In 1997, however, the Food and Drug Administration - encouraged by the Clinton administration - relaxed its rules on this issue. The pharmaceutical industry got a green light to bypass providers and market directly to consumers.
To gauge the effect of that change, just follow the money. The year before the ruling, drug companies spent $595 million on DTC advertising, according to the Food and Drug Law Journal. Within a year of the change, their spending rose to $844 million. By 2000, it shot up to $2.24 billion. And an August 2007 New England Journal of Medicine article put the total for all drug-related marketing in 2005 at $29.9 billion, with $4.1 billion spent annually on DTC advertising. That's more than $11 million a day.
Although "prescription drug spending remains a relatively small proportion (11 percent) of personal health care spending, it is one of its fastest-growing components, increasing at double-digit rates" between 1993 and 2001, says a 2003 Kaiser Foundation study.
If Congress is serious about lowering health care costs, including for vastly expensive (price-controlled) pharmaceuticals, it can start by reversing the 1997 FDA ruling and banning DTC advertising. That is because such costs are always passed on to providers, and then to patients, in the form of higher prices, co-pays and premiums. Even when insurance providers decline coverage for treatments such as "eyelash hypotrichosis," as mine does, they - and eventually consumers - end up subsidizing the treatments because the drug makers inflate prices on regimens that are covered. Above all, there are so many more urgent needs in pharmaceutical research, including dealing with the H1N1 virus and the spiraling rates of HIV infection.
Health care reform involves a lot more than the bottom line. It's also an opportunity to weigh priorities, push preventive care and re-establish our fundamental needs in public health. If the pharma ads on TV are any indication of our priorities, it's time for some serious discussion.
Meanwhile, to those desperate for thicker, longer lashes, may I suggest more mascara? Umpteen brands promise "volume express" and a "luscious, intense definition," whose only side effect is a lightening of the purse.
Christopher Lane is the author of, most recently, "Shyness: How Normal Behavior Became a Sickness." This article originally appeared in the Los Angeles Times.
