Turn on the TV, pick up a magazine, pass a bus shelter. You're bombarded with prescription drug advertising. Keep the following in mind the next time you think a prescription drug ad appears convincing:

-Ads are not about educating the public; they're about marketing a product. Anyone trying to sell you something isn't going to give you the most balanced picture of the product's effectiveness and risks.

-You are being sold the newest--and therefore, the most expensive--drug of its kind. New is not necessarily better. Pharmaceutical companies need only prove that their drug is better than a placebo; they are not required to prove that it is any better than older, less expensive drugs for the same condition.

-Taking a new medication on a long-term basis is like going into uncharted territory. Most drug trials last only a few months, at best. It takes years and a broader level of usage than usually found in clinical trials before adverse interactions and rare side effects can be identified.

-Notice how unusual it is for an ad to tell you what percentage of people showed improvement taking the drug during clinical trials. This is because many of the most heavily promoted drugs are only moderately effective.

-Much of the advertising dollar goes to "me too" drugs, designed to cut into the market share of a competing blockbuster medication. Think Zoloft and Prozac, Vioxx and Celebrex, Pepsi and Coke.

-If an ad tells you that a drug cuts your risk by 50%, always ask "50% of what?" Daily aspirin cuts the risk of heart attack by 50%. Look carefully at the study results, you might find that halving the risk is less than meets the eye. For example, a five-year study showed that heart attacks occurred in 1% of the participants taking aspirin, as compared with 2% of those taking the placebo.

-Be aware that an ad's graphics alone can be misleading. No one looks sick in these ads. You'll see men with AIDS hiking up mountains and elderly people with osteoarthritis running around with their grandchildren. One might get the impression that a cure has been found for AIDS, osteoarthritis, and chronic pain in general.

-The next time you see an ad featuring a happy woman walking along the beach, be on the alert for a weight loss drug. Notice that the drug's efficacy is contingent upon cutting calories and regular exercise.

-Ads need not be pre-screened for accuracy by the Food and Drug Administration (FDA), though drug manufacturers may voluntarily submit ad copy to the agency beforehand.

-The FDA has issued over 90 warning letters to drug companies about misleading ads in the last year alone. You can learn the names of the offending companies and why the FDA acted by visiting the agency's web site (www.fda.gov), click on drugs, and continue to "Warning Letters and Notice of Violation Letters."

-Once the FDA has been alerted that a pharmaceutical company is running a misleading ad, it takes the agency about six months to verify the charge. Then, the offending company is allowed another six months grace period before retracting the ad. Drug companies usually change their ads yearly anyway.

-A drug company incurs no penalty for having run a misleading ad. In rare circumstances, the company may be required to run a corrective ad.

-The few studies exploring the effect of pharmaceutical promotional activities aimed at physicians show that they can be seriously misled. If they can be fooled, why not us?

-Don't take a drug without reading about it first. Ask for the labeling information from the pharmacist. Go to the local library and consult The Physicians' Desk Reference. And for your home library, buy The Essential Guide to Prescription Drugs 2001 by James J. Rybacki, Pharm.D, and James W. Long, MD, and Worst Pills, Best Pills by Sidney M. Wolfe, MD, Larry D. Sasich, Pharm.D, Rose-Ellen Hope, R.Ph, and Public Citizen's Health Research Group.

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Maryann Napoli is the associate director of the Center for Medical Consumers in New York City.

COPYRIGHT 2001 Center for Medical Consumers, Inc.
COPYRIGHT 2001 Gale Group