Direct-To-Consumer Advertising by Pharmaceuticals

In 1997, the Food and Drug Administration relaxed itsoutlays on prescriptions save
restrictions on direct-to-consumer marketing ofmoney in the long run by preventing the need for
pharmaceuticals. Prior to this ruling, drug manufacturersmore extensive medical care
were prohibited from mentioning both the name of the(Moore, 2000). Critics, however, cite the fact that the
drug and its indications in consumer-directedlargest portion of the drug
advertisements without also including a large amountindustry's advertising budget goes toward drugs for
of technical information about the drug, including allnon-critical ailments such as
known side effects, contraindications, and dosageheartburn, allergies, and hair loss (Moore,
recommendations (Stevens, 1998).In addition to2000).Another argument presented by DTC
interfering with the appeal of the advertisements, suchopponents holds that these ads result in
requirementsincorrect prescriptions by creating consumer demand
rendered broadcast ads infeasible due to timefor products regardless of
constraints, and hindered ads in printactual need. Critics believe that consumers are sold
media due to cost and space availability. Thesethe idea that a pill can instantly
requirements were abolished in theprovide them with good health (Health Matters, 1998).
1997 FDA policy changes, and pharmaceuticalOften, however, the drugs to
companies were permitted to marketwhich consumers are exposed are not even the
drugs by name as treatments for specific conditions,most effective, but simply the ones
with the minimal requirementwith the largest advertising budgets (Headden and
that ads give mention to major risks identified in clinicalMelton, 1998). According to
trials (Melillo, 2001). As aShapiro and Schultz, patients, if refused specific
result, manufacturer expenditures onprescriptions, will frequently visit
direct-to-consumer advertising, which totaledanother physician, who may comply with the request
$791 million in 1996, rose to $2.6 billion for the year(2000). In addition to
2000 (Mitchell, 2001).unnecessarily adding to healthcare costs, patient
Television, radio, and print media became saturateddemand pressures doctors to give
with ads promoting treatmentspatients the drugs they request for fear of losing
for conditions ranging from depression to highbusiness (Shapiro and Schultz,
cholesterol.Names such as Zoloft, Claritin, and Lipitor,2000). Specific drug requests, according to Dr. Angelo
which were previously known mostly toAgro, often cause physicians
health professionals, quickly became part of theto lose credibility in the eyes of the patient, who has
national vocabulary. Consequently,been convinced by
spending on prescription drugs has increasedadvertisements that the drug a physician refuses to
significantly over the past severalprescribe is nonetheless the
years as consumers are enticed to seek advertisedbest option (Tanner, 2001).Responding to such
medications (HealthBizNews.com,concerns, the AMA, at its July 2001 meeting, debated a
2001). This new face of drug marketing has sparked
a raging debate about theproposal for the organization to encourage the federal
accompanying effects on the health of the Americangovernment to ban all DTC
public: does direct to consumerprescription drug advertising (Tanner, 2001). While I
marketing benefit the public by providing educationagree that public exposure
about available treatments, orthrough advertising of the latest treatments for
does it diminish the quality of healthcare by raisingcommon conditions raises public
costs and causing unnecessaryawareness and prompts people to visit physicians, I
treatment? Proponents of direct-to-consumer, ornonetheless 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 marketingIn the case of overt maladies, such as allergies or
results in improved public health by increasingdepression, for which a large
consumer awareness. According toshare of advertised drugs are indicated, a condition
this view, direct marketing to the consumer alerts theaffecting a person's life to the
public of the availability ofpoint of warranting medication would certainly cause
treatment for a given condition, a fact of which it mayhim or her to notice it and
not otherwise be aware. Thispresumably to seek treatment. While many other
knowledge may prompt people to seek medical helpproducts, such as cholesterol
rather than unnecessarilylowering drugs, are used to treat conditions of which
accepting their ailments (Miller, 1998). Furthermore,an individual may not be
supporters claim that ads raiseaware and that may eventually adversely impact
awareness of undiagnosed conditions by providinghealth, these conditions would, in
information about symptoms.Since countlessnearly all cases, be uncovered during a routine
Americans suffer from undiagnosed disorders-only halfexamination. In both cases, the
of thecentral benefit accomplished by these ads is getting
estimated 16 million Americans with diabetes knowpeople through the doors of
they have the disease-thedoctors' offices, an end that can easily be achieved
motivation to seek treatment provided by these ads ismore cheaply without the use of
a valuable public benefitDTC advertising. For example, less expensive public
(Health Matters, 1998). Similarly, by prompting people toservice campaigns encouraging
visit a doctor, ads maypeople to have routine checkups and informing the
help identify conditions unrelated to the specific areapublic of warning signs of
of concern. For example,common conditions would achieve the same results
according to Mike Magee, a medical adviser for Pfizer,without affecting the cost of
a large proportion ofhealthcare. As the situation now stands, the benefits
consumers seeking Viagra would not otherwise see athat do result from DTC
doctor, so visits seeking helpadvertising are purchased at the price of reduced
for erectile dysfunction often uncover conditionshealthcare quality for some.As drug advertising drives
warranting medical attention, suchup the cost of treatment, healthcare providers will be
as diabetes (Shapiro and Schultz, 2000). Someforced to cut costs in other areas and may find it
doctors support DTC ads as well,necessary to compromise coverage
claiming that they make their jobs easier by resulting inby denying certain procedures or raising premiums.
better informed patients.Increased premiums may drive
Many ads, particularly for diabetes, stress thepeople who fund their own health insurance out of the
importance of self-management ofsystem by making personal
disease, which may increase compliance with doctorsinsurance unaffordable. Additionally higher premiums
orders and result in reducedmay discourage large
need for more extensive medical care (New Yorkemployers, which often independently provide their
Times, 2001).Doctors appreciate having patients whoemployees with health
are already briefed about current drugcoverage, from continuing this practice. General
therapies, which saves time in a medical system thatMotors spent $900 million covering
often requires doctors to seeprescription drugs in 2000, a 19% increase over the
as many as thirty patients per day (New York Times,previous year (Cassels, 2001).
2001). Critics of direct-to-Escalating costs may render those without
consumer drug ads, including the American Medicalprescription coverage unable to afford
Association, insurancenecessary medications. Furthermore, the production of
providers, and many physicians cite increasinga drug is only possible when
healthcare costs, improperthe disease it treats becomes understood through
prescriptions, and corrupted doctor-patient relations asyears of basic research, most of
this type of marketing'swhich is conducted by publicly funded academic
major resultant evils. Substantial evidence exists thatinvestigators. Since public money
the escalation of DTClays the groundwork for pharmaceutical production,
advertising has increased expenditure ondrug companies have a
pharmaceutical purchases. Prescriptionresponsibility to the taxpayers not to engage in
drug spending increased 84% between 1993 andpractices that will result in a
1998, and it is estimated thatreduction in the quality of healthcare.The major
consumer-directed advertising increased drugproblems underlying this situation is that, under our
expenditure by $13 billion in 1998current insurance
alone (Cassels, 2001).The twenty-five most advertisedstructure, the costs of increasing drug prices do not
drugs of 2000 accounted for forty-one percent ofaccrue to the consumer and
expenditure on new prescriptions (Sherrid, 2000).thus do not decrease demand as they should in a
Escalating prescription cost is offree market system. As a result,
particular concern to healthcare providers such asthe pharmaceutical companies are not given proper
HMOs and large corporations,incentive to control prices.
which face a choice between curbing costs andInsurance providers, rather than transferring rising
cutting benefits (Cassels, 2001).costs to consumers through
Additionally, those without prescription drug coveragereduced care, need to restore the incentive to curb
must pay the increased ratesdrug prices and hold the
out-of-pocket (Shapiro and Schwarz, 2000). DTCpharmaceutical companies responsible for their
proponents counter argumentsexorbitant budgets.
centered on rising costs by claiming that increased