Direct-To-Consumer Prescription Drug Advertising: Trends, Impact, And Implications

Abstract

PROLOGUE: Anyone who watches television or reads newspapers or magazines in modern-day America cannot help but notice the dramatic upsurge in the number of prescription drug ads. Drug companies spent $905 million on direct-to-consumer (DTC) advertising in the first half of 1999 alone—a 43 percent increase over spending levels a year earlier, according to IMS Health. CBS HealthWatch reports that in 1998, 66 percent of drug consumers in the central United States recalled seeing a particular product advertised in print, and 61 percent of Southern consumers recalled seeing one advertised on TV. The explosion in DTC drug advertising is fueling the trend toward better-informed consumers. Although this trend might appear benign, it is changing the physician/patient relationship. The authors of this study conclude that evidence is accumulating to suggest that clinical quality of care is harmed by DTC advertising. Michael Wilkes is an associate professor of medicine at the University of California, Los Angeles (UCLA), where he is senior chair of the School of Medicine's four-year Doctoring Curriculum. Robert Bell is a professor of communication at UC Davis. He holds a doctoral degree in communications from the University of Texas, Austin. Richard Kravitz is a professor in the Department of Internal Medicine at UC Davis and directs its Center for Health Services Research in Primary Care. He holds a medical degree from UC San Francisco. We provide an overview of what is known about the impact of direct-to-consumer (DTC) advertising of prescription drugs. Specifically, we explore the historical trends that led to the industry's increasing use of this form of promotion. Then, using the published literature to date, we review the impact of DTC advertising on the consumer, the medical profession, and the health care system. We conclude by offering policy suggestions for how the pharmaceutical industry can promote its products more responsibly, how the Food and Drug Administration (FDA) can regulate DTC advertising more effectively, and how the medical and public health communities can educate the public about drug therapies more constructively.