Direct-To-Consumer Advertising by Pharmaceuticals

In 1997, the Food and Drug Administration relaxed its				outlays on prescriptions save
restrictions on direct-to-consumer marketing of				money in the long run by preventing the need for
pharmaceuticals. Prior to this ruling, drug				more extensive medical care
manufacturers were prohibited from mentioning both				(Moore, 2000). Critics, however, cite the fact that
the name of the drug and its indications in				the largest portion of the drug
consumer-directed advertisements without also				industry's advertising budget goes toward drugs for
including a large amount of technical information about				non-critical ailments such as
the drug, including all known side effects,				heartburn, allergies, and hair loss (Moore,
contraindications, and dosage recommendations				2000).Another argument presented by DTC
(Stevens, 1998).In addition to interfering with the				opponents holds that these ads result in
appeal of the advertisements, such requirements				incorrect prescriptions by creating consumer demand
rendered broadcast ads infeasible due to time				for products regardless of
constraints, and hindered ads in print				actual need. Critics believe that consumers are sold
media due to cost and space availability. These				the idea that a pill can instantly
requirements were abolished in the				provide them with good health (Health Matters,
1997 FDA policy changes, and pharmaceutical				1998). Often, however, the drugs to
companies were permitted to market				which consumers are exposed are not even the
drugs by name as treatments for specific conditions,				most effective, but simply the ones
with the minimal requirement				with the largest advertising budgets (Headden and
that ads give mention to major risks identified in				Melton, 1998). According to
clinical trials (Melillo, 2001). As a				Shapiro and Schultz, patients, if refused specific
result, manufacturer expenditures on				prescriptions, will frequently visit
direct-to-consumer advertising, which totaled				another physician, who may comply with the
$791 million in 1996, rose to $2.6 billion for the year				request (2000). In addition to
2000 (Mitchell, 2001).				unnecessarily adding to healthcare costs, patient
Television, radio, and print media became saturated				demand pressures doctors to give
with ads promoting treatments				patients the drugs they request for fear of losing
for conditions ranging from depression to high				business (Shapiro and Schultz,
cholesterol.Names such as Zoloft, Claritin, and Lipitor,				2000). Specific drug requests, according to Dr.
which were previously known mostly to				Angelo Agro, often cause physicians
health professionals, quickly became part of the				to lose credibility in the eyes of the patient, who has
national vocabulary. Consequently,				been convinced by
spending on prescription drugs has increased				advertisements that the drug a physician refuses to
significantly over the past several				prescribe is nonetheless the
years as consumers are enticed to seek advertised				best option (Tanner, 2001).Responding to such
medications (HealthBizNews.com,				concerns, the AMA, at its July 2001 meeting, debated
2001). This new face of drug marketing has sparked				a
a raging debate about the				proposal for the organization to encourage the
accompanying effects on the health of the				federal government to ban all DTC
American public: does direct to consumer				prescription drug advertising (Tanner, 2001). While I
marketing benefit the public by providing education				agree that public exposure
about available treatments, or				through advertising of the latest treatments for
does it diminish the quality of healthcare by raising				common conditions raises public
costs and causing unnecessary				awareness and prompts people to visit physicians, I
treatment? Proponents of direct-to-consumer, or				nonetheless believe that direct-
DTC, pharmaceutical advertising,				to-consumer pharmaceutical advertising does not
most prominently the drug companies themselves,				adequately justify its social costs.
argue that DTC marketing				In the case of overt maladies, such as allergies or
results in improved public health by increasing				depression, for which a large
consumer awareness. According to				share of advertised drugs are indicated, a condition
this view, direct marketing to the consumer alerts				affecting a person's life to the
the public of the availability of				point of warranting medication would certainly cause
treatment for a given condition, a fact of which it				him or her to notice it and
may not otherwise be aware. This				presumably to seek treatment. While many other
knowledge may prompt people to seek medical help				products, such as cholesterol
rather than unnecessarily				lowering drugs, are used to treat conditions of which
accepting their ailments (Miller, 1998). Furthermore,				an individual may not be
supporters claim that ads raise				aware and that may eventually adversely impact
awareness of undiagnosed conditions by providing				health, these conditions would, in
information about symptoms.Since countless				nearly all cases, be uncovered during a routine
Americans suffer from undiagnosed disorders-only				examination. In both cases, the
half of the				central benefit accomplished by these ads is getting
estimated 16 million Americans with diabetes know				people through the doors of
they have the disease-the				doctors' offices, an end that can easily be achieved
motivation to seek treatment provided by these				more cheaply without the use of
ads is a valuable public benefit				DTC advertising. For example, less expensive public
(Health Matters, 1998). Similarly, by prompting people				service campaigns encouraging
to visit a doctor, ads may				people to have routine checkups and informing the
help identify conditions unrelated to the specific area				public of warning signs of
of concern. For example,				common conditions would achieve the same results
according to Mike Magee, a medical adviser for				without affecting the cost of
Pfizer, a large proportion of				healthcare. As the situation now stands, the benefits
consumers seeking Viagra would not otherwise see				that do result from DTC
a doctor, so visits seeking help				advertising are purchased at the price of reduced
for erectile dysfunction often uncover conditions				healthcare quality for some.As drug advertising drives
warranting medical attention, such				up the cost of treatment, healthcare providers will be
as diabetes (Shapiro and Schultz, 2000). Some
doctors support DTC ads as well,				forced to cut costs in other areas and may find it
claiming that they make their jobs easier by resulting				necessary to compromise coverage
in better informed patients.				by denying certain procedures or raising premiums.
Many ads, particularly for diabetes, stress the				Increased premiums may drive
importance of self-management of				people who fund their own health insurance out of
disease, which may increase compliance with doctors				the system by making personal
orders and result in reduced				insurance unaffordable. Additionally higher premiums
need for more extensive medical care (New York				may discourage large
Times, 2001).Doctors appreciate having patients who				employers, which often independently provide their
are already briefed about current drug				employees with health
therapies, which saves time in a medical system that				coverage, from continuing this practice. General
often requires doctors to see				Motors spent $900 million covering
as many as thirty patients per day (New York				prescription drugs in 2000, a 19% increase over the
Times, 2001). Critics of direct-to-				previous year (Cassels, 2001).
consumer drug ads, including the American Medical				Escalating costs may render those without
Association, insurance				prescription coverage unable to afford
providers, and many physicians cite increasing				necessary medications. Furthermore, the production
healthcare costs, improper				of a drug is only possible when
prescriptions, and corrupted doctor-patient relations				the disease it treats becomes understood through
as this type of marketing's				years of basic research, most of
major resultant evils. Substantial evidence exists that				which is conducted by publicly funded academic
the escalation of DTC				investigators. Since public money
advertising has increased expenditure on				lays the groundwork for pharmaceutical production,
pharmaceutical purchases. Prescription				drug companies have a
drug spending increased 84% between 1993 and				responsibility to the taxpayers not to engage in
1998, and it is estimated that				practices that will result in a
consumer-directed advertising increased drug				reduction in the quality of healthcare.The major
expenditure by $13 billion in 1998				problems underlying this situation is that, under our
alone (Cassels, 2001).The twenty-five most				current insurance
advertised drugs of 2000 accounted for forty-one				structure, the costs of increasing drug prices do not
percent of				accrue to the consumer and
expenditure on new prescriptions (Sherrid, 2000).				thus do not decrease demand as they should in a
Escalating prescription cost is of				free market system. As a result,
particular concern to healthcare providers such as				the pharmaceutical companies are not given proper
HMOs and large corporations,				incentive to control prices.
which face a choice between curbing costs and				Insurance providers, rather than transferring rising
cutting benefits (Cassels, 2001).				costs to consumers through
Additionally, those without prescription drug				reduced care, need to restore the incentive to curb
coverage must pay the increased rates				drug prices and hold the
out-of-pocket (Shapiro and Schwarz, 2000). DTC				pharmaceutical companies responsible for their
proponents counter arguments				exorbitant budgets.
centered on rising costs by claiming that increased

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Direct-To-Consumer Advertising by Pharmaceuticals