Could You Live Without Direct-to-Consumer Ads?

In the New England Journal of Medicine, Dr. Miriam Shuchman writes about the movement in Congress to allow the FDA to block direct-to-consumer ads for new drugs.

“There is popular support for a ban: in a telephone survey conducted in March 2007 by Consumer Reports, 59% of respondents ‘strongly agreed’ that the FDA should ban advertisements for drugs that had safety problems,” Shuchman writes. “But some legal scholars believe that such a ban would be overturned by the courts as unconstitutional.”

There is a big difference, of course, in ads for “drugs that had safety problems” and all the rest. Still, here is a look at the increase in DTC advertising in recent years:

I was thinking about DTC advertising a few weeks ago when I was in Madison, Wisc., and visited an exhibit on the history of toys at the Wisconsin Historical Museum. The exhibit made the argument that the advent of television, and particularly TV advertising, is what turned the toy industry into a juggernaut. Why? Because, for the first time, manufacturers could market their goods directly to the customers — that is, to children. Mattel was apparently the first company to grasp this phenomenon, and saw its sales increase from $6 million to $49 million in the space of six years. (I have no idea how accurate this information is, nor do we learn how much money Mattel spent on its TV advertising; but still … the DTC point seems valid.)

Almost every knowledgable person I know in the healthcare field, when talking about high healthcare costs, points to the advent of DTC advertising as a major factor, since it is so good at driving consumer demand. These same people universally bemoan the fact that this demand is not only costly but, from a medical standpoint, often counterproductive.

I do know of some people, however, whose lives would be gravely endangered if DTC advertising were restricted or limited: TV executives. It is no secret that the networks have come to depend very heavily on pharmaceutical ad dollars, particularly the evening news broadcasts. I remember seeing a list not long ago of the top ten advertisers on the three big networks’ nightly newscasts. Twenty-nine out of the thirty advertisers were pharmaceuticals; the 30th was for an affordable car — I think it was a Hyundai.

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  1. DHH says:

    Only physicians can prescribe drugs. If DTC results in wasteful prescriptions, then it must be the case that physicians are not doing a good job dispensing medical advice and acting as gatekeepers. That is the root cause of the problem.

    DTC is not the cause of “high healthcare costs”. Costs were rising steeply prior to use of DTC.

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  2. DHH says:

    Only physicians can prescribe drugs. If DTC results in wasteful prescriptions, then it must be the case that physicians are not doing a good job dispensing medical advice and acting as gatekeepers. That is the root cause of the problem.

    DTC is not the cause of “high healthcare costs”. Costs were rising steeply prior to use of DTC.

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  3. Deckard says:

    One thing is clear and that is that DTC raises the awareness of certain drugs to a position where they doctors are forced to prescribe a branded drug over an equally effective generic version (Nexium springs to mind).

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  4. Deckard says:

    One thing is clear and that is that DTC raises the awareness of certain drugs to a position where they doctors are forced to prescribe a branded drug over an equally effective generic version (Nexium springs to mind).

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  5. pkimelma says:

    The counter to this is that many Doctors are not aware of the latest options for treatment of various diseases. Although the internet and patient groups have helped a lot, the DTC information can at least make sure people are aware of their options. If their Doctor is not a quack, he/she will inform the patient whether the branded med is suitable or not, based on specific characteristics and price. The DTC model is probably more fair than the old reps bribing the Doctor approach of the past.
    Note that most Doctors know if a generic is available (or can check) and are usually aware of the insurance policy of the patient. Any patient can ask the Doctor if there is a generic available. Also, many prescriptions indicate that a generic is OK, so the pharmacist will select the generic.
    The real story here is that patients can and should get more involved in their own treatment, with or without DTC marketing.

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  6. pkimelma says:

    The counter to this is that many Doctors are not aware of the latest options for treatment of various diseases. Although the internet and patient groups have helped a lot, the DTC information can at least make sure people are aware of their options. If their Doctor is not a quack, he/she will inform the patient whether the branded med is suitable or not, based on specific characteristics and price. The DTC model is probably more fair than the old reps bribing the Doctor approach of the past.
    Note that most Doctors know if a generic is available (or can check) and are usually aware of the insurance policy of the patient. Any patient can ask the Doctor if there is a generic available. Also, many prescriptions indicate that a generic is OK, so the pharmacist will select the generic.
    The real story here is that patients can and should get more involved in their own treatment, with or without DTC marketing.

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  7. furiousball says:

    Man those poor TV Execs, they wouldn’t be able to buy any more Asheras!

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  8. furiousball says:

    Man those poor TV Execs, they wouldn’t be able to buy any more Asheras!

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