Why Drug Side Effects Shouldn’t Be Public Knowledge

Skyler Simpkins ’23

Opinion Editor

The world of pharmaceuticals eludes us; it always has and probably always will. We are often left in the dust, incapable of understanding the rapid proliferation of new drug names and the exponential increase in prices following new developments. While there are many needed discussions that revolve around pharmaceuticals such as price, use of animals in testing, and the large role Big Pharma has in our economy, today I instead want to discuss something that goes under the radar: nonspecific drug effects. More specifically, nonspecific effects regarding disclosure of side effect symptoms.

The rapid speech at the end of the drug commercial, spoken with such enunciation yet seemingly murmured at the same time due only to the pace of the words, has become a hallmark of drug advertising. Of course, companies would like to exclude information about potentially harmful (or even lethal) side effects, but FDA regulation requires disclosure of such things to the public. While this might seem like a win on the side of the public, is it actually? On the positive side, we are hearing about the potential harm to be endured when we sign on to a new pharmaceutical regimen, but it is in the functioning of our own brains that the disclosure of side effects might actually cause us more harm. This factor lies under a blanketed term regarding all reactions to a drug not biologically engineered known as nonspecific drug effects. 

More specifically, all phenomena illustrating anxiety that is expectation-induced is referred to as the “nocebo” effect. When we hear the list of potential side effects, most of us compile a plethora of negative expectations with the use of a drug. These expectations can induce anxiety in treatment creating a hyperbolic inner state wherein your expectations are producing the biological effects mimicking the side effects of the drug. As a matter of fact, in trials where a control group receives a placebo, negative side effects are often reported to a greater degree than the experimental group. In addition, anti-anxiety drugs have been proven to reduce the side effects reported by the control group. Expectation-induced anxiety from hearing a list of intimidating side effects can, therefore, be more harmful to the human body than the drug itself.

Due to the implication of nocebo on the human body, I believe drug companies should no longer be required to publicize lists of side effects in their advertising campaigns. Drug companies should not, however, be able to forgo disclosing the drug’s side effects entirely but should instead publish a list of potential side effects on a more private forum. This forum could be only accessible by prescribing physicians who could keep up with their patients and document whether the symptoms the patient is presenting are in line with the side effects of the drug or not. By removing side effects from widely publicized advertising campaigns, the public can no longer be expected to develop expectation-induced anxiety when taking a new medication which should in turn more fairly and accurately demonstrate the efficacy and therapeutic index of pharmaceuticals.

Even though this privatization of drug information would help with nocebo effects, it is still a leap of faith in our relationship with the pharmaceutical and medical occupational sphere. We must trust pharmaceutical companies to publish the side effect information for prescribers to see. We must trust prescribers to routinely check up with patients in order to assess their symptoms and whether the new medication poses a potential danger to them. 

While the FDA could relatively easily require such submission from pharmaceutical companies, they could never ensure that physicians are continually checking up on their patients in order to assess their symptoms while taking the drug. Frankly, we should never expect all physicians to show this level of care. Our medical world is a fast-paced one, prioritizing the quantity of patients over the quality of care. If we do proceed down the road of eliminating public disclosure of side effects, which I believe we should, we must be the arbiters of our own health and lobby with our respective physicians for the attention and care we deserve.