorable outcomes. Currently DTC advertisements need to only include “major risks,” a vague term that allows companies to selectively present their side effects of choice;this paired with the traditional marketing strategies of transforming a depressed looking individual into an exceptionally happy one after taking the drug, it is no wonder why viewers tend to place trust in these drugs shown in advertisements.They are presented as miracle workers. Ideally, DTC advertisements would be banned, but this is an unlikely scenario considering the free speech protections they currently hold. A more pragmatic resolution would be to screen advertisements for signs of misleading consumers and use current laws surrounding false advertisements to push back on pharmaceutical companies. If elders had a realistic view of the medications, they would be less inclined to claim the drug would cure them and force physicians to prescribe them these medications. This presents a unique way of tackling the all too common problem of over-prescribing medication. This solution may be particularly effective in also improving patient-physician relations. Comparatively, if prescriptions were just restricted, over-prescribing unnecessary medications would only be combatted, with likely negative impacts on patient-physician relations because patients would most likely view the restrictions as harmless at best and malpractice at worst. Regulating DTC advertisements, or banning them altogether, will positively impact how medications are viewed and prescribed in America.