December 6, 2007--Stocking Stuffer

I’ve managed to get used to those TV ads that picture a naked man and a naked woman holding hands while immersed in separate side-by-side bathtubs set in a verdant meadow. I like the mood music and the frankness of the approach—if the man had popped a Cialis pill as long as 36 hours ago, the voice-over assures, he would even now be ready to go at it.

It’s pleasant to picture myself in one of those tubs and, in spite of the warning that the pill could induce Priapism (a four-hour erection), with its assistance I think I can handle both her and that troubling side effect.

So you can only imagine how eager I was the other day while watching the Dallas Cowboys overwhelm the NY Giants to see a new ad for another medical product. This was NFL football and I knew it wouldn’t be for ways to treat osteoporosis. They had just run a series of ED commercial and I was wondering what this Cypher thing was.

As I remember the ad, it showed a guy of about my age sitting on his living room couch, maybe tuned in as I was to a Sunday afternoon football game. Hovering in the background was a woman who I assumed was his wife. Here we go again I thought. But he appeared not to be randy. Coughing and wheezing, it was clear that he was in some distress. Ah, I thought, it’s flu season and this Cypher-whatever is probably another mucous medication, a Musinex competitor. Or maybe it's a new Christmas gift item.

Losing interest, I reached around behind me to grab another bottle of Bud. But out of the corner of my eye, with the sound muted, looming on the screen was a luminous, rotating image of what appeared to me to be a small section of a mesh garden hose.

Intrigued now, I switched the sound back on and learned that Cypher is a “drug-eluting” stent that can be inserted into coronary arteries to alleviate chest pains and shortness of breath, both symptoms of heart disease.

This, I thought, they’re advertising on TV?

But I quickly concluded that if half the so-called entertainment shows on television are about medical subjects, including forensic medicine and plastic surgery, and more and more of the commercials are for prescription and non-prescription medications, why not then ads for stents?

I later learned from an article in the New York Times (linked below) that the Cypher company, a division of Johnson & Johnson (a Johnson incidentally, “Woody.” Is the owner of the NY Jets), plans to run this ad, titled “Life Wide Open”—get it--nearly 200 times during subsequent NFL games. I guess the assumption is that guys get so excited watching pro football that they give themselves chest pains and thus this is an ideal ad placement opportunity.

Beyond the silliness, there are medical complexities about the value and safety of stents; and although the Cypher ad and the Cialis ads and the ubiquitous Lipitor ads all include various warnings about potential side effects, these passing cautions are inadequate. If all you care about is getting it up, a little warning about Cialis potentially causing blindness or Lipitor kidney failure isn’t going to stop you. But the Cypher spot doesn’t even allude to the fact that many cardiologists feel that stenting is far from the best treatment in a significant number of cases.

This direct-to-consumer medical marketing, many feel, is leading to considerable over-prescribing. When patients come in to see their doctors and pressure them to give them a drug that they’ve seen advertised on TV, it isn’t easy for an over-busy physician not to just take out his or her pad and begin to write script.