Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Direct to consumer advertising works in correction facilities

Jeffrey Knuppel, MD
Meds
October 25, 2011
Share
Tweet
Share

One might assume that inmates in correctional facilities would not be influenced by big pharma’s direct-to-consumer advertising (DTCA) strategies. After all, their communication channels with the outside world have largely been silenced.

However, many do have access to television. And despite an increase in online pharmaceutical marketing, TV remains a common medium for trying to persuade patients to “ask your doctor” about drug X. Inmates also read magazines, another common advertising medium.

I’ve seen many inmates who have asked about prescription sleep medications (often costing close to $200 per month) that they saw advertised. “Why can’t I get some of that?” I’m often asked. I explain that it would be very unusual for correctional formularies to carry such medications. I explain that even my own health insurance plan, which is quite comprehensive, does not cover many of the newer sleep medications.

I’ve also frequently been asked about Abilify, a newer antipsychotic drug that has been marketed for use in combination with an antidepressant to treat depression. It’s not uncommon for a patient to have been on a starting dose of a generic antidepressant (pennies per pill in my correctional system) for a few weeks and then ask me about adding Abilify because they don’t think the antidepressant is working well enough.

If the antidepressant isn’t working sufficiently, then the next step would be to increase the dose of their current medication, not to add something else. When I explain that increasing their dose of is not only the next logical step but that adding Abilify, even at a low dose, will cost close to $500 per month and increase their risk of diabetes, high blood pressure, and other serious health problems, I usually get an “Oh, okay, let’s increase my antidepressant” response. They usually seem quite surprised when they learn just how expensive Abilify actually is.

But this necessary discussion also takes extra time–time which costs taxpayers money. Primary care providers also have to spend time addressing such DTCA issues in jails and prisons.

According to Wikipedia, New Zealand and the U.S. are the only two nations that permit DTCA. A U.S. Government Accountability Office report (pdf) in November 2006 revealed that in 2005, drug companies spent $4.2 billion on DTCA and $31.4 billion on research and development.

The report explains:

…studies we reviewed found that increases in DTC advertising have contributed to overall increases in spending on both the advertised drug itself and on on other drugs that treat the same conditions. For example, one study of 64 drugs found a median increase in sales of $2.20 for every $1 spent on DTC advertising. Consumer surveys suggest that DTC advertising increases utilization of drugs by prompting some consumers to request the advertised drugs from their physicians, who studies find are generally responsive to these requests. The surveys we reviewed found that between 2 and 7 percent of consumers who saw DTC advertising requested and ultimately received a prescription for the advertised drug.

So, DTCA clearly works. But is prescribing in correctional settings actually influenced by DTCA? I don’t know. Not surprisingly, I haven’t found any data about this topic. I suspect that it influences it some but not to the extent that it does in non-correctional settings (since correctional formularies are typically more restrictive than community formularies and because samples are not used in corrections). But if it influences prescribing to inmates at all, then it’s costing taxpayers extra money, money that’s not available in the current economic climate.

DTCA benefits nobody but the bottom lines of the drug companies. Contrary to what they want you to believe, it does not benefit patients. Patients deserve access to quality, unbiased health information. And with so much money at stake, the conflict of interest will always be too great for us to assume that their information is anything more than a sales pitch. But it’s been a very effective pitch, one that’s even managed to reach and influence those who are incarcerated.

Jeffrey Knuppel is a psychiatrist.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

5 tips to evaluate medical websites

October 25, 2011 Kevin 8
…
Next

PSA testing: Information is better than ignorance

October 26, 2011 Kevin 2
…

ADVERTISEMENT

Tagged as: Medications

Post navigation

< Previous Post
5 tips to evaluate medical websites
Next Post >
PSA testing: Information is better than ignorance

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Jeffrey Knuppel, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Physicians who treat inmates are at greater risk of litigation

    Jeffrey Knuppel, MD
  • a desk with keyboard and ipad with the kevinmd logo

    A psychiatrist on the compulsion behind running and exercise

    Jeffrey Knuppel, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Where do we draw the line on criminalizing mistakes?

    Jeffrey Knuppel, MD

More in Meds

  • A world without antidepressants: What could possibly go wrong?

    Tomi Mitchell, MD
  • The truth about GLP-1 medications for weight loss: What every patient should know

    Nisha Kuruvadi, DO
  • The hidden bias in how we treat chronic pain

    Richard A. Lawhern, PhD
  • Biologics are not small molecules: the case for pre-allergy testing in an era of immune-based therapies

    Robert Trent
  • The anesthesia spectrum: Guiding patients through comfort options in oral surgery

    Dexter Mattox, MD, DMD
  • Functional precision oncology: a game changer in cancer therapy

    Chris Apfel, MD, PhD, MBA
  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
  • Recent Posts

    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • The invisible weight carried by Black female physicians

      Trisza Leann Ray, DO | Physician
    • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

      Dr. Damane Zehra | Physician
    • Addressing America’s reliance on psychotropic medication [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden cost of malpractice: Why doctors are losing control

      Howard Smith, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
  • Recent Posts

    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • The invisible weight carried by Black female physicians

      Trisza Leann Ray, DO | Physician
    • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

      Dr. Damane Zehra | Physician
    • Addressing America’s reliance on psychotropic medication [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden cost of malpractice: Why doctors are losing control

      Howard Smith, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Direct to consumer advertising works in correction facilities
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...