Attorneys spend millions of dollars each year on ads to recruit people who may have been injured by a drug or device. Some of these fear-mongering ads frighten people to stop taking medications that can help prevent life-threatening problems like blood clots.
It’s time these ads come with a warning.
Given their television-viewing habits, older adults are easy targets for such ads and infomercials. The Nielsen Company reports that adults aged 65 and older spend an average of seven hours a day in front of the TV. And they often absorb the message.
A 2017 survey by Public Opinion Strategies found that more than half of respondents said they would be “very concerned” if they saw a lawsuit ad about a drug they were taking. One in four said they would stop taking it immediately without consulting their doctor.
Their concerns aren’t just hypothetical. A review by the Food and Drug Administration of its Adverse Event Reporting System database identified 213 reports in which individuals saw a lawsuit ad, stopped taking their medication, and experienced a health problem. The summary, provided in a Feb. 6, 2019 letter to Rep. (and physician) Andy Harris (R-Md.), who had requested the FDA review, included 32 reports of strokes, two transient ischemic attacks (also known as mini-strokes), and 11 reports of blood clots among individuals who stopped taking anticoagulants after watching these ads. Their average age was 81.
Atrial fibrillation (A-fib) is the most common type of irregular heartbeat, affecting as many as 6 million Americans. It can cause blood clots to form in the heart and then travel to the brain, causing a stroke. People with A-fib are five times more likely to have a stroke than those without the disease; such strokes are twice as likely to occur among African-Americans as among whites. Strokes related to A-fib are also more severe than other types of stroke: Individuals with the condition are more likely to die from a stroke and twice as likely to become bedridden compared to people who have strokes due to other causes.
Anticoagulant medications like Pradaxa, Eliquis, Xarelto, and warfarin prevent blood clots from forming in the heart and bloodstream, and are highly effective at reducing stroke risk. Although they also increase the risk of bleeding, the FDA has determined that when it comes to stroke reduction in A-fib, the benefits of taking these medications almost always outweigh the risks.
Medical lawsuit ads are not usually tied to firm scientific evidence indicating a problem. In the case of A-fib, the public was inundated with hundreds of thousands of lawsuit ads after the FDA released results in 2011 suggesting merely the possibility of an association between one anticoagulant and severe bleeding events. Between 2012 and 2014, thousands of lawsuits were filed in federal courts, most of which were resolved by a settlement in 2014.
Medical lawsuit ads give the clear impression that the products they describe are neither safe nor effective. It would be reasonable for any viewer to conclude that their medication is too dangerous to take when, in fact, it is approved by the FDA, prescribed by a doctor or other health care provider, and saves lives. These advertising tactics create a new group of victims: people whose health has been harmed by the ads.
The American Medical Association became so concerned with the surge in medical lawsuit advertising that it called on lawyers to better regulate fear-mongering commercials. “The onslaught of attorney ads has the potential to frighten patients and place fear between them and their doctor,” the organization said in a resolution.
AARP sent out a fraud alert last year about attorney ads soliciting older adults to join class action lawsuits if they have taken certain medications, noting the “surge in television, radio and internet ads from law firms and lawsuit marketing companies is causing some patients to take serious risks.”
While TV, radio, and other media ads technically fall under the jurisdiction of the Federal Trade Commission, it has never pursued an investigation or taken action against attorney ads.
We urge the FTC to work with the FDA on a framework of regulations that requires this kind of advertising to convey, both verbally and visually, that individuals should never stop taking prescribed medications without conferring with their health care providers. The ads should also be required to state the FDA-approved indication for the medication (such as preventing stroke in people with A-fib) and include factual information regarding the risk of the condition. Ads that fail to follow these requirements should not be allowed to air.
Policymakers responsible for protecting the public’s health and safety should work to ensure that medical lawsuit ads aren’t the source of new injuries as they try to recruit individuals who may have legitimately suffered from the use of a drug or device. Until then, everyone — especially seniors — should be aware of the exaggerations in these ads and not stop taking a targeted medication without first checking with a health care provider.
F. Roosevelt Gilliam III, M.D., is the chief science officer for the Association of Black Cardiologists, a clinical professor of medicine at the University of South Carolina School of Medicine, and a cardiologist with Palmetto Heart in Columbia, S.C. Susan Peschin is president and CEO of the Alliance for Aging Research in Washington, D.C. Both organizations receive funding from companies that make anticoagulants, including Bristol-Myers Squibb, Janssen, and Pfizer (PFE), and the Association of Black Cardiologists also receives funding from Boehringer Ingelheim.