Are Pharmaceutical Companies Targeting Kids?

As nurse practitioners, we're far too familiar with the influence that drug companies have on our patients. Asking for medications by name, patients often come to us knowing exactly what they want. They are influenced by friends, family, or marketing campaigns. While marketing efforts by pharmaceutical companies aren't inherently a bad thing, drugs help billions of people, the tactics of these companies have been called into question. Recently, the issue has taken on new light given it's effect on increasingly younger populations. 

According to a 2010 MEDCO Drug Trend Report, children who are covered by health insurance are the drug industry’s fastest growing market. In fact, from 2001 to 2010 the growth in children’s prescription drug use rose at a rate four times higher than the rise seen in the overall population. Likewise, prescription drug spending on children’s medication increased by 10.8% over the course of the decade. Perhaps what is most alarming about the findings is that more than one-in-four children take medication on a regular basis to treat ongoing health conditions; specifically atypical antipsychotics for severe mental disorders and a variety of medications for the treatment of chronic conditions not typically associated with children like type 2 diabetes, hypertension, and asthma.

Coincidentally, in 2009 the FDA gave several large drug companies the go-ahead to expand the use of certain adult medications for children, particularly medications for cholesterol control, migraines, hypertension, as well as atypical antipsychotic medications, of which are known to come with serious side effects including extreme weight gain. Although supporters of the FDA’s approval say that it has allowed providers more options as well as peace of mind in prescribing medications for pediatric patients (as opposed to having to calculate the proper dosage of adult drugs, etc.), strong opponents have argued that the approval from the US government has allowed drug manufacturers to exploit children in order to meet industry marketing goals.

While the statistics found in the 2010 report have stayed relatively steady since the MEDCO report came out, a separate study in 2013 found that children between the ages of 2 and 5 are the pharmaceutical industry’s fastest growing market for antipsychotics. With insurance companies now covering more of the cost of prescription drugs, the pharmaceutical industry has undoubtedly continued to profit on the growing number of children requiring continued use of medication, and it seems they know just how to keep it flowing by target marketing their number one consumers: kids.

According to a 2016 STAT examination, drug companies are framing their efforts as a service to children with so-called educational initiatives, claiming that their materials (in the form of lesson plans, comic books, smart phone apps and sponsored events) are aimed at informing the youth of certain health conditions; conditions for which the sponsoring pharmaceutical companies just so happen to manufacture treatments for. The drug industry and their supporters argue that such efforts are to strictly serve educational purposes. But as many other providers and educators argue, the sponsorship of such materials creates a serious conflict of interest and is unethical, concluding that the drug company's ultimate goals through these initiatives are to create brand recognition amongst children. Just as a child would ask for a specific brand of cereal or clothing, so will he or she ask for a specific medication.

Take for example a Pfizer-sponsored meningitis worksheet said to be an educational tool in teaching high school students about meningitis outbreaks on college campuses. The worksheet includes a true or false quiz about the virus, but the bottom of every page includes the statement, “Check with your doctor about getting vaccinated,” with a small Pfizer logo. Pfizer happens to market one of two vaccines that which protects against meningitis.

In another example, a company called Medikidz produces comic books aimed at explaining medical conditions like ADHD, type 1 diabetes and growth hormone deficiencies. While the company does use doctors to write and peer-review each edition, the editions are often sponsored by drug companies that sell medications for the “featured” condition; such as an ADHD-themed comic book sponsored by Shire, which markets several ADHD drugs. Medikids defends that there is never any mention of a specific medication, but the comics do discuss the potential benefits of medications. On the other hand, they also mention the side effects as well as alternative methods of treatment such as therapy and counseling for certain conditions. It is estimated that over 3.5 million comic books have been distributed.

Other companies have begun using technology and social media as a way to reach kids. For example, Sanofi has released a smartphone app that features a game aimed at kids with type 1 diabetes, of which the drug company markets treatments for. Over the counter acne medications and even birth control have been marketed to teens through ads on social media platforms as well as TV. Even when the marketing strategies are not aimed directly at children, kids are still being exposed to such pharmaceutical advertisements. In fact, a 2013 study found that children viewed TV ads for erectile dysfunction drugs Viagra, Cialis, and Levitra an estimated 30 billion times between 2006 and 2010.Some of these marketing efforts have caught the attention of the FDA, and the agency has launched a study to evaluate how teens perceive risks and benefits for ads for acne and ADHD drugs.

As nurse practitioners, we must be aware of these marketing and prescribing trends to help our patients cut through the 'noise' and determine which treatments are in their best interest. This is particularly true for pediatric patients who are easily influenced by media and also establishing health habits for the future. In our patient's bodies who are still rapidly developing, it's our responsibility as NPs to help them grow into adulthood as safely and healthfully as possible. We walk a fine line as prescribers when it comes to treating pediatric patients. 
 
Nurse practitioners, what do you think about the growing pharmaceutical influence on children and adolescents?
 
 
 

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