Healthy Skepticism Library item: 6965

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Kravitz RL.
Direct-to-consumer advertising of prescription drugs.
West J Med 2000 Oct; 173:(4):221-2
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11017964

Abstract:

The pharmaceutical industry has long relied on marketing to sell drugs. It has employed large armies of sales representatives to promote drugs to physicians. However, recent changes in the health-care system, including managed care, have reduced physicians’ prescribing autonomy. Consequently the pharmaceutical industry has altered its marketing strategy to include direct-to-consumer advertising (DTCA) to educate consumers who can push doctors to prescribe particular drugs. The Food and Drug Administration decided, after a long moratorium, that DTCA required no new regulation. DTCA expenditure currently comprises 15-20% of total drug marketing costs and is projected to reach $7.5 billion by 2005. Proponents of DTCA argue that it will encourage patients to seek medical treatment and they will receive safe and effective drugs. Critics argue that DTCA is not about educating patients of relieving suffering, and that it will drain healthcare resources, increase unnecessary prescribing, and strain doctor-patient relationships. Both sides tend to overstate their case. The net public health gain or loss will be determined by (1) the current prevalence of undertreatment, (2) the amount of inappropriate prescribing that might be stimulated, and (3) the degree of harm accruing to undertreated versus overtreated patients. Research is needed to assess this. However, DTCA is here to stay, so the real question is how to maximize the benefits while minimizing harms. Drug manufacturers should do more educating and less selling. They should focus on conditions, not drugs; assist patients with home-based triage and self-care; present information on treatment alternatives, including non-drug therapies; and help patients optimize adherence. They should also promote partnerships with physicians, e.g. alerting them before launching DTCA campaigns and helping them prepare for patients’ questions. Government should impose serious limits on the industry to ensure that consumers receive complete and nonconfusing information, and it should fund research to assess the benefits and risks of DTCA. The medical profession should partner with government, foundations, and news media to provide objective consumer drug information. Meanwhile doctors should brace themselves for growing hordes of patients bearing ads.

Keywords:
*analysis/United States/DTCA/direct-to-consumer advertising/FDA/Food and Drug Administration/undertreatment/inappropriate prescribing/INFLUENCE OF PROMOTION: CONSUMERS AND PATIENTS/INFLUENCE OF PROMOTION: DOCTOR-PATIENT RELATIONSHIP/PROMOTION AS A SOURCE OF INFORMATION: CONSUMERS AND PATIENTS/PROMOTIONAL TECHNIQUES: DIRECT-TO-CONSUMER ADVERTISING/REGULATIONS, CODES, GUIDELINES: DIRECT GOVERNMENT REGULATION Advertising* Drug Industry* Health Education Humans United States