Role of Socioeconomic Status on Consumers’ Attitudes Towards DTCA of Prescription Medicines in Australia
- 378 Downloads
The Pharmaceutical Benefits Scheme, operating in Australia under the National Health Act 1953, provides citizens equal access to subsidised pharmaceuticals. With ever-increasing costs of medicines and global financial pressure on all commodities, the sustainability of the PBS is of crucial importance on many social and political fronts. Direct-to-consumer advertising (DTCA) of prescription medicines is fast expanding, as pharmaceutical companies recognise and reinforce marketing potentials not only in healthcare professionals but also in consumers. DTCA is currently prohibited in Australia, but pharmaceutical companies continuously lobby for the ban to be lifted. There is evidence that such marketing strategies influence consumer behaviour and concerns have been raised about whether DTCA could affect government expenditure on the PBS in Australia. This pharmacy-based study explored Australian consumer attitudes towards DTCA and whether consumer attitudes regarding DTCA differ based on socioeconomic status, measured in terms of income and education. Consumers from different socioeconomic areas in Sydney were asked to respond to a survey about an advertisement created specifically for the promotion of a mock prescription medicine. Their views about the intent, value and reliability of the advertisement were explored. The study found that consumers of lower socioeconomic status were more likely to perceive DTCA as a source of valuable and reliable medical information, and that they were more likely to request an advertised medication from their physician. If DTCA of prescription medicines was to be introduced in Australia, an increase in government expenditure on the PBS would be anticipated. Findings of this study also expose a deficit in respect for patients’ right to autonomy and informed consent which should be based on evidence-based, unbiased, information rather than advertisements.
KeywordsAustralian government expenditure Autonomy Consumer attitudes Direct-to-consumer advertising of prescription medicines (DTCA)
Food & Drug Administration (USA)
Pharmaceutical Management Agency
Pharmaceutical Benefits Scheme
United States of America
World Health Organisation
- Australian Bureau of Statistics. (2006). Socioeconomic indexes for areas (SEIFA) Postal Areas. Australian Bureau of Statistics. Accessed June 13, 2009, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/2033.0.55.001Main+Features12006?OpenDocument.
- Auton, F. (2004). The advertising of pharmaceuticals direct to patients: A critical review of the literature and debate. International Journal of Advertising, 23(1), 5–52.Google Scholar
- Beauchamp, T., & Childress, J. (2009). Principles of biomedical ethics (6th ed.). New York: Oxford University Press.Google Scholar
- Centrelink. (2009). Low income health care card. Commonwealth of Australia. Accessed October 24, 2009, from http://www.centrelink.gov.au/internet/internet.nsf/payments/conc_cards_iat.htm.
- Cleanthous, P. (2002). Patient welfare implications of innovation and diffusion in the US antidepressant market. Working Paper, New York University.Google Scholar
- Cleanthous, P. (2004). Analyzing the effects of marketing efforts by pharmaceuticals on patient welfare. Working Paper, New York University.Google Scholar
- Davis, K., Schoen, C., Schoenbaum, S. C., Doty, M. M., Holmgren, A. L., Kriss, J. L., et al. (2007). Mirror, mirror on the wall: An international update on the comparative performance of American health care. The Commonwealth Fund. Accessed October 24, 2009, from http://www.commonwealthfund.org/usr_doc/1027_davis_mirror_mirror_international_update_final.pdf?section=4039.
- Department of Health and Ageing. (2005). Overview of the Australian healthcare system. Department of Health and Ageing. Accessed 12 October 12, 2009, from http://www.health.gov.au/internet/main/publishing.nsf/Content/healthsystem-overview-3-funding.
- Department of Health and Ageing. (2008). Quality use of medicines. Commonwealth of Australia. Accessed October 15, 2009, from http://www.health.gov.au/internet/main/Publishing.nsf/Content/nmp-quality.htm.
- Department of Health and Ageing. (2009). About the PBS. Commonwealth of Australia. Accessed October 24, 2009, from http://www.drinkingnightmare.gov.au/internet/main/publishing.nsf/Content/health-pbs-general-aboutus.htm-copy2.
- Fetto, J. (2002). Drugged out. American Demographics, 24, 11.Google Scholar
- Galbally, R. (2001). Review of drugs poisons and controlled substances legislation. Final Report. Canberra: Commonwealth of Australia. Accessed September 03, 2010, from http://www.tga.gov.au/docs/html/rdpdfr.htm.
- GAO. (2006). Prescription drugs: Improvements needed in FDA’s oversight of direct-to-consumer advertising. Report No. 07-54. United States General Accounting Office. Accessed September, 2010, from http://www.gao.gov/new.items/d0754.pdf.
- Gardner, D. M., Mintzes, B., & Ostry, A. (2003). Direct-to-consumer prescription drug advertising in Canada: Permission by default? Canadian Medical Association Journal, 169, 425–427.Google Scholar
- Gascione, D. (2004). DTC at the crossroads: A “direct” hit… or miss? IMS issues and insights, September 23, 2004, pp. 111–123. Plymouth Meeting, PA: IMS Health.Google Scholar
- Gillon, R. (2003). Ethics needs principles—four can encompass the rest—and respect for autonomy should be “first among equals”. Journal of Medical Ethics, 29(5), 307–312.Google Scholar
- Kerridge, I., Lowe, M., & Stewart, C. (2009). Ethics and law for the health professions (3rd ed., pp. 79–90). Annandale: The Federation Press.Google Scholar
- Medicines Australia. (2008). Pharmaceutical benefits scheme quarterly fact sheet. Commonwealth of Australia. Accessed October 24, 2009, from http://www.medicinesaustralia.com.au/pages/images/PBS-Quarterly-facts-June-Quarter-2008.pdf.
- Miller, K. E., & Waller, D. S. (2004). Attitudes towards DTC advertising in Australia: An exploratory study. International Journal of Advertising, 23(3), 389–405.Google Scholar
- Mintzes, B., & HAI Europe. (1998). Blurring the boundaries—New trends in drug promotion. Accessed January 24, 2011, from http://www.haiweb.org/pubs/blurring/blurring.intro.html.
- Mintzes, B. (2006). What are the public health implications? Direct-to-consumer advertising of prescription drugs in Canada. Health Council of Canada. Accessed June 15, 2009, from http://www.healthcouncilcanada.ca/docs/papers/2006/hcc_dtc-advertising_200601_e_v6.pdf.
- National Prescribing Service (NPS). (2009). Proton pump inhibitors-prescribing practice review for primary care. RADAR, 1–4.Google Scholar
- Prat, P. (2000). The results of a regulatory compliance survey of direct-to-consumer advertisements for medicines. Wellington: Ministry of Health (Medsafe).Google Scholar
- Sub-Committee DU. (2008). Top 10 drugs. Commonwealth of Australia. Accessed October 21, 2009, from http://www.australianprescriber.com/upload/pdf/articles/992.pdf.
- Weissman, J. S., Blumenthal, D., Silk, A. J., Newman, M., Zapert, K., Leitman, R., et al. (2004). Physicians report on patient encounters involving direct-to-consumer advertising. Accessed October 21, 2009, from http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.219.
- WHO. (1988). Ethical criteria for medicinal drug promotion. The World Health Organisation. Accessed June 14, 2009, from http://whqlibdoc.who.int/publications/1988/924154239X_eng.pdf.
- Williams, J. R., & Hensel, P. J. (1995). Direct-to-consumer advertising of prescription drugs. Journal of Health Care Marketing, 15(1), 35–41.Google Scholar