Schwitzer health news blog

Taking consumer-driven medicine to new depths

Maggie Mahar and Niko Karvounis on the HealthBeatblog.org write about direct-to-consumer ads taking "consumer driven medicine" to "absurd heights." Or depths. Excerpts:

"In a piece titled “Crossing the Line in Consumer Education?� that will appear in the May 22 issue of The New England Journal of Medicine (NEJM), Drs. William E. Boden, and George A. Diamond tackle the issue, arguing that a new campaign to peddle medical devices directly to patients warrants close scrutiny. Manufacturers are inviting consumers to decide not only what is best for them, but what is best for their surgeons. This is “consumer-driven medicine� at its most dangerous.

Boden and Diamond focus on a 60-second television spot for Johnson & Johnson’s drug-eluting coronary stent, “the Cypher,� which debuted during last year’s Thanksgiving match-up between the Dallas Cowboys and the New York Jets. (Click here to view the advertisement in question).

The commercial has all of the hallmarks of the drug industry’s highly polished DTC advertising: First, we’re introduced to “the tough guy� – a once-powerful man who now is “cornered by chest pains� and sits slumped in his arm chair. Then, we are shown how he can reclaim his life in a montage of joyous physical activity accompanied by upbeat music. Of course, “this product isn’t for everyone,� we’re told. But “life is wide open. It all depends on what you’ve got inside.�

In the campaign to put the health care “consumer� in the driver’s seat, where he can have “control� and “choice,� J&J is breaking new ground. This ad isn’t for a pill that you buy in a pharmacy but rather for a coronary stent, a wire mesh device that is placed in an artery which has been blocked by fatty deposits. Doctors first thread a tiny balloon into the artery and inflate it to clear the blockage; then they insert a stent into the artery, and a second balloon expands the stent to keep the newly cleared blood vessel wide open.

“Unlike a drug,� Boden and Diamond point out, “whose use merely requires an office visit to a physician and a prescription the patient can fill at a pharmacy, a specialized medical device such as a stent can be selected and implanted only by someone with a very sophisticated medical understanding that no member of the lay public could realistically expect to gain from a DTCA campaign.�

This is an important point. It’s bad enough that some patients are now sold drugs via a sound-bite, but it is even more pernicious to pretend that the pros and cons of a medical device can be condensed into a 30-second spot. ...

One last question: even if patients get the Cypher they want, what happens when they develop a blood clot? Who is responsible then?"