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    Is Dr. Robert Jarvik Public Health Enemy Number 1?

    There was quite an uproar when the politicians who decide what information Americans may or may not see attacked Pfizer for using a certain physician in its ad campaign for Lipitor, the popular anti-cholesterol pill.

    Remarkably, the spokesperson, Dr. Robert Jarvik, was the inventor of the first artificial heart. Apparently, the fact that the doctor earned his medical degree but never sought a physician’s license (because he was too busy inventing things like artificial hearts), should disqualify him from speaking out.

    The resulting media firestorm spurred Pfizer to pull the ads and fire Jarvik.

    This fallout has reignited calls to restrict direct-to-consumer advertising (DTC) for prescription drugs.

    The anti-DTC crowd claims that drug makers use TV and print commercials to convince people to buy pills they don’t actually need. But the evidence leans heavily to the opposite conclusion.

    According to a scholarly study published in 2003, one third of folks decided to visit their doctors as a result of seeing DTC advertising. One quarter of ad-inspired consultations led to a new diagnosis, and almost half of these new diagnoses were for high-priority conditions.

    Nevertheless, doctors prescribed advertised medicines cautiously. Over half the time, newly diagnosed patients did not get the prescription that they wanted.

    Ad-inspired visits to the doctor had other positive health outcomes: about one quarter of the time, the patient was referred to a specialist. So even if the advertised drug wasn’t prescribed, patients benefited.

    Anything that prompts better physician-patient relationships, especially for those with high cholesterol, is good. According to the American Heart Association, two thirds of Americans fail to take any or all of their prescription meds, more than half are not taking their medicines properly, and more than half do not follow their doctor’s lifestyle advice.

    And our political and media elites are upset that DTC ads are motivating us to see our doctors more often, and take their guidance more seriously? Incredible!

    Moreover, DTC restrictions would lead to a reduction in scientific research and development.

    There was virtually a one-to-one relationship between R&D and promotional spending between 1997 and 2005. In other words, the two complement each other, rising in almost complete lockstep.

    The average new medicine takes about a billion dollars and over a decade of research to develop. If manufacturers are hamstrung in telling us about their inventions, they won’t recoup their investments.

    That means that you (and your pension fund) will be unlikely to invest in the companies that invent these medicines. The result? No more new drugs.

    And there’s reason to believe that Washington’s motivations on this issue aren’t so pure.

    Medicare and Medicaid are on the hook for the prescription drug bills of millions of Americans. Lawmakers might be looking for an easy way to cut costs. DTC bans are an obvious choice — less ads for drugs, less demand.

    Finally, advertisements are one of the few tools manufacturers have to cut through the clutter of false and misleading information about prescription drugs.

    Case in point: A recent study found that of the first three pages of results of a Google search for the terms “Crestor” and “Avandia” — two popular prescription pills — over 40 percent of the hits were sites fishing for plaintiffs for class-action lawsuits against pharmaceutical companies.

    Others were either run by anti-drug activists or bloggers with unverified qualifications.

    Only 12 percent of the hits were websites run by legitimate drug makers or government agencies.

    The Dr. Jarvik scandal is worse than a distraction — it’s a concerted attempt to choke off one of the few ways pharmaceutical firms can communicate with the public. Restrictions on DTC are effectively restrictions on the supply of life-improving medicines.

    Claiming otherwise is the real scandal.

    John R. Graham is Director of Health Care Studies at the Pacific Research Institute.

    Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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