Are direct-to-consumer ads helpful or harmful?

The flow of direct-to-consumer (DTC) advertising for the latest wonder drugs is constant and seemingly endless. TV, Internet and print ads captivate consumers with tales of medicines that can solve their health issues and improve their lives. But opinions vary about whether DTC advertising is helpful or harmful, not only for patients but for physicians.

“People who see ads aren’t more likely to get a prescription for the advertised drug,” says Michael Ybarra, MD, an emergency physician and senior director for alliance development at Pharmaceutical Research and Manufacturers of America (PhRMA). “In fact, most patients who go to a doctor’s office and request a prescription don’t walk away with one. Instead, DTC advertising can open up a dialogue between the doctor and the patient-patients ask questions about their health and their medicines, and they end up working more closely with their doctor on their care.”
Ybarra adds that a 2004 FDA study found 53% of physicians reported better discussions with patients exposed to DTC advertising.
The American Medical Association (AMA) disagrees. In November 2015, the association adopted a resolution opposing DTC advertising, citing concerns that the surging tide of ads drives patient demand for expensive medicines despite the clinical effectiveness of less-costly alternatives.
AMA members voted to support a ban on DTC advertising for prescription drugs and implantable medical devices, maintaining that the negative effects of commercially driven ads outweigh the minimal educational information the ads may offer to patients.

“The vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially driven promotions, and the role that marketing costs play in fueling escalating drug prices,” says AMA board chair-elect Patrice A. Harris, MD, MA. “Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”
Market research firm Kantar Media found that advertising dollars spent by drug manufacturers grew 30% in the last two years to $4.5 billion. In recent years prices for both generic and brand-name prescription drugs have risen as well, including a 4.7% spike in 2015, according to the Altarum Institute Center for Sustainable Health Spending.
The U.S. Food and Drug Administration’s (FDA) Office of Prescription Drug Promotion is investigating DTC and professional drug promotion. “We recognize that drug promotion raises certain issues for health care professionals and different issues for consumers, in light of differences in medical and pharmaceutical expertise,” Sarah Peddicord, a spokesperson for the FDA told Medical Economics. “The FDA is monitoring DTC promotion very closely to help ensure that adequate information is included to help the consumer accurately assess promotional claims and presentations.”
Opponents of DTC advertising claim that increases in drug prices can make it difficult for doctors to offer their patients the best therapies. “Patient care can be compromised and delayed when prescription drugs are unaffordable and subject to coverage limitations by the patient’s health plan,” says Harris. “In a worst-case scenario, patients forego necessary treatments when drugs are too expensive.”