[Congressional Record (Bound Edition), Volume 147 (2001), Part 9]
[Extensions of Remarks]
[Page 12190]
[From the U.S. Government Publishing Office, www.gpo.gov]



INTRODUCTION OF THE FAIR BALANCE PRESCRIPTION DRUG ADVERTISEMENT ACT OF 
                                  2001

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Wednesday, June 27, 2001

  Mr. STARK. Mr. Speaker, I rise today to introduce the Fair Balance 
Prescription Drug Advertisement Act, a bill to deny tax deductions for 
unbalanced direct to consumer (DTC) pharmaceutical advertising placing 
more emphasis on product benefits rather than risks or failing to meet 
Federal Food, Drug and Cosmetic Act Requirements.
  The bill will ensure that DTC advertisements are presented in a fair 
manner, balancing risks and consequences. Print ads would be required 
to display pros and cons in equal typeface and space, and on the same 
or facing pages. If the advertisements ran onto additional pages, those 
pages would have to be consecutive with the first pages. In television 
and radio ads, risk and benefit descriptions would be allotted equal 
airtime and volume level. Pharmaceutical companies who do not follow 
these guidelines will not be eligible for an advertising tax deduction.
  Since the FDA relaxed restrictions on television advertising in 1997, 
DTC advertising has soared. Drug companies' advertising expenditure 
doubled between 1998 and 2000. Last year, Merk-Medco cited a report 
that projected that by 2005, DTC advertising expenditure will reach 
seven billion dollars annually.
  This increased spending correlates with increased prices of 
prescription drugs. Like any other commodity, greater product 
recognition leads to increased demand, and higher prices.
  Large-scale advertising may also lead consumers to demand drugs that 
may not be medically necessary or appropriate for the patient's 
condition. According to the National Institute for Health Care 
Management, 86% of patients who request a prescription for Claritin 
from their doctor receive one.
  Doctors often find that patients are difficult to dissuade when they 
have heard the promises of a new drug. Physicians who acquiesce, 
however, can put their patients' health at risk. Before the FDA had 
published clinical trial results of the arthritis drug Celebrex, 
physicians had prescribed $1 billion worth of the drug in response to 
patient demands. The doctors had done this without realizing that 
Celebrex contains an ingredient to which many patients are allergic. In 
another example, between its release in October of 1999, and the summer 
of 2000, 22 patients taking the flu drug Relenza had died. The FDA 
later determined that in the majority of these cases, the drug should 
never have been prescribed.
  Physicians are beginning to recognize dangers of DTC as well. This 
month, the American Medical Association in their annual convention 
decided to ask the
  In addition to health dangers, physician's responses to pressure from 
``informed'' patients can have economic consequences. According to the 
Blue Cross and Blue Shield Association, a one year dosage of the 
arthritis medicine Celebrex costs $900, while the same dosage of 
ibuprofen, which may be adequate to treat many patients' pain, costs 
only $24.
  Just yesterday, the Wall Street Journal raised concerns about the 
power of DTC advertising. Due to an intensive new campaign by the 
Genzyme corporation, many dialysis patients who used to use the over-
the-counter medication Tums as a calcium supplement are switching to 
Renagel, a prescription medication that costs up to $12 a day.
  DTC advertisements may also prevent patients from requesting, and 
physicians from prescribing generic brand drugs. According to a Merk-
Medco 2000 study, increasing a health care plan's dispensing rate of 
generic drugs by 1% can reduce drug spending by 12%.
  Although prescription drug advertisements are purportedly intended to 
educate consumers, a University of California study determined that 
drug companies frequently fall short of this goal. In a survey of 320 
print ads, only 9% included information on the drug's success rate, and 
the same number attempted to clarify misconceptions about the condition 
the drug is prescribed to treat. Clearly, something must be done to 
make these ads more honest.
  According to a May 2000 Business Week article, some drug companies 
claim that the increased advertising can alert hospital physicians to 
new medications that may reduce a patient's length of stay, and thus 
reduce overall costs. However, most of the money spent on DTC drug 
advertisements goes to heartburn, allergy medications, and vanity drugs 
like those that prevent hair loss. These advertisements promote 
consumers to seek expensive treatment for conditions that they might 
not have felt the need for treatment in the past.
  This bill I am introducing today would decrease the economic 
incentives for DTC advertising by taking away the tax deduction for ads 
that are not fairly balanced. Why should taxpayer funds go to drug 
companies' questionable advertising techniques that endanger lives and 
ultimately raise overall health expenditures? By denying tax deductions 
for unbalanced prescription drug ads, we may be able to change 
pharmaceutical company behavior to ensure that that their advertising 
includes clear, life saving information that will better inform the 
American public, reduce health care costs, and save lives. I urge my 
colleagues to join me in support of this legislation, and look forward 
to working with them to make fair, balanced drug advertising a reality.

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