As Medical Marketing Soars, Is Regulation Needed?

It may help lift the “stigma” attached to conditions like HIV or depression, he said, or help people get appropriate tests or treatments.

There’s a flip side, though: overdiagnosis and overtreatment.

Woloshin mentioned a study where researchers had actors go to primary care doctors portraying symptoms of either major depression or adjustment disorder. Some specifically asked for an antidepressant, citing something they’d seen on TV.

The result: People who asked for medication were more likely to get it, even when they did not report depression symptoms.

“Marketing can have benefits, but also harms,” Woloshin said. “That’s why we need strong regulation.”

However, the study found little evidence that regulation has kept pace with the explosion in marketing. According to Woloshin, the FDA has taken some action in recent years — to curtail marketing of unapproved genetic tests that promise to reveal your risks of developing various diseases.

But the public might be surprised by how little regulatory oversight there is, said Meredith Rosenthal, a professor of health economics at the Harvard School of Public Health.

“Don’t assume an ad has been reviewed and blessed by the FDA,” said Rosenthal, co-author of an editorial published with the study.

The FDA can act when an ad’s content violates law, she noted. But it does not put a stamp of approval on every ad.

In theory, Rosenthal said, doctors are the “bulwark,” steering patients away from inappropriate treatments, even if they demand them. But, she noted, doctors are targeted by marketers, too, or may advertise services themselves.

Plus, Woloshin said, even when doctors try to convince patients that lifestyle changes, for example, are a better option, they can end up fighting a losing battle.

For now, he and Rosenthal suggested the public regard medical ads with a healthy dose of skepticism.

That includes “disease awareness campaigns,” which are often funded by drug companies, Woloshin said.

Again, Woloshin said, that kind of marketing can have benefits, but also harms when campaigns try to expand a disease definition and “medicalize” normal experience. He cited “low testosterone” as one example.

“Some people say we should ban [medical marketing],” Woloshin said. “But that’s not going to happen, because of the First Amendment. What we need is stronger regulation.”

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