Harvard Health Ad Watch: A fibromyalgia treatment (“But you look so good!”)

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It’s one thing I’ve heard numerous occasions from sufferers with fibromyalgia. They’re telling a pal or member of the family about their situation and the response is, “However you don’t look sick” or “However you look so nicely.” Typically, the response is extra of an eye fixed roll or another response that displays skepticism that the issue is even “actual.”

These are points addressed head-on in a TV advert for Lyrica (pregabalin), a therapy for fibromyalgia. “To most individuals, I seem like most individuals,” a lady says. “However on the within I really feel continual, widespread ache.” After clarifying that the ache is actual, this direct-to-consumer drug commercial strikes on to say one of many present theories concerning the origin of ache in fibromyalgia is that it’s “considered attributable to overactive nerves.”

The temper of the advert is somber at first. Unhappy music serves as backdrop to a lady who’s clearly struggling as a person — maybe her husband? — performs within the park with two lovable youngsters. That every one modifications when she talks about taking Lyrica. Then the music soars and the voiceover tells us that “Lyrica is believed to calm these nerves.” The now-smiling girl appears to be like into the digicam and pronounces, “I’m glad my physician prescribed Lyrica.” The scene brightens and she or he’s smiling as she goes about establishing for a neighborhood block social gathering. The voiceover informs us that, “For some, Lyrica delivers efficient reduction for fibromyalgia ache and improves operate.”

Then comes the litany of uncomfortable side effects which may accompany therapy. Extra on these shortly.

The great

The advert will get a variety of issues proper, together with:

  • the truth that the situation could also be “invisible” to others
  • the notion that the reason for fibromyalgia is unknown, however specialists consider it could be as a consequence of “overactive nerves”
  • the character within the advert who has fibromyalgia is a lady — the truth is, the situation is as much as six occasions extra frequent in ladies than males
  • mentioning the dangers (and never simply advantages) of a drugs is vital. The commonest, and plenty of uncommon, potential uncomfortable side effects are described. Have in mind, although, that together with an outline of uncomfortable side effects or referring shoppers to extra data is required by the FDA, as I famous in my preliminary weblog on direct-to-consumer adverts describing professionals, cons, and phrases to think about very rigorously).

What’s lacking

Some vital data is lacking from this advert, together with:

  • The restricted effectiveness of the drug. Be aware the language within the advert: Lyrica works nicely “for some.” You would possibly surprise simply what number of “some” is! A current evaluation of previous research discovered that solely about 10% of handled research topics reported glorious outcomes, and solely about 40% reported superb or glorious outcomes. Lyrica was solely modestly higher than a placebo capsule. One other evaluation discovered that amongst prior research, solely 20% to 25% of research topics skilled “not less than 50% ache depth discount” inside two to 3 months of therapy.
  • The advert solely mentions one therapy possibility: treatment. However that’s not the one possibility. In truth, nondrug choices, resembling common train and improved sleep, are thought-about important for the profitable therapy of fibromyalgia.
  • No comparability to different drugs. A lot of different drugs are permitted and prescribed for fibromyalgia, but there’s no point out of how Lyrica measures as much as these different drugs prescribed. In response to a current assessment, Lyrica appears to be no higher (or worse) than different permitted drugs, together with milnacipran (Savella) and duloxetine (Cymbalta).
  • As with almost all drug adverts, the worth of the drug just isn’t talked about. In November, the worth of Lyrica was about $12 per 75-mg capsule, in response to Medication.com. The beneficial beginning dose is 75 mg twice each day, which provides as much as round $24/day or greater than $760/month. Typically, larger doses are wanted, which pushes the worth even larger. In fact, treatment prices are a shifting goal, as a result of medical insurance protection, copayments, deductibles, drug firm coupons, and different components could have an effect on the worth you pay.

The dangers of therapy

The checklist of uncomfortable side effects on this business is so lengthy that many (or maybe most) viewers will tune out. Whereas frequent uncomfortable side effects embody dizziness, sleepiness, weight acquire, or swelling of the extremities, “extreme allergic reactions” and “suicidal ideas or actions” are the primary ones talked about. These dangers are listed in opposition to a visually fascinating and splendidly distracting backdrop — on this advert, it’s large bubbles and puppies. Sure, bubbles and puppies! Perhaps offering a distraction from the checklist of issues that would go mistaken for those who take Lyrica just isn’t a coincidence. In truth, most drug adverts do that.

The underside line

Advertisements for medicine are usually not meant to be thorough or balanced. Their intent is to extend gross sales of their drug. Drug makers typically discuss concerning the significance of those adverts to teach the general public about therapy choices. However the apparent (and comprehensible) bias towards the drug being marketed — Lyrica, on this case — makes the standard of the training suspect. That’s why I’m against direct promoting to shoppers for drugs and medical procedures, and that’s in all probability a cause most nations don’t enable it.

Sure, fibromyalgia is an actual and troublesome situation that’s invisible to others. However treatment therapy, resembling Lyrica, is just one a part of commonplace therapy. And it’s not at all times efficient. Need extra full and balanced details about fibromyalgia? Speak to your physician or seek the advice of unbiased sources that aren’t attempting to promote you something. A pharmaceutical commercial is probably not your finest wager.

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