CNS Drugs

, Volume 18, Issue 2, pp 69–77 | Cite as

Direct-To-Consumer Marketing of Prescription Drugs

A Current Perspective for Neurologists and Psychiatrists
Current Opinion

Abstract

In the US and New Zealand, the past decade has seen tremendous growth in the marketing of prescription drugs directly to patients. The pharmaceutical industry has applied pressure in other countries to relax regulations governing such marketing although this has not yet been successful. While we still have much to learn about the potential impact on the public’s health of direct-to-consumer (DTC) marketing, some data are available.

This article summarises the current literature on the benefits and risks of DTC marketing. This marketing strategy has grown substantially in the US, but only select drugs are advertised. Whether there is net benefit or harm to the public’s health as a result of DTC marketing depends critically on which drugs are advertised and the quality of the information provided in promotional material. Critical reviews of this promotional material suggest the information is of poor quality. Notably, 18% of the 50 drugs advertised most intensively in the US were medications used to treat psychiatric and neurological disorders. The impairments in decisional capacity often seen in psychiatric and neurological illness leave patients vunerable to the controlling influence of DTC marketing and, thus, undermine the patient autonomy that is said to be promoted by this marketing strategy. If there is any benefit from DTC marketing it is for significantly undertreated conditions. International restrictions on DTC marketing should remain in place until further evidence of net benefit or harm emerges from the DTC marketing experiment that is taking place in the US and New Zealand.

References

  1. 1.
    Pinkus RL. From Lydia Pinkham to Bob Dole: what the changing face of direct-to-consumer drug advertising reveals about the professionalism of medicine. Kennedy Inst Ethics J 2002; 12(2): 141–58PubMedCrossRefGoogle Scholar
  2. 2.
    Lyles A. Direct marketing of pharmaceuticals to consumers. Annu Rev Public Health 2002; 23: 73–91PubMedCrossRefGoogle Scholar
  3. 3.
    Perri M, Shinde S, Banavali R. The past, present, and future of direct-to-consumer prescription drug advertising. Clin Ther 1999; 21(10): 1798–811PubMedCrossRefGoogle Scholar
  4. 4.
    Mello MM, Rosenthal M, Neumann PJ. Direct-to-consumer advertising and shared liability for pharmaceutical manufacturers. JAMA 2003; 289(4): 477–81PubMedCrossRefGoogle Scholar
  5. 5.
    DiMasi JA, Hansen RW, Grabowski HG. The price of innovation: new estimates of drug development costs. J Health Econ 2003; 22: 151–85PubMedCrossRefGoogle Scholar
  6. 6.
    General Accounting Office. Prescription drugs: FDA oversight of direct-to-consumer advertising has its limitation. Washington, DC: United States General Accounting Office, 2002 OctGoogle Scholar
  7. 7.
    Findlay SD. Direct-to-consumer promotion of prescription drugs. Pharmacoeconomics 2001; 19(2): 109–19PubMedCrossRefGoogle Scholar
  8. 8.
    The National Institute for Health Care Management. Prescription drugs and mass media advertising, 2000n [online]. Available from URL: http://www.nihcm.org/DTCbrief2001.pdf [Accessed 2003 Oct 27]
  9. 9.
    Rosenthal MB, Berndt ER, Donohue JM, et al. Promotion of prescription drugs to consumers. N Engl J Med 2002; 346: 498–505PubMedCrossRefGoogle Scholar
  10. 10.
    IMS Health. IMS reports 11.8% dollar growth in 2002 US prescription sales [online]. Available from URL: http://www.imshealth.com/ims/portal/front/articleC/0,2777,6599_3-665_41276589,00.html [Accessed 2003 Apr 28]
  11. 11.
    Holmer AF. Direct-to-consumer advertising: strengthening our health care system. N Engl J Med 2002; 346: 526–8PubMedCrossRefGoogle Scholar
  12. 12.
    Kravitz RL. Direct-to-consumer advertising of prescription drugs. West J Med 2000; 173: 221–2PubMedCrossRefGoogle Scholar
  13. 13.
    Baylor-Henry M, Drezin NA. Regulation of prescription drug promotion: direct-to-consumer advertising. Clin Ther 1998; 20Suppl. C: C86–95PubMedCrossRefGoogle Scholar
  14. 14.
    Mintzes B. Direct to consumer advertising is medicalising normal human experience. BMJ 2002; 324: 908–11PubMedCrossRefGoogle Scholar
  15. 15.
    Wilkes MS, Bell RA, Kravitz RL. Direct-to-consumer prescription drug advertising: trends, impact, and implications. Health Aff (Millwood) 2000; 19(2): 110–28CrossRefGoogle Scholar
  16. 16.
    Berger JT, Kark P, Rosner F, et al. Direct-to-consumer drug marketing: public service or disservice? Mt Sinai J Med 2001; 68(3): 197–202PubMedGoogle Scholar
  17. 17.
    Henney JE. MSJAMA: challenges in regulating direct-to-consumer advertising. JAMA 2000; 284(17): 2242PubMedCrossRefGoogle Scholar
  18. 18.
    Kahn C. How media influences women’s perceptions of health care. Mark Health Serv 2001; 21(1): 12–7PubMedGoogle Scholar
  19. 19.
    Bell RA, Kravitz RL, Wilkes MS. Direct-to-consumer prescription drug advertising and the public. J Gen Intern Med 1999; 14: 651–7PubMedCrossRefGoogle Scholar
  20. 20.
    Hollon MF. Direct-to-consumer marketing of prescription drugs: creating consumer demand. JAMA 1999; 281(4): 382–4PubMedCrossRefGoogle Scholar
  21. 21.
    Villanueva P, Peiro S, Libero J, et al. Accuracy of pharmaceutical advertisements in medical journals. Lancet 2003; 361: 27–32PubMedCrossRefGoogle Scholar
  22. 22.
    Drug advertising: is this good medicine. Consum Rep 1996 Jun; 61 (6): 62-3Google Scholar
  23. 23.
    Bell RA, Wilkes MS, Kravitz RL. The educational value of consumer-targeted prescription drug print advertising. J Fam Pract 2000; 49: 1092–8PubMedGoogle Scholar
  24. 24.
    Woloshin S, Schwartz LM, Tremmel J, et al. Direct-to-consumer advertisements for prescription drugs: what are Americans being sold? Lancet 2001; 358: 1141–6PubMedCrossRefGoogle Scholar
  25. 25.
    Pear, R. Marketing tied to increase in prescription drug sales. New York Times 2000 Sep 20; Sect. A: 16Google Scholar
  26. 26.
    UnitedStates Food and Drug Administration Center for Drug Evaluation and Research. Warning letters and untitled letters to pharmaceutical companies 2000 [online]. Available from URL: http://www.fda.gov/cder/warn/warn2000.htm [Accessed 2003 Oct 27]
  27. 27.
    Wolfe SM. Direct-to-consumer advertising: education or emotion promotion? N Engl J Med 2002; 346: 524–6PubMedCrossRefGoogle Scholar
  28. 28.
    Cohen EP. Direct-to-the-public advertisement of prescription drugs. N Engl J Med 1988; 318(6): 373–6PubMedCrossRefGoogle Scholar
  29. 29.
    Bradley LR, Zito JM. Direct-to-consumer prescription drug advertising. Med Care 1997; 35(1): 86–92PubMedCrossRefGoogle Scholar
  30. 30.
    Johnson GL, Ramaprasad A. Patient-physician relationships in the information age. Mark Health Serv 2000; 20(1): 20–7PubMedGoogle Scholar
  31. 31.
    Pines WL. Direct-to-consumer advertising. Ann Pharmacother 2000; 34: 1341–4PubMedCrossRefGoogle Scholar
  32. 32.
    Zachary WM, Ginsburg DB. Patient autonomy and the regulation of direct-to-consumer advertising. Clin Ther 2001; 23(12): 2024–37CrossRefGoogle Scholar
  33. 33.
    Elliot VS. FDA survey puts positive spin on direct-to-consumer ads. Am Med News 2003 Feb 3; 46(5): 25,28Google Scholar
  34. 34.
    Mitka M. Survey suggesting that prescription drug ads help public is met with skepticism. JAMA 2003; 289: 827–8PubMedCrossRefGoogle Scholar
  35. 35.
    Mintzes B, Barer ML, Kravitz RL, et al. Influence of direct to consumer pharmaceutical advertising and patients’ requests on prescribing decisions: two site cross sectional survey. BMJ 2002; 324: 278–9PubMedCrossRefGoogle Scholar
  36. 36.
    Rosenstein DL, Miller FG. Ethical considerations in psycho-pharmacological research involving decisionally impaired subjects. Psychopharmacology [online]. Available from URL: http://link.springer.de/link/service/journals/00213/contents/03/01503/ [Accessed 2003 Jun 23]
  37. 37.
    Metzl JM. Angela. Am J Psychiatry 2002; 159(10): 1665–6PubMedCrossRefGoogle Scholar
  38. 38.
    Gollust SE, Hull SC, Wilfond BS. Limitations of direct-to-consumer advertising for clinical genetic testing. JAMA 2002; 288: 1762–7PubMedCrossRefGoogle Scholar
  39. 39.
    Coons SJ. Direct-to-consumer advertising: the jury is still out. Clin Ther 2001; 23(12): 2022–3CrossRefGoogle Scholar
  40. 40.
    Toop L, Richards D, Dowell T. The leadership role of general practice in public health: advocating a ban of direct-to-con-sumer advertising of prescription drugs in New Zealand: ’Pos-sums in the headlights?’. Br J Gen Pract 2003; 53: 342–5PubMedGoogle Scholar
  41. 41.
    Hoek J, Gendall P. Direct-to-consumer advertising down under: an alternative perspective and regulatory framework. J Public Policy Marketing 2002; 21(2): 202–12CrossRefGoogle Scholar
  42. 42.
    Toop L, Richards D, Dowell T, et al. Direct to consumer advertising of prescription drugs in New Zealand: for health or for profit [online]? Available from URL: http://www.chmed-s.ac.nz/report.htm [Accessed 2003 Oct 27]
  43. 43.
    Holmer AF. Direct-to-consumer prescription drug advertising builds bridges between patients and physicians. JAMA 1999; 281: 380–2PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2004

Authors and Affiliations

  1. 1.Department of MedicineUniversity of WashingtonSeattleUSA

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