Yesterday, we wrote thata new study found the accuracy of ads for antidepressants and antipsychotics often make claims that can’t be verified and attempts to obtain data cited in the ads from the drugmakers were rarely successful. The study, which examined the accuracy of 69 ads that appeared in four widely read medical journals in 2005, was conducted by Glen Spielmans, an assistant psychology professor at Metropolitan State University in St. Paul, Minnesota, who previously conducted a study showing advertising for Lilly's Cymbalta was skewered. We spoke with him about his reasons for doing the study and the take-away message. This is an excerpt...
Pharmalot: What made you look at this in the first place? Spielmans: I was just reviewing drug ads for that period - 2004 and 2005 - because I was curious to see if they were accurate. The findings about ads for other kinds drugs advertising in journals showed that many were not accurate. I suspected the same thing would be the case (with antidepressants and antipsychotics). I thought it was strange that no one had looked at ads for that particular type of drug, given how widely used they are. So when I had some time, I had some students help me work on it.
Pharmalot: So why is this important? Spielmans: Physicians frequently read medical journals - at least we hope they do. Market research says they do. And we know physicians can be influenced by an ad. So if they're going to prescribe, perhaps based in part on advertising, we hope the advertising is accurate. But when claims are made that aren't supported, the impression created is overly optimistic. It’s possible that the claims are true, but because data wasn’t reported and isn’t easily obtained or verified, we don’t really know.
Pharmalot: How difficult was it to verify or obtain sources cited in these ads? Spielmans: It turned out not to be so easy. If we could get the source cited, maybe a study, we'd search to verify the claim in the ad. We'd look for the data, for instance. But there wasn't a lot of cooperation when we asked for verification. Legally, the drugmakers don't have any obligation to cite source or cite them accurately. As for providing references, it's not required.
Pharmalot: You noted that Wyeth's ad suggests doc look at data, but they wouldn't give you any data. What happened? Spielmans: I'm trying to think of a punchline. I chalk it up to the power of marketing. They made something and just do what they want to do. It's somewhere between ironic and ridiculous.
Pharmalot: What do you think can be done to enhance the accuracy? Spielmans: When I look at the FDA budget and staffing relative to the number of ads to be reviewed, well, they simply don't have the number of people needed to do the work. They don't pre-screen (ads), so it seems to be pretty difficult to catch ads early before they go out.
Pharmalot: But are doctors so easily fooled? Spielmans: It's difficult to know how easily fooled they may be. I think it's safe to say that some ads are influencing prescribing habits. The ads may use a lot of footnote to make things look more impressive, but just because the footnotes are there doesn't mean they support the claim. I think it would behoove journal editors to engage in some sort of oversight. You know, on one page there's an article on medicines and evidence, and the next page there is an ad with unsubstantiated claims. They could check that the ads are accurate, although I'm sure it would be difficult and become an ugly tug of war.
Pharmalot: Of course, you're a psychologist. So are you predisposed to oppose prescribing psych meds for these ailments? And if so, why? Spielmans: In general, I have some problems with psych meds. But I’m certainly not 100 percent against them either. It makes sense to prescribe meds in some cases. I’m not saying that meds should never be prescribed. I don’t think evidence supports that kind of position. But there’s also evidence that psychotherapy works as well if not better in the long term for many conditions.