...what a great salesperson!

It seems like every commercial on TV is for a prescription drug. And yet consumers can't buy them without a doctor's approval. So why target consumers with these ads? Here's how the U.S. became one of the only countries in the world where pharmaceutical companies peddle drugs to ordinary people.

FDA loopholes...

The United States and New Zealand are the only countries in the world that allow direct-to-consumer advertising of pharmaceuticals. Most countries banned the practice in the 1940s. The direct-to-consumer market was pioneered not in a corporate boardroom, but by Joe Davis, a regular salesman who sold packaged goods.  At the time, pharmaceutical companies marketed only to physicians through print mailings, visits, and free samples, with the patient knowing little about the drugs they were taking. The physician told them what to take, and they followed directions.

Davis went to his friend, an executive at the medical advertising company Medicus in the mid-1980s. The advertising problem was that the FDA required any drug ad to include a full list of possible side-effects, which often took several pages of tiny print....hard to do that in a TV spot.

So the two devised a way to recommend drugs in ads that did not mention the name of the medication, but only the positive effects of a hypothetical drug with the exact attributes of a specific pharmaceutical. Commercials ended with instructions for the consumer to 'see their doctor' for more information. By omitting the name of the drug, the two were able to slide their ads through a loophole in FDA regulations.

The unnamed drug they marketed was Seldane, which they tagged as an "antihistamine that did not cause drowsiness." When patients asked doctors for this exact type of drug, they got Seldane. Over the next few years, Seldane went from sales of $34 million a year in 1985, to $800 million per year. (Seldane, interestingly, was removed from the U.S. market in 1997 after it was found that the drug could cause heart arrhythmias.)

Advertising to consumers puts physicians under a new kind of pressure. If they want to keep you as a patient, and if giving a prescription for a drug that you asked for keeps you happy, they might do it.

Pharmaceutical commercials often have a strangeness as well, dominated by cartoons, unusual scenes, 'blankets with eyes,' and just about anything that can be done to convey a general sense of wellness and direct you to your physician.

The Nielsen Company determined that there are, on average, 80 drug commercials every hour of every day on television. Say it ain't so Joe.....

Side effects may include...

Commercials that advertise prescription medicines on TV are my pet peeve. Doctors should be prescribing the drugs people need without the rest of the world being subjected to these irritating commercials. I’m sure many others agree with me. Chances are you've seen more prescription drug commercials than you can count — Viagra, Cymbalta, Celebrex, and Yaz are just a few that I can name from memory. Oh yeah, Yaz!

Yaz, a birth control pill may be linked to several serious side effects such as strokes, blood clots and heart attacks, has been the subject of a misleading marketing campaign. Deceptive Yaz commercials prompted the Food & Drug Administration (FDA) to issue Bayer a warning letter, and the company was forced to correct its false advertising. Unfortunately, the correction came too late for many women who had believed Bayer's false Yaz promises. When I was younger, you used a rubber and guess what? No side effects.

The ads are pervasive and influential and pharmaceutical companies know that. From 1997 to 2005, drug companies tripled their spending in television ad campaigns from $1.3 billion to $4.2 billion. In 2008 that number bumped up even further to $5.6 billion.

Though the ads do inform consumers of what's available to them, health advocates say they present drugs and symptoms in very general terms and can confuse consumers into thinking they have something they don't. A national study found that one-third of all Americans have asked for a drug they saw on a commercial and of those that asked, 82 percent were given a prescription of some sort. Let's ask Michael Jackson how well that went for him...oh yeah, it KILLED him.

Only the United States and New Zealand allow pharmaceutical companies to advertise their medications directly to consumers, according to the FDA.

And don't forget. Side effects may include: Allergic skin reactions, including hives, blurred vision and vision changes, drowsiness, dry mouth, fluttery heartbeat, headache, high body temperature, mental confusion (especially in the elderly), nausea, nervousness, painful or difficult urination.

Rapid heartbeat, vertigo, vomiting, abdominal pain, chest pain, constipation, cough, diarrhea, dizziness, fatigue, flu-like symptoms, gas, heartburn, inflammation of nasal passages, muscle aching or weakness, possible involvement in formation of stomach ulcers and bleeding, rash, small amounts of blood in stool, stomach or intestinal discomfort.

Tiredness, impaired coordination, irritability, memory impairment, lightheadedness, joint pain, trouble sleeping (insomnia), anxiety, abnormal involuntary movements, decreased or increased sexual drive, depression, confusion, muscle twitching, weakness, fainting, numbness, increased or decreased salivation, stomach pain, upper respiratory tract infection, ringing in the ears, fast heartbeat, chest pain, sweating, change in appetite, weight loss or gain, menstrual disorders, sexual dysfunction, water retention, accidental injury, back pain, bone/joint pain.

Cases of life-threatening liver failure have been reported. As well as, malaise, muscle ache, pain, redness, or swelling at the injection site, signs of severe allergic reactions, ringing in the ears, difficulty breathing, and swelling of the throat. Gastrointestinal symptoms (such as abdominal cramps and bloating), breakthrough bleeding, spotting, change in menstrual flow, amenorrhea, temporary infertility after discontinuation of treatment, edema, melasma that may persist, breast changes (tenderness, enlargement, secretion),change in weight or appetite, migraine, mood changes (including depression).

Gallbladder disease, hepatic adenomas, benign liver tumor. Dizziness, flushing, headache, indigestion, runny or stuffy nose, body pain, abnormalities in thinking, decreased libido, runny nose, sore throat. Constipation, cough, vaginal itching or burning, increased vaginal discharge, stomach discomfort, cramps, skin rash, headache. abdominal cramps, bloating, breast enlargement, breast tenderness and secretions, change in amount of cervical secretion, changes in vaginal bleeding patterns, chorea (irregular, rapid, jerky movements, usually affecting the face and limbs), depression, enlargement of benign tumors, excessive hairiness.

Hair loss, inability to use contact lenses, reduced ability to tolerate carbohydrates, spotty darkening of the skin, especially around the face, skin eruptions (especially on the legs and arms) with bleeding, skin irritation, skin redness and scaling, vaginal yeast infection, yellow eyes and skin, hepatitis, light headedness, inflammation of the esophagus, burning/tingling/prickly sensation on the skin, cold/warm sensation, neck/throat/jaw pain, increased blood sugar, unusual taste in the mouth, nipple soreness , swelling of the face, extremities, eyes, lips, tongue, delirium, difficulty in swallowing or breathing, irregular and unpredictable bleeding, vaginitis (inflammation of the vagina), weight gain, acne, viral infections such as colds, sore throat, sinus infection, mood swings, pain at the site of insertion.

More serious side effects may include: coughing blood, or sudden shortness of breath (possible clot in the lung); persistent pain in the calf (possible clot in the leg); crushing chest pain or heaviness in the chest (possible heart attack); sudden severe headache or vomiting, numbness in an arm or leg (possible stroke); sudden partial or complete blindness (possible clot in the eye); yellowing of the skin or whites of the eyes (jaundice), especially with fever, tiredness, loss of appetite, dark colored urine, or light colored bowel movements (possible liver problems); severe pain, swelling, or tenderness in the abdomen (possibly indicating an ectopic pregnancy, a ruptured or twisted ovarian follicle, or gallbladder or liver problems); breast lumps; difficulty sleeping, weakness, lack of energy, tiredness, or sadness (possible severe depression); heavy vaginal bleeding.

Priapism, or an erection that won't go away, is an uncommon but serious side effect . If you get an erection that lasts more than 4 hours, you should get medical help right away. If any of these events occur, seek immediate medical attention.

Can you say over-medicated?