Drug Deals


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Amongst true connoisseurs of female beauty, it has long been a well-known fact that the otherwise stunning Brooke Shields had been cursed with one striking flaw: puny, stick-thin eyelashes that resembled the legs of a sickly spider. But no more: The disease of “inadequate” lashes now has a cure, and as Shields explains in a recent TV commercial, that cure is called Latisse. Although Latisse sounds like either an upscale brand of French mascara or a Sunset Strip hooker, it is in fact a prescription drug that you brush on your scrawny lashes, like extremely specialized Rogaine. In her commercial for the product, Shields testifies that Latisse has made her lashes longer, thicker, and darker. If the accompanying visuals are any indication, it has also given her the confidence to boogie with prim, cautious abandon at fictional birthday parties. Score one for modern medicine!

Soon, however, federal regulators might come between Shields and her pharmacologically bulked up eyelashes. While commercials like Shields’ pitch for Latisse have graced television airwaves since 1997. That’s when a change in Food and Drug Administration policy first made it feasible for pharmaceutical companies to hawk their products in explicit fashion, instead of just mentioning a product’s name and encouraging consumers to ask their doctor about it. Such ads remain controversial, and the U.S. is the only nation in the world that allows this kind of advertising. In order to comply with federal regulations, prescription drug advertisers must “present a true statement of information in brief summary relating to [the] side effects, contraindications, and effectiveness” of their products. In other words, they can’t just talk benefits. They’re also compelled to reveal dangerous complications that might arise, common side effects, precautions that should be taken with usage, etc. Advertisers are expected to convey this information in a prominent, understandable manner, and they also have to include some means by which consumers can obtain more comprehensive information about the drug and its effects — i.e., a toll-free number, a Web page, or a print advertisement (which is why virtually every erectile dysfunction drug advises viewers to see its ad in Golf magazine).

But while the regulation governing prescription drug advertising runs to approximately 5,000 words and is quite explicit it in prohibition of commercials that are “false, lacking in balance, or otherwise misleading,” the text is ultimately vague enough to leave advertising agencies plenty of literary and cinematic license: Over the last 12 years, advertisers have honed the art of presenting information in a prominent, understandable manner that is simultaneously easy to ignore.

Two months ago, in an effort to combat this phenomenon, the FDA published a “guidance document” (PDF) that elaborates on the practices advertisers should follow to comply with the law. In it, the FDA asserts that “inconsistent tone or images” and “busy scenes, frequent scene changes, vivid and compelling visuals and moving camera angles [that] can misleadingly minimize the risks of the product being promoted” may be enough to establish a commercial as “false and misleading,” and, consequently, illegal.

At this point, the new guidance document is not yet official FDA policy but merely a “draft.” To get a sense of the impact should it become official FDA policy, imagine how it might be applied to Brooke Shields’ Latisse commercial. The ad currently starts out with a series of simple, declarative statements that are both spoken by an unseen narrator and displayed on screen in a large, highly legible typeface. “Grow lashes,” it begins. “Grow lashes. Grow longer. Grow fuller. And darker lashes.” There are brief pauses between each declaration, and while the imagery cuts quickly between shots of text and various close-ups of Shields’ face and her newly voluptuous lashes, this section is easy to follow.

About halfway through the commercial, however, which is the point at which viewer interest is most likely to wane according to cognitive scientists, the action accelerates. Suddenly, Shields is at a birthday party, greeting friends, chatting up a handsome stranger on a couch.  At 35 seconds into the spot, she breaks out into a dazzling smile. What’s she so happy about? The off-screen narrator is delivering some alarming information about Latisse: “May cause eyelid skin darkening, which may be reversible.” Moments later, Shields is dancing and continuing to enjoy herself. “And there is potential for increased brown iris pigmentation, which is likely permanent,” the narrator advises.

Inconsistent tone or images? Check. Busy scenes, frequent scene changes, vivid and compelling images? Check, check, check. But should this ad and others that employ similar techniques really be illegal? In their short 12-year life, prescription drug ads have proven to be highly effective at increasing sales.  In 1996, consumers spent $85.4 billion, or $116.06 billion in 2008 dollars, on prescription drugs. In 2008, that number had increased to $291 billion. Critics of prescription drug ads contend that one reason they’re so effective is because they’re so misleading. But while it’s true that few prescription drug ads, if any, go out of their way to call attention to the shortcomings of their products, there’s an alternate explanation for their success: Prescription drug ads are amongst the most honest content that appears on TV.

Indeed, it doesn’t matter if you’re watching a Sopranos rerun, a detergent commercial, or American Idol — television typically depicts life in a highly idealized form. Sure, people get murdered by lovable mob bosses and insulted by Simon Cowell far more frequently on TV than they do in real life, but at least the world TV presents is a glamorous, fast-paced, exciting one. The sub-domain of prescription drug ads presents an exception, however: Beneath its superficial gloss of backyard whiffleball games and geriatric foreplay in postcard-perfect locales, a bleak universe lurks. Everyone’s depressed. No one’s genitalia works. People spend their lives sneezing and sniffling, peeing at inopportune times, and staring sleeplessly at the ceiling until they die of heart disease

In addition, the positive spin they attempt to put on the grim, quotidian indignities of life is extremely transparent. Indeed, parodies of prescription drug ads abound at sites like YouTube, and it’s not because the ads are so ingeniously deceptive that no one can crack the codes by which they operate. Instead, it’s because such ads are compelled by law to blurt out truths whose unseemliness is only intensified by doomed efforts to maintain a sense of normalcy. Ultimately, there is just no way to casually impart the knowledge that Mirapex, the cure for Restless Leg Syndrome, may cause you to “experience increased gambling, sexual, or other intense urges.” Or that the anti-depressant Abilify might leave with you “uncontrollable muscle movements [that] could be come permanent.”

Until automobile ads start routinely including information about how often drivers are killed or injured, or Anheuser-Busch gives you a calm head’s-up about the increased gambling, sexual, or other intense urges a 12-pack of Budweiser can inspire, prescription drug ads will stand as benchmarks of candor. The small print that identifies Brooke Shields as a “compensated spokesperson” during the midst of the Latisse commercial may not be particularly large, but it’s as big as a billboard compared to the microscopic disclaimers that typically infest the bottom of the screen at the end of commercials for Progressive Insurance, Sprint, and countless other advertisers.

Thus, while the FDA ponders whether or not to make Brooke Shields illegal — if she’s not a vivid and compelling image, what is? — other advertisers should probably consider adopting the methods prescription drugs ads employ. After all, prescription drugs are not an easy sell. To buy them, you have to schedule at least one doctor’s appointment (and possibly more); attend that appointment; convince your know-it-all primary care physician to write a prescription for your self-diagnosis; submit that prescription to your local pharmacy; and finally, at last, pick it up. In the world of one-click Internet shopping, that’s the retail equivalent of an Ironman triathlon.

And yet millions of consumers go through all that trouble anyway. Apparently there is something incredibly persuasive about issuing dire warnings about all the ways your product might harm consumers. And soberly noting its limitations. And acknowledging that it’s not for everyone.  Which of course makes a lot of sense. Such tactics establish credibility and exclusivity. If every ad on TV functioned like a prescription drug ad, our ailing economy might finally get some real relief. • 15 July 2009