Although I am generally enthusiastic about providing more health information to consumers, I must confess that I have serious reservations about direct-to-consumer (DTC) drug advertisements on TV. Part of my concern is that pharmaceutical companies and their advertising agencies know how to tune these spots to manipulate less sophisticated viewers. As a prime example of their skills, one of the fastest selling categories these days in retail drug stores these days are the "as seen on TV" items, much of which are often junk. I was thus drawn to a recent article on the web discussing a survey of the effect of DTC drug advertising. Below is an excerpt from it (see: Doctor Visits and Direct to Consumer Rx Advertising) with boldface emphasis mine:
Direct to Consumer (DTC) advertising for prescription drugs has a measurable impact on the delivery and cost of health care, and the complexity of the business of health care. A paper presented this week during a health care consumersim conference shared some interesting data in this regard....During [a recent] conference, Paul H. Rubin, PhD, [of] Emory University, gave a presentation on "The Cost Effectiveness of Direct to Consumer Advertising for Prescription Drugs", discussing findings from a study and paper he co-wrote with Adam Atherly of Emory University, in which they found during patient visits to their physician:
- 4% of patients schedule physician visits to ask about a drug
- 14% of patients discussed a concern because of DTC advertising
- If patients ask for a drug, 39% receive that prescription, 22% are prescribed a different drug, and 18% receive no drug
- 5.5% of physicians prescribed a requested DTC drug, but thought a different drug was better
- 88% of patients requesting a DTC drug had a relevant condition
- 75% who received the requested drug reported subsequently feeling better
I was most impressed with the third item in this list -- 61% of patients who ask for a drug during a visit with their physician receive it, with 39% receiving that specific drug and 22% receiving a different one. Past of this latter group may be patients receiving a generic equivalent of the drug that they had requested. It's also clear from the first and second items above that DTC advertising serves to draw patients into their physicians' office. The last item may related, in part, to the placebo effect of drugs.
I am a strong advocate for having informed consumers and the blogosphere help to achieve this goal. However, I disagree with the contention of the pharmaceutical industry (see: DTC Advertising’s Benefits Far Outweigh Its Imperfections) that "a growing body of research shows that DTC advertising, for all of the controversy, is having precisely [the] effect [of producing more productive, physician/patient encounters].' I believe that the phenomenon is having the opposite effect of manipulating consumers, using emotional messages with little informational content.
A 2003 report from the Kaiser Family Foundation indicated that U.S. spending for prescription drugs was $140.6 billion in 2001, more than tripling since 1990 (see: Impact of Direct-to-Consumer Advertising on Prescription Drug Spending). In my view, this is a major problem but am not sure what steps should be taken to reverse the trend. Certainly steps are underway to curb the some of the inappropriate influence that the pharmaceutical industry has over physicians (see: Corporate Support for Continuing Medical Education Conferences). Perhaps more attention should be paid to their influence over healthcare consumers.