Like it or not, direct-to-consumer (DTC) advertising of prescription drugs is here to stay. Although various factions within the healthcare industry have contradictory views
about its benefits or harm, DTC is a successful strategy that has captured the attention of the new medical services consumer - an informed individual who wants to share in
decisions that affect his or her health and well-being.
Each segment of the healthcare industry can cite results of surveys that either promote the educational benefits of DTC or support claims that it has eroded the patient-
physician relationship, caused drug prices to increase, or taken away research dollars for new treatments. Many of these studies, however, have been parochial in nature. They do
not provide the insight the medical community needs as it prepares to enter into the new age of medical consumerism.
Nonetheless, both proponents and opponents agree on one fact: DTC works. Studies from the FDA's Center for Drug Enforcement and the Coalition for Healthcare Communication
report that drugs heavily promoted via television and print ads grabbed a higher share of the market. In fact, NIHCM reported in "Prescription Drugs and Mass Media Advertising"
that spending for drug-specific advertisements was $1.6 billion in 1999. The result: Expenditures on drugs in 1999 rose $17.7 billion, and 25 of the 50 most advertised drugs
accounted for 40.7 percent of the increase.
First Steps
Before formulating policies and strategies, the healthcare industry should carefully analyze all available data to form a realistic picture of the evolving medical consumer
marketplace.
For instance, providers should clarify reports that state an increase in drug expenditures means that drugs cost too much or are being over-prescribed. Or they need to
determine if there is truth to the speculation that a rise in drug expenditures is offset by a reduced number of hospitalizations and expensive treatment options. Also, is the
fear that patients will doc shop to get a name-brand drug or that physicians are pressured to prescribe unnecessary medications due to information collected in controlled studies,
or is this information anecdotal?
DTC advertising has been successful because it recognizes that the medical consumer has changed. The new consumer is older, more educated and technologically literate.
PricewaterhouseCoopers, in "HealthCast 2010," reports that as patients pay more for their medical care, they want to have more say in where their dollar goes. Another study cited
that half of America's 100 million households that chose a new physician in the last two years did so because they were dissatisfied with the physician they had - not because of
managed care or unfilled requests for prescriptions.
The National Health Care and Quality Association conducted a survey of HMO patients to determine if DTC eroded the patient-physician relationship. The survey reported that a
large majority of participants would consider switching to a less expensive medication or alternative form of treatment if their physician asked them to. The participants also
indicated that they would be most receptive if the recommendation came from a trusted physician, if they had the freedom to choose otherwise, and the alternative was equally
effective and convenient. The message: If a physician discusses and explains other options, most patients do not leave a practice because they do not receive a prescription for a
specific drug.
Today's healthcare consumers want information that allows them to share in medical decisions. In responding to a more empowered consumer, physicians, hospitals and insurers
must acknowledge that the balance of power between the patient and medical community has shifted. Consumers now want their medical providers to be partners and help them to filter
through the massive amounts of available information and provide expertise and advice. Studies have shown that the top reason consumers gave for being satisfied with their
physician was quality communication, well above the ranking for quality of care.
Yet, the healthcare industry is generally not prepared to meet the demands of today's consumers. According to the PricewaterhouseCoopers survey of top healthcare executives,
employers and policymakers, only 25 % of the 390 survey participants agreed that hospitals were prepared. Hospital executives surveyed thought that they were more prepared than
others thought they were, and only 14 % of the survey group thought health insurers could meet the demands of empowered consumers.
Without a doubt, DTC's impact is being felt throughout the medical services community. According to AMA's Robert Mills, "Consumer advocates of DTC marketing argue that this
strategy, highlighting the evolving relationship between physicians and patients, shifts control over prescription decisions from physicians to patients, giving patients greater
command over their healthcare. In reality, the principal effect of DTC marketing is to create consumer demand, changing the physician-patient relationship to a physician-consumer
relationship. The consequences of this change are open for debate, but the impact is noticeable.
Perceptions Of DTC
The AMA reports that almost 90 % of physicians responding to the latest AMA Member Pulse poll believe direct-to-consumer advertising has resulted in increased patient demand
for specified brand name drugs. Further, 72 % of respondents believe that DTC has had a negative impact on their practice; and 73 % believe that DTC has resulted in physicians
spending more time supplying patients with accurate information.
FDA/CDER's Attitudes and Behaviors Associated with Direct-to-Consumer (DTC) Promotion of Prescription Drugs survey reports that 15 % of survey participants would change doctors
if they did not prescribe a specific medication.
AARP's survey reported that many consumers stated that health professionals are not a source of information about medications. Only 54 percent of all consumers reported that
their physicians, when prescribing, or pharmacists, when dispensing, "usually" talk to them about a product's risks or potential side effects. Also, survey results suggest that
consumers and their doctors may not always have the same level of awareness of prescription products available in the marketplace, with 21 % of all consumers reporting that they
had asked their doctors about prescription products with which the doctors were not familiar.