NATIONWIDE — When you’re not streaming your favorite detective program—when you’ve switched to network television—it’s hard to miss all those drug ads hawking the merits of a new medication.

The brand name is often unpronounceable, lacking vowels and loaded with Xs,Ys or Zs. 

The drug’s target might be unfamiliar to you, not to mention its three-letter acronym assigned to the condition being treated. 

The 30-second TV segments come with a six-figure cost for air time alone and many thousands of dollars more in production costs. 

The sufferers of chronic and life-threatening illness in these ads seem as happy as the narrator, who is at times accompanied by a spirited marching band, as he lists the benefits of the product. They might even have you beginning to think that having stage 4 cancer or myasthenia gravis is a happy place to be. 

A softer, lower-pitched voice presents the significant risks that may accompany the use of the drug. The most serious risks (e.g. deaths, critical illness) are noted as events that “have happened.”  

You are then advised to inform your “provider” about other conditions you have that could interfere with the efficacy of the new product. This bit of advice can be particularly aggravating to any primary care internist listening.  He/she might ask, “Why would my patient think I hadn’t taken a complete history and done a physical exam during the first visit?” 

The advice reveals at least a lack of confidence in “providers” and is most likely a defense against potential litigation.

As commercials go, though, drug ads are second to insurance-industry spots in entertainment value, and they do provide a revealing picture of our current health care system.

Americans get less than they pay for in health care dollars. Drug costs in the U.S. are more than twice that of comparable nations. The corporations developing and producing those medications can afford to purchase a multimillion-dollar barrage of ads. The corporate leadership of “Big Pharma” views the expense of direct-to-consumer marketing as part of the cost of doing business, since their competitors are doing the same. 

Yet it is the public that ultimately pays the price. The ads currently waste health care resources and are at best an inefficient means of promoting population health.

The impact of scientific achievements of the past decade should not be underestimated. Drug ads do their part to proclaim the benefits of that remarkable work. Many of the drugs, however, are “me too” drugs that are chiefly competing for a share of an extremely small market of patients with rare, serious conditions. Other products have clearly had a significant impact on the national burden of chronic illness, obesity or hospitalization. 

Great progress, but the timing is off. Many of the heavily advertised agents are aimed at patients with established chronic disorders. Our current system is heavily weighted toward “secondary” and “tertiary care,” that is, treatment of common illness by specialists and hospital-based intervention respectively.  

Preventive measures and “primary care” (e.g. internal medicine, pediatrics, geriatrics, palliative care) are not adequately supported and medical school graduates are not choosing this path.

The ideal approach to chronic illnesses is prevention. Many preventive strategies are based on effective communication. Why don’t we spend more time, effort and money on flashy public health messages?