I have been channel-surfing at the ACR in the evening while reading emails. I am so surprised at how much direct to consumer advertising is going on in the USA and wonder about its impacts. The most commercials are on biologics/advanced therapeutics that rheumatologists (and dermatologists and gastroenterologists) prescribe – TNFinhibitors, new biologics for PsA and PsO, and oral agents. Next in line are the non-coumadin oral anticoagulants. These seem to far exceed erectile dysfunction and depression ads – perhaps it is the channels I am watching, but it speaks to the frequency of prescriptions and sales in these areas. I was surprised about ads to see how old my DNA is – no, not ancestry DNA, but how old / unstable my telomeres are. No thanks, we can look in the mirror and see our parents' health to answer that for far less.
In Canada, the top 5 sales/costs on pharma plans are certainly products we use in rheumatology (3 of the top 5 are TNFi!). So this has me wondering if there is an impact on prescriptions with all this advertising. Most commercials detail all the potential side effects (tell your doctor if…) and also end with "ask your doctor if this is right for you." The money spent on the American TV ads suggests there is a return on investment.
At the 2016 ACR in Washington DC, there was a randomized trial of counselling people who were 'at risk' for RA such as first degree relatives of patients with RA (genetic, autoantibody and lifestyle risks) (Sparks JA et al. #989). They used a web-based assessment tool personalized to risks such as smoking cessation, exercise, weight loss, and dental care. They found that those who received the intervention were 15% more apt to consider changing their behaviour. They did not assess the holy grail – WOULD THEY ACTUALLY CHANGE THEIR HABITS? However, in behavioural change theory, you are more likely to change if you actually contemplate change than if you don't, even though the gains are not high within that framework.
So, direct to consumer targeting in people at risk for RA (or any lifestyle disease) may have some effect. I think the commercials are here to stay until the next generation only streams all their entertainment.
Dr. Janet Pope is Professor of Medicine at Western University and Division Head of Rheumatology. Dr. Pope's research interests include epidemiologic studies in scleroderma, classification criteria in systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis.View Full Bio