WASHINGTON -- "Blue skies smiling at me... Nothing but blue skies
do I see."
Set to a catchy tune and images of a colorful soaring balloon,
Schering-Plough commercial for its Claritin allergy medicine, and
others like it, are increasingly spurring patients to ask for
specific drugs when they visit allergists like Stanley Lane. The
inquiries have become more common since last August, when the U.S.
Food and Drug Administration took controversial steps to relax
standards for broadcast advertising of prescription drugs, the
American Medical Association says.
Lane, who practices in Moorestown, N.J., estimates between 10
percent and 15 percent of his patients ask for specific brands.
While he says his patients listen to him if he thinks a different
drug would be more appropriate, "usually, you want to go along with
what they're asking -- it makes for a better relationship."
That's music to the ears of companies such as Schering-Plough,
which in 1997 tallied up worldwide sales of $1.7 billion for its
Claritin, up from about $1.2 billion in 1996.
It's not such good news for managed care companies, which face
rising drug costs, helped along by increased demand for pricey drugs
advertised directly to patients.
"This appears to be primarily a tool of the pharmaceutical
manufacturers to bypass some of the managed care interventions that
we have," said Robert Seidman, vice president of pharmacy for Blue
Cross of California, an operating subsidiary of Wellpoint Health
Foes of direct-to-consumer advertising, including consumer groups,
medical associations and a majority of doctors, say the commercials
aren't properly emphasizing the risks inherent in prescription
And managed care companies worry that the ads are adding to their
costs by prompting patients to see a doctor unnecessarily to ask
about getting an advertised drug.
"The advertising is purposely directed at driving patients to
demand medications -- irrespective of whether those medications are
medically necessary," said Francis Crosson, the top physician at
Kaiser Permanente. He added that doctors are spending more time with
patients "dealing with prejudices" they've garnered from ads.
For managed care companies, demand from consumers targeted by the
ads will help drug costs at health plans continue to rise 12 percent
to 15 percent per year, according to Norm Fidel, an analyst and
manager at Alliance Capital Management with $600 million in health
funds under management.
While direct-to-consumer advertising is a good concept, the FDA's
guidelines are too lax on drug companies, according to Seidman. Many
of the ads don't properly convey the risks that come along with any
prescription drug and could lead to problems down the road, he
argued. "When you see the commercial, you see all the bright and
happy people. And then at the end, very quickly you hear all the
side effects," Seidman said. "There's a lot of fizzle associated
His concerns are echoed by the watchdog group Public Citizen, the
American Medical Association and a majority of doctors, according to
surveys by the industry consulting group IMS Health. Results to date
of an updated survey by the group found that about 65 percent of
doctors want to see direct-to-consumer advertising decrease or stop