US Pharm. 2007:32(7):1.
I don't watch a lot of television, but it
seems an evening doesn't go by that I am not exposed to a direct-to-consumer
(DTC) ad for a prescription medication. Like many other pharmacists, I
probably view these ads a little differently than the average consumer. When
DTC advertising started airing more than a decade ago, I remember just shaking
my head and saying they wouldn't last. I just didn't believe that physicians
would change their prescribing habits as a result of the ads, and I certainly
didn't believe consumers would pay much attention to the very sketchy clinical
information that was being presented. But that all changed in 1997 when the
FDA eased up on some of the restrictions attached to DTC advertising, and the
ads became more creative and appealing to consumers. Obviously, I was very
wrong about them going away, because they only increased in frequency. So, to
answer my own question, I have to draw the conclusion that pharmaceutical
manufacturers would not be spending the multimillions of dollars on these ads
if they did not produce the desired result: more prescriptions written for the
products being advertised.
When these ads first started
being aired, I asked some of the people who created the ads and others who
paid for them what their expectations were. Many at the time said they simply
served an educational purpose. I suppose to a limited extent they did then and
still do today, but I had no way of proving it. However, several months ago I
came across an interesting piece of research published in the Annals of
Family Medicine. The authors of this paper set out to see if DTC
prescription advertising messages were prompting consumers to request
medication that might be "clinically inappropriate or more expensive than
equally effective alternatives."
It's a lengthy paper with very
good information, which makes it impossible to include all the results here,
but I found some of the findings fascinating. The researchers claim that
American television viewers see as many as 16 hours of DTC ads a year. They
conclude that most of the advertising (82%) made "some factual claims" and
"rational arguments" (86%) for product use. But only about a quarter of them
described condition causes (26%), risk factors (26%), or prevalence (25%).
Instead, virtually all of them played on consumers' emotions (95%). None of
the ads mentioned lifestyle change as an alternative to taking the medication,
but some (19%) connected lifestyle changes as an adjunct to the medication
being advertised. One particularly interesting fact was that almost 60% of the
ads portrayed the advertised product as a medical breakthrough.
Perhaps you've noticed that
there are basically two kinds of consumer prescription ads running on TV these
days: those that make claims about the product and reminder ads. As you would
expect, the claims ads require more information, including the name and
indication of the drug, as well as a major statement of product risks, and
then must point the consumer to another source, like the Internet, a toll-free
phone line, or a magazine ad for a detailed summary of those risks.
While the controversy
continues to swirl around DTC Rx advertising and whether they serve the
purpose of educating the consumer, one thing is for sure: it means the
pharmacist must answer many more questions from consumers about prescription
products that many of them can hardly pronounce. I am all for an educated
consumer, but I am not in the camp that believes the purpose of these ads is
to educate consumers about their medical condition orthe products they
may be taking; it is about selling the product. The only reliable source of
disease state information is from a licensed physician, not an actor who plays
one on TV. Drug information should come from a pharmacist, not a 45-second TV
ad.
Harold E. Cohen, R. Ph.
Editor-in-Chief
hcohen@jobson.com
To comment on this article, contact editor@uspharmacist.com.
