Commentary: Direct-to-Consumer Advertising Saves Lives

Published June 1, 2005

When a consumer sees an ad for the latest Ford truck, it catches his attention. Perhaps he goes on the Internet to learn more about that truck and compare it with the latest trucks from Dodge, Nissan, and other manufacturers. Maybe he asks his friends about it and goes to the local dealership for a test drive. Heck, maybe he even decides that truck is right for him and buys it.

Strange as it may sound, that scenario is not much different for direct-to-consumer (DTC) prescription drug ads. Those ads help make consumers aware of the signs and symptoms of various diseases and prompt people to see their doctors and learn about potential illnesses and treatments.

A study performed by J. Weissman et al. and published in the February 26, 2003 online edition of the journal Health Affairs revealed that one-fourth of U.S. adult patients who visited their physician after seeing a DTC ad were diagnosed with a new condition, including high cholesterol, high blood pressure, diabetes, and depression.

DTC Useful to Patients, Doctors

Advertising is a critical piece of the free-market economic system. It empowers consumers with information, and it keeps the wheels of innovation in motion. Yet, there is a clear double standard when it comes to direct-to-consumer prescription drug advertising when compared with advertising of other consumer products.

Many physicians believe DTC drug ads help create awareness and often prompt individuals to seek out more information or visit a doctor when they recognize symptoms identified in an ad. As a practicing endocrinologist, I can attest to that: Patients who have seen pharmaceutical ads related to their illnesses are often better-informed and therefore easier to work with.

Not everyone shares this opinion. Many worry that prescription drug ads contain only enough information to be misleading and create false hope for a guaranteed cure.

What is often overlooked is that the Food and Drug Administration closely monitors these ads and can force the removal of any that are determined to be untrue. If DTC ads are making claims they cannot support, as critics worry, empowered consumers consulting with their doctors and pharmacists will sort that out–just as they do with other products.

DTC Improves Treatment, Compliance

With the use of advertising, companies can build awareness of symptoms and diseases. Diseases that were once taboo to discuss are now commonly addressed in the media. Direct-to-consumer ads also help educate the patient about treatment options, thereby improving patient compliance.

In my practice, I have found that patients who have seen drugs advertised are more likely to try them. A study prepared by New York-based Pfizer, Inc. in 2001 revealed that patients who have seen a DTC ad are 75 percent more likely to stay on their arthritis medications, twice as likely to stay on their allergy medications, and 37 percent more likely to stay on their antidepressant medications.

Direct-to-consumer ads reach out to the undiagnosed and under-treated. On more than one occasion in my practice, patients made an appointment to see me when they recognized in themselves diabetes symptoms they had learned about by watching DTC ads.

The ads also help under-treated patients, who in the past might have seen their doctor and been told, “There is nothing more we can do.” Advertising makes information on new drugs available to the patient.

Advertising Is Economical

There are also many economic misconceptions regarding DTC advertising of prescription drugs, particularly the concern that such advertising raises the price of drugs.

That argument is reminiscent of the arguments involving air conditioning in the 1950s. Some held that retail stores should not be air-conditioned because the cost of the air conditioning would ultimately increase the cost of the product sold. However, shoppers flocked to stores that were air-conditioned and thus offered a respite from the stifling outdoor heat, and these stores were able to sell their products at a lower price and still reap a handsome profit.

Critics claim the pharmaceutical industry spends more on DTC advertising than on research and development. The opposite is actually true. In 2001, the pharmaceutical industry spent $30 billion on research and development. It spent less than a tenth of that amount on DTC ads.

Physicians Cannot Inform Everybody

And what is often forgotten is that the cost of advertising is just one of the costs incurred in bringing a drug to the marketplace. The cost of research is the price paid to generate scientific knowledge of how to make these drugs. The cost of advertising is the price paid to generate public knowledge of these drugs. It is the production cost of public awareness.

You can have the best drug in the world, but if no one knows about it, no one will benefit from it. How else could you get this information to the patient? Some say physicians should be the ones to communicate that. But in the case of individuals who do not regularly see a physician, how are consumers to get this important information if not via DTC advertising?

A typical primary care physician has approximately 2,000 patients in his care. Let’s imagine a new drug enters the marketplace on Monday morning. In a physician’s office, the patients he sees that day can be notified of this drug, if appropriate.

What do we expect the physician to do next? To make sure this new drug is available to those patients in his practice who could benefit from it, he would have to sit down and review all of his charts to pick out the appropriate patients, and then notify them. Even if he could review his charts at the rate of one per minute, it would take him at least 33 hours to determine which patients could benefit from this new drug.

Then it would take countless more hours for his staff to reach out and notify those patients. The cost this would add to his overhead would be huge. Furthermore, during the 33-plus hours the doctor would spend reviewing the charts, he would not be able to see patients. The cost to them in pain and suffering could be significant.

DTC Ads Save Lives

It is obviously much more efficient to have patients self-select, after seeing a DTC ad, and contact the doctor and make an appointment to see him.

DTC ads save lives. They make people aware of drugs that are now available to treat life-threatening diseases.

To be against DTC advertising is to be in favor of ignorance.

Richard O. Dolinar, M.D. ([email protected]) is a Phoenix-based endocrinologist and senior fellow for The Heartland Institute. This article originally appeared in Pharmaceutical Representative. Reprinted with permission.