Will Drugmakers Back Off The Hard Sell?

The Food & Drug Administration panel charged with reviewing the safety of Cox-2 painkillers left little doubt as to where it stands on using advertising to sell the controversial class of drugs: It shouldn't happen -- period. "The committee wanted to send a clear message that [consumer] ads for these drugs were inappropriate," said committee Chairman Dr. Alastair J.J. Wood on Feb. 18.

So will the uproar around Cox-2 drugs lead pharmaceutical companies to cut back the money they pour into consumer ads? Probably not. Despite criticism that excessive marketing of prescription drugs in the same breezy manner used to pitch beer or shampoo has led to their overuse, print and TV ads have become crucial to the drug-marketing machine.

Still, many experts foresee a return to more sober marketing messages. "The pendulum is swinging back," says Beth L. Miller, senior vice-president of Campbell Mithun, a unit of ad agency Interpublic Group of Companies "I think [that drug] ads will become more conservative."

There is only so much the FDA can do about drug advertising. Even in a case like the Cox-2 drugs -- and armed with the panel's clear recommendation to end ads -- the agency can't simply prohibit companies from advertising certain drugs. That would require Congress to change the law. And imposing restrictions on ads would be dicey legally, since commercial free speech is strongly protected.

Still, regulators hardly remain powerless. They can follow the panel's recommendation and require the Cox-2 drugmakers to put a severe "black-box" warning about cardiovascular problems on their labels. That also would compel pharmaceutical companies to display these risks prominently in their ads. The agency says another option would be to negotiate voluntary bans or limits on consumer advertising for those drugs.

Ultimately, the drugmakers control how and to whom they advertise -- and they are loath to make big changes because consumer advertising routinely turns drugs into blockbusters. According to research by Meredith Rosenthal, an assistant professor at the Harvard School of Public Health, for every additional dollar spent on consumer advertising in such big niches as antidepressants and anti-ulcer drugs, the product category reaps an extra $4.25 in sales.

That helps explain why the drug industry shelled out $4.4 billion in consumer advertising in the 12 months ending November, 2004, according to TNS Media Intelligence. That's a 57% leap from the $2.8 billion spent just two years earlier.

Yet there are signs that industry executives are rethinking their pitches. Pfizer Inc.'s (PFE ) big spending on Celebrex -- $119 million over the 12 months ending in November -- helped turn it into a blockbuster. But, for the industry as a whole, Chairman and CEO Henry A. McKinnell Jr. acknowledges a downside to the drugmakers' marketing successes. "We've managed with our advertising to create this image of a perfectly safe drug," McKinnell says. "And that is never true."

He argues that drug ads need to return to more balanced communication of risks and benefits and not depend so much on catchy phrases and images. The question is whether the industry is ready to take that lesson to heart.

By Amy Barrett in Philadelphia

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