A Monster Headache

When the FDA relaxed the prescription-drug advertising rules a few years back, and drug commercials started punctuating prime time, I found myself feeling anxious.  Perhaps it was the implication that watching a commercial qualified me to diagnose my own symptoms and prescribe my own treatment, or maybe it was the laundry-list of possible side effects requisitely rattled off at the end of each spot, but the ads always made me a little nervous.

And though I’ve come to enjoy the nuanced artistry of the four-hour-erection warning, lately drug commercials have been making me very nervous.

This is because I always thought things like bacteria and viruses made you sick.

Turns out, it’s actually monsters.

For example, you probably believed that when you got a cold, naturally-occurring processes in your body led to congestion and the buildup of mucus in your system.  Actually, when you get a cold, Mr. Mucus, a trademarked, brown-green blob with a Samsonite, moves into your chest and makes your life miserable.

Fortunately, if you have to fight Mr. Mucus, there’s Mucinex, which is “safe and effective in helping to relieve chest congestion so you can cough more productively.”

Once you’ve kicked that unproductive coughing, you might start to worry about your discolored toenails.  Of course, you probably thought a fungus was to blame there, but you’d be wrong again -- that’s Digger the Dermatophyte™, a devilish-looking critter with a sour attitude who makes his home under your nails.

Digger is the star of a series of cringe-worthy commercials; in the worst of them, he lifts a toenail from a big toe like it’s a toilet seat and, cackling, climbs into the nail bed.

But Digger’s hardly a one-dimensional commercial star (and seriously, these spots are so painful, I wince every time I see them -- but if you’re feeling bold, go here and click on the “Get the Fast Facts” button) -- he’s also a touring artist.  Lamisil, the medicine that can send this dastardly Dermatophyte packing, is -- somewhat ironically, I suppose -- taking him on the road with the “Hit the Road Digger! Bus Tour.”

Should you be so lucky to have the tour roll through your town, you can get a free foot screening by a podiatrist, information about nail fungus you can take to your doctor, and best of all, a free photo of yourself taken with Digger the Dermatophyte.

Never before had I considered the Iowa State Fair a summertime draw, but lately, I find myself idly checking airfares to Des Moines.

And though a portrait of me with Digger would instantly merit a place of prominence above my mantel, that Dermatophyte is no Eczema Beast.

The Eczema Beast, if you’ve not yet met him, is a pink monster that looks like Grimace’s misshapen younger brother -- but instead of giving you fries and Shamrock Shakes, he gives you eczema.

A star in his own right, the Eczema Beast of course appears in his own commercial, but he’s also earned a mark of distinction reserved for the pathological elite -- he has his own plush toy.

Naturally, when I saw that a plush Eczema Beast existed, I had to have one.

As Eczema Beast dolls are not available in stores, I feverishly dialed the Protopic hotline (in another ironic twist, the medicine that claims to rid you of the Eczema Beast is giving away stuffed versions of it), anxious to have one of my very own.

The automated answering system asked if I was calling for myself or for a friend with eczema.

I haven’t talked to my one friend with eczema in two years, but I didn’t figure they would ask me to qualify the friendship, so I pushed the button that said I was calling for a friend.

They thanked me for my interest, and hung up on me.

Now, I’m generally honest to a fault, but there was a plush Eczema Beast on the line here.  I called back and lied.

For what it’s worth, I felt terrible doing it.

But is it unethical to lie to a drug pusher who would have you believe that a lumpy pink monster causes eczema?

Not to suggest that anybody in the pharmaceutical industry is worried about ethics or anything.

According to a recent story by Steve Wiegand and Dorsey Griffith in the Sacramento Bee, “Drug industry figures show that spending on consumer advertising quadrupled between 1996 and 2003, to $3.2 billion annually.  That’s twice the rate of increase of the industry’s spending on research and development over the same period.”

In other words, once drug companies were free to advertise on TV without “an exhaustive summary of [a drug’s] possible side effects, how it interacted with other drugs and how effective it was in clinical trials” and “only had to mention a few of the most prevalent potential side effects and provide a toll-free number, Web page or referral to a print ad,” the floodgates opened -- and through them marched these medical menaces.

What’s most troubling about these monsters -- and in the disease brigade, Mr. Mucus, Digger the Dermatophyte, and the Eczema Beast have numerous comrades, including Pneumin (a purple peanut-looking thing in a top hat whose real name is streptococcus pneumoniae; Prevnar will be happy to help you rid your child of him) and the Nighttime GERD Monster (GERD standing for Gastro Esophageal Reflux Disease, also known as acid reflux disease; if that horned beast is hounding you, Protonix claims it’ll tame him), just to name two -- is that they target two of our greatest societal weaknesses:  they play on our fears, and they dumb us down.

Now, I suspect -- and in my more cynical moments, “hope” would be the more accurate term here, but I’m feeling optimistic today -- I suspect that most adults understand that eczema is not, in fact, caused by fuzzy pink monsters, and that no matter what color your toenails, no horned goblins actually live beneath them.

But those monsters sure are a convenient way to oversimplify complex symptoms and diseases -- and to encourage people with nominal knowledge gleaned from 30-second commercials starring creepy cartoon critters to suggest, often vehemently, that their doctors, with their years of medical education, prescribe that monster-beating drug for what they think ails them.

Even assuming you’re savvy enough to realize that it’s not boogey monsters -- or, in the case of Mr. Mucus, boogie monsters -- that make you sick, these commercials are still ultimately designed to make you think there’s something wrong with you.

I understand that the fundamental conceit of advertising is to make you feel deficient, then deliver a product to cure your deficiency, but there’s a difference between convincing someone that their whites aren’t white enough and encouraging them to believe that the mild discomfort they’re experiencing is actually a disease in need of a prescription.

Until there was a marketing campaign for Viagra -- and now its brothers Levitra and Cialis -- erectile dysfunction was something most people had never heard of, and accordingly, four-hour hard-ons were not a public concern.  They are now.

To hear the drug companies tell it, their TV spots are more public service announcement than product advertisement.  But according to Wiegand and Griffith, “Some medical professionals blame the boom in drug ads for a host of deleterious side effects, ranging from ‘medicalizing’ normal conditions that don’t need treatment, to treating symptoms rather than underlying causes, to convincing people there’s a cure for everything.”

Is it any wonder, then, that the number of drug prescriptions has skyrocketed (between 1996 and 2004, overall prescription drug sales jumped from $85.3 billion to $229.4 billion, a 169 percent increase) right along with the number of pharmaceutical ads on TV?

As prescription expenses have risen, so has the cost of health care -- and now Congress has taken note.  Senate Majority Leader Bill Frist (R-TN) -- himself a former heart and lung surgeon -- has called for a two-year ban on direct-to-consumer advertising for new drugs.  “Research evidence indicates that this blitz in direct marketing has unwittingly led to inappropriate prescribing,” he told the Senate a few weeks ago.  “Let there be no mistake.  Drug advertisements are the fuel to America’s skyrocketing prescription drug costs.”

Of course, considering how much money is at stake -- in 2004 alone, pharmaceutical companies spent $4 billion on direct-to-consumer advertising, $128 million lobbying on Capitol Hill and another $17.4 million in campaign contributions -- I’m not holding my breath waiting for an act of Congress.

I am, however, going to keep checking on flights to Des Moines.  My Eczema Beast just arrived in the mail, and I think he’d look great in that portrait with me and Digger.