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Drug companies and other proponents contend that DTC advertising educates the public about health issues and helps them make informed choices. Critics charge that DTC advertising creates consumer demand for brand-name products that often aren't needed—and that DTC falls short in explaining risks and costs of drug therapy.
Last summer, the Pharmaceutical Research and Manufacturers of America (PhRMA) adopted guiding principles for drugmakers with a voluntary advertising code. The code encourages FDA review of television ads. It also suggests age-appropriate targeting of messages, including information about a drug's risks and benefits, and making claims only when evidence can support them.
Some suggest that the measures, although laudable, don't go far enough and mainly reinforce policies within FDA regulations.
DOC News asked:
What are the risks and benefits of DTC drug advertising? How could rules that govern the ads be improved?
I would suggest a 1- to 2-year time limit between FDA approval and direct-to-consumer ads. It would not be smart to ban direct advertising. Rules are adequate but need to be better enforced.
Regina Druz, MD
Nuclear Cardiology
Roslyn, N.Y.
In my opinion, DTC advertising of prescription drugs should be banned. I can see absolutely no benefit and many risks. I believe that advertising a prescription drug to the general population is a ridiculous waste of money on the part of the drug manufacturers. I also believe that DTC ads undermine the authority and expertise of the physician. This type of advertising only feeds into the mentality that a pill can cure any ailment. As if it is not bad enough that physicians have to deal with patients that self-diagnose via the Internet, with the help of these ads, patients can now self-prescribe based on a 30-second ad. So much for 4 years of medical school and 4-plus years of residency.
If these ads were banned, there would be no need for rules to govern them, public meetings to discuss regulations, and the manpower to do so. All the money that would be saved by banning DTC advertising and the need to regulate these ads could be donated to people who can't afford to pay for their prescription drugs or reinvested in research and development of new drugs. What a concept!
Colleen Murray, RD
Registered Dietitian
San Gabriel, Calif.
I think DTC advertising can be informative, especially when they use well-known celebrities like B.B. King or Patti LaBelle. I think they're targeting a certain hard-to-reach group. It's empowering—you can measure your own glucose, you can manage your diabetes. I've been struck by some of these testimonials; the selling wasn't that blatant. You're more drawn in by the personality, somebody you can relate to. I saw a commercial for one glucose monitor several times before I realized who the manufacturer was.
Diane Harris, BS, CHES
Health Educator
Atlanta, Ga.
Just in the past 5 years there has been such a rise in DTC advertising, and I definitely think health consumers would benefit from more stringent regulations. In an age of strong advertising, information seeking, and the Internet, self-diagnosis is common and generates high demand for drugs by patients who often lack the full medical knowledge of a disease or treatment.
Pharmaceutical companies use the same techniques that other companies use to advertise their products—entertainment goods, food, clothing, or anything—and consumers are going to recognize what is advertised to them the most, which may not always be the best option for them. It is often subconscious the way pharmaceutical advertising affects health decisions, so people don't usually recognize the impact that it can and does have. I do think that when it comes to health-related matters, there should be more to protect consumers and their health care decisions.
Ilyssa Hollander, MPH
Research Associate
Boston, Mass.
There are instances where drug companies have gone farther than they should have in terms of public advertising. And then there are cases [where] we need [to get] more information out to the public, and the media would be helpful where there isn't enough being said about some behavioral things—people need to exercise more and eat better foods, that kind of thing. Pharmaceutical companies have more money and are able to push their side of the story, so it could use a little more balance. But DTC advertising has a role in informing and educating the public.
Bill Gloyd, MD, MPH
Public Health
Albuquerque, N.M.
TALK BACK: ARE STATINS READY FOR PRIME TIME?
In recent years, the status of a slew of drugs has switched from prescription to over-the-counter (OTC). For many consumers, this has meant less expensive, more convenient treatment for common health issues. Drug companies favor the switch too, as it usually extends the market for their brands.
The move to switch statins to OTC status gives many reason to pause. Such a designation may help patients reach treatment goals by making statin drugs more accessible and affordable. However, there is little evidence that statins have a measurable impact on primary outcomes such as cardiovascular mortality.
The other drugs switched from prescription to OTC status are indicated mainly for relatively minor, self-limiting conditions such as headache and seasonal allergies. None is for a chronic condition with no outward signs and symptoms.
Low-dose simvastatin (Zocor, Merck) has been available OTC in Great Britain since summer 2004. The Food and Drug Administration has been asked three times to approve an OTC statin, and three times the agency has said "no."
What do you think? Should statins be switched to OTC status?
Send your comments to docnews{at}diabetes.org.
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