Guest Editorial of February 29, 2024 by Maureen Dill

Big PhRMA/Big Business, Big PhRMA/Bad Business

According to the latest report, the United States and New Zealand are the only countries in the world that permit advertising of prescription and over-the-counter drugs on television. License to promote these products on television in the U.S. came about some time in the 1980s, with the approval of the Federal Drug Administration. (If you have viewed the film “Dopesick,” starring Michael Keaton, and have seen the harm done by Purdue Pharmaceutical, you may feel as I do concerning the merits of the FDA.) Some sources suggest that permission by the FDA to promote these products on our airwaves may have been influenced not only by lobbyists in Washington, D.C., but also by physicians who had been sued by patients after having prescribed certain prescription or over-the-counter drugs.

The sometimes harmful side effects of many drugs promoted through television ads are often obscured by visually pleasing or pastoral images, sometimes accompanied by soothing music. In November 2023, the FDA published its final rule (https://www.natlawreview.com/article/fdas-final-rule-direct-consumer-advertising-presentation-risk-information) to amend its regulations concerning radio and television direct-to-consumer advertisements for human prescription drugs by firms, which includes manufacturers, packers, and distributors of prescription drugs and all of their representatives, both individuals and corporate entities (prescription drug firms).

The rule implements a statutory requirement established by the FDA Amendments Act of 2007 that DTC television or radio ads must be formatted to state the name of the applicable drug and its conditions of use and that the “major statement” relating to side effects and contraindications is presented in a clear, conspicuous, and neutral manner. The rule complements longstanding requirements, including risk information in prescription drug ads, setting standards for the manner in which the “major statement” is presented in DTC ads. The rule further ensures that this risk information is presented effectively, meaning in a way that helps consumers notice, attend to, and understand the applicable drug’s risks.

Financial payments from the drug industry to U.S. physicians are common and may influence physicians’ clinical decision-making and drug prescribing. Pharmaceutical companies often give doctors incentives, such as free trips, meals, gifts, and other perks to promote their products, but many companies offer financial incentives, such as cash payments for prescribing certain drugs or attending sponsored events.

An estimated $2 billion a year was paid by PhRMA (Pharmaceutical Research and Manufacturing of America) companies to doctors, fueling an increase in prescriptions, according to a new report published in the “Annals of Internal Medicine.” Records show that 67 percent of doctors received some kind of payment from 2015-2017. The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. As an example, with regard to statins (prescription medicines that lower cholesterol and reduce the risk of heart attack and stroke) your doctor may be taking industry money. A Harvard study shows doctors who take industry payouts are more likely to prescribe brand-name drugs, which is driving up unnecessary healthcare spending, and some of the most excessive healthcare spending involves the purchase of cholesterol-lowering statins.

Add to this that the number of licensed lobbyists in Washington, D.C., according to a 2022 report, is more than 12,400, while men and women elected to the U.S. Senate number only 100, and those representatives elected to the House total only 435. The number of paid licensed lobbyists does not include advocates or advocacy groups.

Lobbying spending in Washington, D.C. in 2022 reached $4.1 billion, with Big PhRMA investment in lobbying overshadowing all but one larger entity. According to the chart, “Leading Lobbying Industries in the United States in 2022,” found at www.statista.com/top, pharmaceutical and health product lobbyists spent $374 million that year. In 2023, it was reported that PhRMA spent $29.2 million in federal lobbying.

To learn more, check out this and other news reports: “Federal Lobbying Spending Reaches $4.1 billion” (https://www.opensecrets.org/news/2023/01/federal-lobbying-spending-reaches-4-1-billion-in-2022-the-highest-since-2010/). According to OpenSecrets— a nonpartisan, independent and nonprofit research group tracking money in U.S. politics and its effect on elections and public policy—Akin Gump reported receiving a total of $53.2 million from clients for federal lobbying in 2022, slightly less than the $53.8 million the firm reported receiving for federal lobbying in 2021. Brownstein Hyatt Farber Schreck, which reported receiving $61.2 million from clients last year, was the highest grossing federal lobbying firm for the second consecutive year. That’s another new record—annual lobbying revenue reported by a single federal lobbying firm never reached $60 million in past years, even adjusted for inflation. The top 10 lobbying firms raked in more than 9 percent of the $4.1 billion spent on federal lobbying in 2022, a new OpenSecrets analysis found.
People concerned enough about this issue to take action may sign a Change.org petition at https://chng.it/n99vq8McCN. They may also contact their representatives at the local, state and federal levels to demand a ban on drug advertising on television.

Maureen Dill is a retired social worker and former disaster preparedness and response planner, having served as human services and emergency services director for two international nonprofit charitable organizations.