Does Direct-to Customer Advertising Of Medication Enhance Patient Choice

By Author: Henry Ford
Total Articles: 189
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For a long time, prescription drugs have been marketed towards doctors. Prescription drugs advertisement to consumers were greatly limited through various regulations. This was because direct-to-consumer advertising (DTCA) on mass media was considered quite expensive. Prior to 1997 review of DTCA, it was required that any advertisement on drugs had to bear both brand name and medical claims which was to feature summary of the effectiveness of the drug, side effects, and also contradictions. This meant that the total words per advertisement was increased making it expensive for most companies to advertise their drugs. However, Foods and Drug Administration (FDA) reviewed this provision in August 1997 allowing pharmaceutical firms to market their drugs directly through the television without giving a brief summary of the drugs. Consequently, pharmaceutical companies trooped the media in large numbers and DTCA expenditure increased from a mere $800 million in 1996 to more than $2.5 billion in 2000. However, this has created a public debate with proponents arguing that DTCA increased consumer education value as they are able ...
... to understand drugs and their mechanism well. DTCA informs patient of a wide range of drugs and the disease they treat which increase consumer ability to seek drugs for a number of ailments. On the other hand, opponents argue that DTCA has misled patients as they tend to demand heavily advertised drugs which contribute to inappropriate use of drugs while some unnecessarily purchases expensive drugs. There is no doubt that DTCA enhance consumer choice of drugs.

DTCA enhance consumer choice
Since FDA allowed DTCA, there have been increased studies which are looking into general or specific effects of DTCA on consumers, doctors, and healthcare organizations. From these studies, it is evident that DTCA has increased demand for drugs that are advertised. Within four years of DTCA, total spending on DTCA increased three folds (Lizuka and Ginger, 2007). Since then, there has been fierce competition as different companies advertise their drugs. The overall effect has been increased demand of drugs that are being advertised. There is no way that drug companies can spend billions of dollars every year without positive results. However, the most important question is not the influence of these advertisements but whether they actually assist consumers to make informed choice of the drugs they purchase. Increased demand of the advertised drugs evidence that consumers are being influenced to purchase these drugs but it is important to understand how they are being influenced and whether they are being empowered to make informed choice before they purchase the drugs (Wolfe, 2002).
To have a concrete understanding of the effect of DTCA consumer choice, it is important to consider the impact of DTCA on consumers in two perspectives. First, one should consider how DTCA has informed the public on the existence of some medical conditions which means more people will be seeking medical treatment when they suffer from these conditions. Second, one should evaluate the effect of the information consumers have on the condition and the drugs that are available to treat the condition and how this will influence prescription choice for both doctor and the patient (Lizuka and Ginger, 2007). For example, if a patient got information about that particular medical condition on the television and drugs that are likely to alleviation the condition, the patient will pressure the doctor to prescribe that particular drug even if there are other underlying medical conditions that doctor thinks require another drug. It may become difficult for the doctor to convince the patient that the drug prescribed is actually the correct one and not the one advertised for that medical condition. Evidently, proponents of DTCA stress more on the first situation but they don’t look at the second condition. On the other hand, opponents stress on the second condition but they don’t look at the first situation.
It is evident that DTCA is affecting consumer choice in different ways. As consumers acquire more information on specific drugs, they are in a position to make more informed choice. Recent studies have found out that DTCA is affecting patients, doctors, and healthcare organization in different ways that had not been predicted before. A recent survey showed that more than one third patients reported to have asked their doctors for more information regarding a drug they had seen in an advertisement (Wolfe, 2002). The survey also showed that majority of doctors gave patients accurate information as it has been presented in the DTCA. Nearly a quarter of participants in the survey asked only about a particular drug based on information they had received about the drug. This evidently shows that DTCA is increased availability of information not only for patients but also for others like doctors and health care organizations. This survey evidence that DTCA is providing more information about particular drugs to patients which means they are becoming more empowered on the drugs available in the market.
Analysts point out that most consumers have little knowledge to understand the clinical and pharmacological background used by pharmacists. This has made it difficult for most consumers to clearly understand pharmacological terminologies and they depend on pharmacists, who are less willing to give full explanation of these terms (Calfee, Winston and Stempski, 2002). However, DTCA has made it easy for consumer to interact with some of these terms and in the process become more interested and search for deeper understanding of the terms. This has increased consumer understanding of medical terms increasing their power to make choice.
However, this has also been cited as a disadvantage. Most DTCA do not take step ahead to empower consumer to concretely understand technical terms used in drugs. This means that most consumers do not understand even the message in DTCA and this creates the possibility of misinformation. Research has clearly documented incidences of miscomprehension of DTCA with most consumers confusing the effectiveness of the drugs (Lizuka and Ginger, 2007).
A recent survey that was conducted on 329 respondents in Sacramento County revealed that consumers’ interest in a certain drug being advertised correlated with familiarity of the condition that is treated by the disease. This survey found out that of the 10 drugs that were being extensively advertised at the time, consumers were aware of 3.7 of those drugs (Wolfe, 2002). However, this awareness was elicited by probability of a consumer or a close friend or relative being diagnosed with a condition treated by the particular disease. This means that DTCA increase consumer interest in understanding more about conditions that are affecting them or that are affecting their relatives and friends. In addition, this survey revealed that persons who were taking drugs for same conditions or those who had poor health and those with good healthcare coverage were more interested in DTCA compared to others.
This study showed consumers are being empowered by DTCA but only when they had particular interest in the drug. The study also showed that receptivity and influence of DTCA depending on demographics (Wolfe, 2002). Men were more interested since they took care of health of their family. The study also showed that old people, who are likely to be affected by a number of health conditions, were more interested and hence greatly influenced by DTCA compared to the young people. This means that how consumers are influenced by DTCA depends on their interest in that particular brand that is being advertised.
DTCA could have increased the information available to assist patient make choice on the drugs but at the same time it may have hampered the relationship between patients and their doctors over the choice they were making. Studies have revealed that patients usually made choice on the drug to be prescribed based on the information they had seen or heard in DTCA. This means that patient consumption of DTCA information is likely to increase their expectation of the kind of prescription they are likely to get (Lizuka and Ginger, 2007). The number of patients informing their doctors of their preferred choice of prescription is on the rise. While most physicians will go an extra mile to explain to patients why they should not be prescribed that particular drug, others are not willing to spend a lot of their time on such issues which constraints the relationship between doctors and patients.
Conclusion
Before 1997, pharmaceutical companies found it difficult to advertise drugs since FDA required them to make a short summary of the drugs. This increased the number of words per advertisement and therefore increases cost of advertisement. In 1997, FDA allowed pharmaceutical companies to advertise without giving a summary of the drug and as a result, the number of DTCA has increased. However, there are concerns about the impact of DTCA. Research shows that DTCA helps patients to have more information about drugs and this helps them to make informed choice. However, most patients are not conversant with pharmaceutical terms which mean most of them are likely miscomprehend the information. Patients are also likely to destroy their relationship with doctors especially when they request to be given a certain prescription contrary to their doctor’s advice.
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