How listing side effects on TV ads can sell more drugs

I must not be the only person to wonder how pharmaceutical companies succeed with direct to consumer advertisements when, stuck in the middle of all their TV ads, are those long lists of side effects.  You know what I mean.  After watching a smiling and attractive person running through a field after receiving some wonder pill, the narrator tucks his voice down an octave and intones that the medication “could cause rashes, constipation, heartburn, bladder dysfunction and cardiogenic syncope.”  How could anyone listening to this ad want to take this product?

Research by Yael Steinhart and colleagues suggests that such warnings may increase how much people like the product, but only after they have had the time to get over their immediate aversion to the side effects.

Steinhart presented people with product advertisements that either did or did not include product warnings. In the short run, such warnings scared consumers — they were less inclined to buy the products. No surprise here.

But for some people, the researchers didn’t ask for their immediate attitudes towards the product. Instead, they re-contacted them two weeks later. This delay people exposed to the warning were acting more inclined to buy the product. Why? Because they believed the manufacturer to be more trustworthy.

This research builds on a field of inquiry exploring how “construal level” influences people’s thoughts and behaviors. Big words, but a pretty simple idea. Construal theory posits that people’s judgments differ when thinking about the immediate future versus the more distant future . When thinking about the here and now, people get  concrete. But in the longer run, the immediacy of the side effects fades, and the more abstract truth of the warnings (“They sure were honest about the downsides of their product!”) loom larger.

Hopefully this means the short run, very concrete response I get from my teenagers when I harass them to do their homework will someday, perhaps in the very very distant future, be replaced by the much more abstract idea that, gosh darn it, I harass them out of love.

Peter Ubel is a physician and behavioral scientist who blogs at his self-titled site, Peter Ubel and can be reached on Twitter @PeterUbel.  He is the author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices TogetherThis article originally appeared in Forbes.

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  • DeceasedMD

    I have a hunch too many people just don’t think about it and comply with what is prescribed. Or some may research it themselves online. I think informed consent has gone out the window, although of course it is thoroughly documented in the EHR. There is not enough time to really thoroughly go over informed consent in a 12 minute visit. I don’t think most pts really understand from their doctor the risks benefits and side effects. They are handed a sheet of paper perhaps to sign but not much is verbally explained. Much different than training from years gone by.

    • Suzi Q 38

      So true.

  • DeceasedMD

    Better said than I. Exactly! Yet none of this will get attention as it seems to be mainstream and doctors comply with CorpMed and their “efficiency” strategies.

    And this will not become a lawsuit unless one can somehow prove there were damages to the pt which I could imagine might be hard to prove. It is so unethical and topics like this are not really even covered here so thoroughly such as this example. And can and I am sure have led to bad outcomes.

    • Patient Kit

      I’m sure it’s not just doctors who work for a hospital or some other form of Corp Med who write scripts and don’t thoroughly explain the risks and benefits and possible side effects to their patients. You’re not saying that private practice docs always take the time to explain more fully the drugs they prescribe to their patients, are you?

      • DeceasedMD

        I don’t know Kit. All I know is that in general what I see and hear is not the way it was taught to me.

      • SarahJ89

        I’ve certainly never had anything that remotely resembles informed consent. Side effects are never mentioned except in passing with a pained look that makes it clear they’re inconsequential. Alternatives? Rarely discussed. The amount of radiation in a CT scan? Fuggeddaboutit.

  • James O’Brien, M.D.

    Great article. I have been wondering about this for a while. Obviously they wouldn’t keep running ads that simply frightened people away.

    • profmichele

      The requirement to list the side effects was the agreement pharma made with the FDA to be allowed to advertise directly to the consumer. They knew, as this research showed, that consumers would focus on the benefits, not the potential risks, and they certainly do. Unfortunately.

  • Patient Kit

    Watching TV last night, the Humira ad came on and, with possible side effects like a compromised immune system, deadly infections and cancers — and a monthly cost of $1,700 (the price wasn’t in the TV commercial but the side effects were), it is hard to understand why people see that ad and want Humira.

    The line in all of the TV Pharma commercials for prescription drugs that always cracks me up is this: “Talk to or ask your doctor about ____________.”. :-D

  • SarahJ89

    Or… it’s handed to us, then taken back after we’ve signed we received it. The first few times this happened I was so taken aback I was struck dumb, but I quickly learned to say “I need a copy of this” *before* I sign anything.

  • SarahJ89

    It’s pretty sad that people are so unaware the listing of side effects is a legal obligation. And scary they misinterpret it as a sign of “integrity.” Ha!

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