Ethics Study: Marketing Prescription Drugs

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Advertisements promoting prescription drugs have increased significantly since the FDA changed regulations in 1997 to allow direct to consumer (DTC) advertising. Among the most widely marketed drugs have been Lipitor, Zocor, Prilosec, Prevacid, Nexium, Celebrex, Vioxx, Zoloft, Paxil, Prozac, Viagra, Cialis, Levitra, Propecia, and Zyban. These drug names, literally household words today, were unheard of or nonexistent even 10 years ago.
Together, they accounted for over $21 billion in sales in 2002.
These drugs treat the following conditions: ulcers and acid-reflux (Prilosec, Prevacid, Nexium), high cholesterol (Lipitor, Zocor), arthritis pain (Celebrex, Vioxx), depression, panic attacks, and anxiety (Zoloft, Paxil, Prozac), "erectile dysfunction" (Viagra, Cialis, and Levitra), hair loss (Propecia), and cigarette and nicotine withdrawal (Zyban).

Ads for these drugs often appeal to such emotional considerations as embarrassment; fear; shame; social, sexual, and romantic inferiority; helplessness; vulnerability; and vanity. Many of these drugs are heavily advertised in women's magazines and during televised sporting events. Perhaps no marketing campaign has received as much critical attention as the Viagra, Cialis, and Levitra campaign to counteract erectile dysfunction. Much of the criticism has focused on the ad placements, particularly in places where young children would see them such as during prime time television and during high-profile sporting events. Other criticisms suggest that although these drugs can be used to treat real medical conditions, they are being marketed as little more than sex toys. Erectile dysfunction can be a problem for older men and especially for men recovering from such medical treatments as prostate surgery. But for younger and otherwise healthy men, the primary causes of erectile dysfunction are alcohol consumption, obesity, and lack of exercise, smoking, and the use of other prescription drugs. All these causes are either easily addressed without reliance on pharmaceuticals or, as in the case of alcohol abuse, use of erectile dysfunction drugs is potentially unsafe with them. Arguments in support of this type of marketing are that they provide information to consumers, respect consumer choice, encourage those who are reluctant to seek medical care to do so, get more people into the health care system, address real public health issues, and increase competition and efficiency in the pharmaceutical industry. Opponents claim that these ads increase the unnecessary use of drugs; that because all drugs have harmful side effects, the ads increase public harms; that the ads increase reliance on pharmaceutical health care treatments and discourage alternative therapies and treatments, many of which have fewer side effects; that these ads manipulate and exploit vulnerable consumers; that they often provide misleading and incomplete information; that they alienate patients from physicians by bypassing the gatekeeper function of medical professionals; and that they treat social and behavior problems with medical and chemical solutions. What is your judgment about the ethics of advertising prescription drugs? What facts would you want to know before deciding this case?

1. Is direct to consumer (DTC) advertising of drugs considered ethical? What facts could be supplied to help you make your decision?
2. What ethical issues should be considered when marketing prescription drugs?
3. What are the costs and benefits of marketing prescription drugs directly to physicians?
Evaluate each assumption you make within your reasoning, and identify and evaluate the evidence. APA format