The Problem with Jarvik's Prescription

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Do you trust Robert Jarvik's medical advice? His rowing tips?

For nearly two years, millions of Americans have seen television ads featuring artificial heart inventor Robert Jarvik touting the benefits of the cholesterol-lowering medication Lipitor. No longer. On Monday, Lipitor's maker, Pfizer, decided to pull the $139 million campaign after a Congressional committee raised questions about Jarvik's qualifications as pitchman.

"The way in which we presented Dr. Jarvik in these ads has, unfortunately, led to misimpression and distractions," Pfizer said in a statement released Monday. "Going forward, we commit to ensuring there is greater clarity in our advertising regarding the presentation of spokespeople."

At issue is the fact that Jarvik, while a graduate of medical school, is not licensed to practice medicine, and therefore not legally able to write prescriptions for medications. In the ads, he admits to taking Lipitor himself, and appears to give medical advice as a practicing physician. "We chose ["Dr. Jarvik"] because he is a well respected heart expert, inventor of the Jarvik heart, and we thought it was appropriate because he is well respected in the area of cardiology and vascular research," Vanessa Aristede, director of corporate communications at Pfizer, told TIME. In defending his decision to become a spokesperson for Lipitor, Jarvik last month said in a statement on his company's website, "I do not practice clinical medicine and hence do not treat individual patients. My career is in medical science. I have the training, experience and medical knowledge to understand the conclusions of the extensive clinical trials that have been conducted to study the safety and effectiveness of Lipitor."

Making matters worse, early ads featured Jarvik rowing on a serene lake, but Jarvik, according to colleagues, does not row. The segments apparently featured a body double, a photographer and avid rower who wrote about his experience subbing for Jarvik in a newsletter published by his Washington rowing club.

The Lipitor ads are certainly not the first to rely on stretching the consumer's belief — others have featured actors posing as doctors, or lesser-known doctors endorsing everything from diet aids to nutritional supplements. But Jarvik is recognized for his work in developing the artificial heart, and to a patient, his stature in the field undeniably lends credibility to every statement he makes about Lipitor. It's certainly a big part of the reason that Pfizer signed him to a two-year, $1.35 million contract.

But the Lipitor ads are only a lightning rod for a growing concern about how prescription drugs are advertised to the public. While patients cannot purchase the drugs on their own, they can — and do — approach their doctors about certain medications they see touted on television or in magazines. Seeing celebrities or other well-known figures endorsing a drug may make a medication all the more appealing. That's why Representatives John Dingell and Bart Stupak, both of Michigan, and the House Energy and Commerce Committee decided last month to investigate how truthful this celebrity-driven drug advertising is — and hope to expose, as in Jarvik's case, instances when the truth is stretched too far.

When products as serious as medications, which can have dangerous side effects, are marketed directly to the public, who should monitor the claims, and how? Bioethicist Katie Watson at Northwestern University notes that the blame for misleading ads such as Pfizer's doesn't always lie with one party. "We have an oil and water situation where we have our drug development and sales done on a free market model in the same way we sell cars and refrigerators," she says. "But our medical care is done on a fiduciary duty, privacy and trust model. We throw those two together and we act surprised that we have conflicts of interest. We have a cognitive dissonance in America where we want the free market and we also want our physicians and everything involved in our health to be loyal to us as individuals. It's hard to have both."

Ostensibly, the Food and Drug Administration (FDA) is charged with protecting the safety of our health and the drugs we take. But the already misfit pairing of the free market pharmaceutical industry with the trust-based medical care model was further strained when the FDA approved direct-to-consumer advertising for drugs in 1997. That allowed pharmaceutical companies to use advertising as a guise for educating patients. While patients feel more knowledgeable about diseases and their options for treating them, where does that information come from? In most cases, it's from industry-sponsored advertising, notes Watson. "The pharmaceutical marketing departments have appropriated the language of the empowered autonomous patient in the service of sales," she says. Moreover, while the FDA can request that pharmaceutical companies provide ads for the agency to review before airing, it does not have the authority to enforce this request. An agency spokesperson estimated that only one-third of such ads are actually reviewed by the FDA before airing. A proposal to increase funding for the FDA to conduct more such reviews was rejected last month.

Which means that, as with any marketed product, the buyer should always beware when it comes to drug ads. "We are taking a hard look at the deceptive tactics of drug companies in their direct-to-consumer advertising," said Stupak in a press release. But ultimately it's up to the consumer and his doctor to decide how much of the truth in advertising to believe.