Matthew Perry’s addiction, death isn’t a one off

By William MacKenzie,

The tragedy of Matthew Perry’s drug addiction and death isn’t a one-time regrettable incident. Americans are addicted to a slew of drugs because of aggressive marketing by pharmaceutical companies.

Watch television for any length of time and you will see that these drug-pushers dominate advertising time.

The U.S. and New Zealand are the only countries that allow direct-to-consumer prescription drug advertisements, according to USC’s Center for Health Policy and Economics. The result? Drug utilization is” highly responsive” to advertising exposure and “…those who initiate treatment due to advertising are on average less adherent, which suggests that some of the increase in utilization might be unnecessary.”

Direct to consumer prescription drug advertising also exposes prospective users to often ignored risks.

Ever heard of Tardive dyskinesia? If you watch television, you probably have seen the commercial for Austedo XR featuring a woman with shaking hands trying to grip a coffee cup.

Tardive dyskinesia is caused by long-term use of neuroleptic drugs, which are used to treat psychiatric conditions.

What you might not pay much attention to is the drug’s possible side effects, which include Irregular heartbeat, Neuroleptic Malignant Syndrome, Restlessness and Parkinsonism.

Or how about LYBALVI^® to treat manic or mixed episodes in adults that happen with bipolar 1 disorder, either alone for short-term (acute) or maintenance treatment or in combination with valproate or lithium.

The list of possible side effects seems endless, including increased risk of death in elderly people with dementia-related psychosis.

In a television commercial for Abbvie’s Rinvoq, prescribed to treat arthritis in adults, a woman enjoys a trek through a rock canyon and a man teaches children how to tap dance.

It all sounds so simple. Take this and you’ll get better.

But the truth is the drug has a lot of potential hazards, including:

• Increased risk for developing serious infections that may lead to hospitalization or death. Reported infections include active tuberculosis (TB), invasive fungal infections, bacterial, viral, including herpes zoster, and other infections.
• Lymphoma and other malignancies.
• A higher rate of major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke).
• Thrombosis, including deep venous thrombosis, pulmonary embolism, and arterial thrombosis, with many of these adverse effects serious and some resulted in death.
• Gastorintestinal (GI) perforations.

The message of most commercials? Adam Lenkowsky, executive vice president, chief commercialization officer and head of U.S. oncology at Bristol Meyers Squibb said at a Jan. 4, 2024, investor event that the point of the commercials is to “bring patients into treatment”.

In other words, in theory, the companies aren’t really pitching their drugs directly to consumers. Instead, they want prospective patients to badger doctors to prescribe it.

Such appeals must drive doctors crazy. After all, if the promoted drug was a realistic treatment option, a skilled doctor would likely have already thought of it. The commercials are an attempt to get in the middle of the patient-doctor relationship in a way that favors the drug company.

The FDA requires that drug advertisements “…must present a fair balance of drug benefits and risks, with the most important risks provided in an audio (i.e., spoken) format.”  But counterintuitively, “… in giving a laundry list of side effects associated with any given prescription drug…consumers may actually be more likely to believe that the drug is effective in treating the condition for which it is designed,” argues Cohen, Placitella & Roth, a Pennsylvania and New Jersey law firm that handles pharmaceutical litigation.

In 2015, the American Medical Association called for a ban of direct-to-consumer advertising (DTCA) for prescription drugs. Nevertheless, spending by the pharmaceutical industry on television advertisements has continued to accelerate, with national health care costs largely driven by drug spending.

It’s time to renew, and act on, AMA’s call.