Direct-to-Consumer Advertising: Its Effects on Stakeholders
Montoya, Isaac D., Lee-Dukes, Gwen, Shah, Dhvani, Journal of Allied Health
The escalating growth in the development of pharmaceutical drugs has caused the pharmaceutical industry to market drugs directly to consumers. Direct-to-consumer (DTC) advertising has increased immensely in the past 15 years and continues to grow each year. The advantages of DTC advertising include an increase in consumer knowledge, patient autonomy, and possibly providing physicians and pharmacists with up-to-date information about the recent trends in the marketplace. However, there is also an equally notable list of disadvantages, which include concerns about the quality of information provided, loss in physician productivity due to time spent convincing patients that what they want is not in their best interest, and increases in the reimbursement expenditure of the insurers. Because of these conflicting outcomes, the issue of DTC advertising has become controversial. This report offers an overview of DTC advertising and focuses on its effects on physicians, pharmacists, consumers, insurers, the government, and pharmaceutical manufacturers. J Allied Health 2008; 37: 116-120.
THE BIOMEDICAL FIELD has greatly evolved in the past 30 years, and one of its greatest achievements is the substantially large and ever-increasing pharmacopoeia of prescription drugs. These prescription drugs enhance a patient's quality of life, functional capacity, and even life expectancy in some cases. The prescription drug segment also represents a considerable portion of costs in the health care industry.1 Revenues to pharmaceutical companies that can be generated from the introduction of a single successful drug may be in the billions of dollars. At the same time, the industry does spend money to research and develop new drugs and the cost is very high; losses due to a failed drug effort could amount to billions of dollars. To increase the consumers' awareness of new drugs, which could result in higher sales, the pharmaceutical industry has started marketing drugs directly to the consumers in addition to health care professionals. Thus, spending on direct-to-consumer (DTC) advertising has accelerated greatly, especially in recent years, and is now the fastest growing component of any health care budget.2
DTC advertising of prescription drugs can be defined as presenting information and messages regarding a drug product directly to the public.3 There are numerous countries where DTC advertising is not permitted, meaning there can be no transmission of information about prescription drugs directly to the general public through either print or electronic media. However, there are exceptions to this ban. For example, Canada permits DTC advertising if the medical condition that the drug is designed to treat is not mentioned or, if the medical condition is stated, then the drug that could be used may not be mentioned in the advertisement.3 These bans are also circumvented by the widespread use of the Internet, which provides easy access to all information required for a particular drug.
The United States is one of only two industrialized nations in the world that permit DTC advertising of prescription drugs. New Zealand, the other country that currently permits DTC advertising, has a treaty with Australia (which does not permit DTC advertising) that will result in common drug standards between the two countries. Hence, many professional and consumer organizations are supporting the implementation of a ban on DTC advertising in New Zealand. Other countries such as Canada and the European Union are considering relaxing their restrictions on this practice.3 Clearly countries are not in agreement on this issue.
DTC advertising has an enormous effect on the health care industry and the general public. It influences the attitudes and behaviors of the stakeholders, including health care professionals (e.g., physicians, pharmacists), consumers (e.g., patients), insurers (e.g., private insurance companies, managed care organizations, the government), and pharmaceutical manufacturers. …