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Direct-To-Consumer Advertising by Pharmaceuticals

In 1997, the Food and Drug Administration				increased outlays on prescriptions save
relaxed its restrictions on
direct-to-consumer marketing of				money in the long run by preventing the need
pharmaceuticals. Prior to this ruling, drug				for more extensive medical care
manufacturers were prohibited from mentioning
both the name of the drug and its indications				(Moore, 2000). Critics, however, cite the
in consumer-directed advertisements without				fact that the largest portion of the drug
also including a large amount of technical
information about the drug, including all				industry's advertising budget goes toward
known side effects, contraindications, and				drugs for non-critical ailments such as
dosage recommendations (Stevens, 1998).In
addition to interfering with the appeal of				heartburn, allergies, and hair loss (Moore,
the advertisements, such requirements				2000).Another argument presented by DTC
				opponents holds that these ads result in
rendered broadcast ads infeasible due to
time constraints, and hindered ads in print				incorrect prescriptions by creating consumer
				demand for products regardless of
media due to cost and space availability.
These requirements were abolished in the				actual need. Critics believe that consumers
				are sold the idea that a pill can instantly
1997 FDA policy changes, and pharmaceutical
companies were permitted to market				provide them with good health (Health
				Matters, 1998). Often, however, the drugs to
drugs by name as treatments for specific
conditions, with the minimal requirement				which consumers are exposed are not even the
				most effective, but simply the ones
that ads give mention to major risks
identified in clinical trials (Melillo,				with the largest advertising budgets
2001). As a				(Headden and Melton, 1998). According to

result, manufacturer expenditures on				Shapiro and Schultz, patients, if refused
direct-to-consumer advertising, which totaled				specific prescriptions, will frequently visit


$791 million in 1996, rose to $2.6 billion				another physician, who may comply with the
for the year 2000 (Mitchell, 2001).				request (2000). In addition to

Television, radio, and print media became				unnecessarily adding to healthcare costs,
saturated with ads promoting treatments				patient demand pressures doctors to give

for conditions ranging from depression to				patients the drugs they request for fear of
high cholesterol.Names such as Zoloft,				losing business (Shapiro and Schultz,
Claritin, and Lipitor, which were previously
known mostly to				2000). Specific drug requests, according to
				Dr. Angelo Agro, often cause physicians
health professionals, quickly became part of
the national vocabulary. Consequently,				to lose credibility in the eyes of the
				patient, who has been convinced by
spending on prescription drugs has increased
significantly over the past several				advertisements that the drug a physician
				refuses to prescribe is nonetheless the
years as consumers are enticed to seek
advertised medications (HealthBizNews.com,				best option (Tanner, 2001).Responding to
				such concerns, the AMA, at its July 2001
2001). This new face of drug marketing has				meeting, debated a
sparked a raging debate about the
				proposal for the organization to encourage
accompanying effects on the health of the				the federal government to ban all DTC
American public: does direct to consumer
				prescription drug advertising (Tanner,
marketing benefit the public by providing				2001). While I agree that public exposure
education about available treatments, or
				through advertising of the latest treatments
does it diminish the quality of healthcare				for common conditions raises public
by raising costs and causing unnecessary
				awareness and prompts people to visit
treatment? Proponents of direct-to-consumer,				physicians, I nonetheless believe that
or DTC, pharmaceutical advertising,				direct-

most prominently the drug companies				to-consumer pharmaceutical advertising does
themselves, argue that DTC marketing				not adequately justify its social costs.

results in improved public health by				In the case of overt maladies, such as
increasing consumer awareness. According to				allergies or depression, for which a large

this view, direct marketing to the consumer				share of advertised drugs are indicated, a
alerts the public of the availability of				condition affecting a person's life to the

treatment for a given condition, a fact of				point of warranting medication would
which it may not otherwise be aware. This				certainly cause him or her to notice it and

knowledge may prompt people to seek medical				presumably to seek treatment. While many
help rather than unnecessarily				other products, such as cholesterol

accepting their ailments (Miller, 1998).				lowering drugs, are used to treat conditions
Furthermore, supporters claim that ads raise				of which an individual may not be

awareness of undiagnosed conditions by				aware and that may eventually adversely
providing information about symptoms.Since				impact health, these conditions would, in
countless Americans suffer from undiagnosed
disorders-only half of the				nearly all cases, be uncovered during a
				routine examination. In both cases, the
estimated 16 million Americans with diabetes
know they have the disease-the				central benefit accomplished by these ads is
				getting people through the doors of
motivation to seek treatment provided by
these ads is a valuable public benefit				doctors' offices, an end that can easily be
				achieved more cheaply without the use of
(Health Matters, 1998). Similarly, by
prompting people to visit a doctor, ads may				DTC advertising. For example, less expensive
				public service campaigns encouraging
help identify conditions unrelated to the
specific area of concern. For example,				people to have routine checkups and
				informing the public of warning signs of
according to Mike Magee, a medical adviser
for Pfizer, a large proportion of				common conditions would achieve the same
				results without affecting the cost of
consumers seeking Viagra would not otherwise
see a doctor, so visits seeking help				healthcare. As the situation now stands, the
				benefits that do result from DTC
for erectile dysfunction often uncover
conditions warranting medical attention, such				advertising are purchased at the price of
				reduced healthcare quality for some.As drug
				advertising drives up the cost of treatment,
as diabetes (Shapiro and Schultz, 2000).				healthcare providers will be
Some doctors support DTC ads as well,
				forced to cut costs in other areas and may
claiming that they make their jobs easier by				find it necessary to compromise coverage
resulting in better informed patients.
				by denying certain procedures or raising
Many ads, particularly for diabetes, stress				premiums. Increased premiums may drive
the importance of self-management of
				people who fund their own health insurance
disease, which may increase compliance with				out of the system by making personal
doctors orders and result in reduced
				insurance unaffordable. Additionally higher
need for more extensive medical care (New				premiums may discourage large
York Times, 2001).Doctors appreciate having
patients who are already briefed about				employers, which often independently provide
current drug				their employees with health

therapies, which saves time in a medical				coverage, from continuing this practice.
system that often requires doctors to see				General Motors spent $900 million covering

as many as thirty patients per day (New York				prescription drugs in 2000, a 19% increase
Times, 2001). Critics of direct-to-				over the previous year (Cassels, 2001).

consumer drug ads, including the American				Escalating costs may render those without
Medical Association, insurance				prescription coverage unable to afford

providers, and many physicians cite				necessary medications. Furthermore, the
increasing healthcare costs, improper				production of a drug is only possible when

prescriptions, and corrupted doctor-patient				the disease it treats becomes understood
relations as this type of marketing's				through years of basic research, most of

major resultant evils. Substantial evidence				which is conducted by publicly funded
exists that the escalation of DTC				academic investigators. Since public money

advertising has increased expenditure on				lays the groundwork for pharmaceutical
pharmaceutical purchases. Prescription				production, drug companies have a

drug spending increased 84% between 1993 and				responsibility to the taxpayers not to
1998, and it is estimated that				engage in practices that will result in a

consumer-directed advertising increased drug				reduction in the quality of healthcare.The
expenditure by $13 billion in 1998				major problems underlying this situation is
				that, under our current insurance
alone (Cassels, 2001).The twenty-five most
advertised drugs of 2000 accounted for				structure, the costs of increasing drug
forty-one percent of				prices do not accrue to the consumer and

expenditure on new prescriptions (Sherrid,				thus do not decrease demand as they should
2000). Escalating prescription cost is of				in a free market system. As a result,

particular concern to healthcare providers				the pharmaceutical companies are not given
such as HMOs and large corporations,				proper incentive to control prices.

which face a choice between curbing costs				Insurance providers, rather than
and cutting benefits (Cassels, 2001).				transferring rising costs to consumers
				through
Additionally, those without prescription
drug coverage must pay the increased rates				reduced care, need to restore the incentive
				to curb drug prices and hold the
out-of-pocket (Shapiro and Schwarz, 2000).
DTC proponents counter arguments				pharmaceutical companies responsible for
				their exorbitant budgets.
centered on rising costs by claiming that

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Direct-To-Consumer Advertising by Pharmaceuticals