"Primetime Pushers" by Lisa Belkin, in Mother Jones (Mar.–Apr. 2001), 731 Market St., Ste. 600, San Francisco, Calif. 94103.

Turn on the TV these days, and you are almost sure to see an ad for Viagra, Prilosec, Lipitor, or a host of other drugs that you cannot buy without a doctor’s permission. Critics contend that this isn’t a healthy development, reports medical writer Belkin, author of First, Do No Harm (1993).

The U.S. Food and Drug Administration (FDA) opened the floodgates four years ago, when it eased restrictions on prescription drug ads. Pharmaceutical companies last year spent an estimated $1.7 billion on television ads, more than twice what they spent in 1998. The "direct-to-consumer" advertising "has paid off handsomely" for the drug firms, says Belkin. Pfizer, for instance, "upped consumer advertising for its cholesterol drug, Lipitor, by more than $45 million in 1999, and sales of the drug jumped too—56 percent, to $2.7 billion."

Proponents of the liberalized FDA policy contend that "it creates a more informed patient because viewers see the ads, then have an intelligent give-and-take with a doctor," says Belkin. Critics, however, maintain that the ads encourage patients "to seek out expensive, potentially dangerous drugs that they—and too often their doctors—know little about." Sales of Celebrex, an arthritis drug, reached $1 billion even before the final clinical-trial results were published in a peer-reviewed journal.

"Patients can be difficult to dissuade," one physician told Belkin. It complicates the doctor-patient relationship, he added, when the patients start directing the treatment "based on what they learned on TV." A further complication, notes Belkin: Some impressionable TV viewers don’t even bother to see a doctor before obtaining the advertised drugs from "the growing number of Web sites that sell prescription medications without a doctor visit." The FDA is scheduled to review its new approach to TV ads this summer.