Big Pharma Products
according to research by Frost & Sullivan
What triggered DTCA for prescription drugs in the United States? How did life-changing discussions that should only happen in a doctor’s office spread into people’s living rooms?
The Prescription Drug PDC Industry Landscape
The DTCA for pharmaceuticals was legalized in 1997. Despite its relatively short existence of 22 years, it has greatly impacted the healthcare advertising landscape in the United States and stands in stark contrast to forms of legal drug advertising in other countries. other countries of the world. Faced with the controversy and questions surrounding the ethics of DTCA, the WE and New Zealand stay the only two countries in the world that allow this practice. The United States could remain the only one if the project of Therapeutic Products Bill in New Zealand manages to include a ban on prescription drug advertising.
Although PDCA has positive effects, these advertisements tend to mislead patients and can lead to the breakdown of the doctor-patient relationship. Between 1983 and 2013, a 30-year period, 449 articles on DTC prescription drug ads were published. These articles have dissected the various pros and cons of the practice. The benefits were primarily based on the belief that when patients saw ads for medications relevant to their symptoms, they entered into a dialogue with their doctor and took a more active role in their healthcare journey. Despite this well-intentioned strategy, prescription drug PDCA has shown the potential to compromise the doctor-patient relationship. According to an FDA survey, 65% of physicians said DTCA for drugs sent confusing messages to patients, and 8% said they felt pressured to prescribe brand name drugs after patients cited a ad of DTP drugs.
The routine use of DTCA and its adverse effects have led the AMA to take a stand against this type of advertising. The AMA feared that “a growing proliferation of advertisements could drive demand for expensive treatments despite the clinical effectiveness of less expensive alternatives”. The AMA’s position is representative of the growing skepticism surrounding DTCA in the medical community. If the the largest medical association in the country speaks out his concerns about this practice, why do pharmaceutical companies continue to use PDCA?
According the Journal of the American Medical Association (JAMA), there has been a drastic increase in DTP prescription drug marketing budgets, from $1.3 billion in 1997 to over $6 billion. in 2016.; it’s a 361% increase. These companies use PDC to promote prescription drugs because it increases the volume of drugs sold. A 2008 House Commerce Committee found that for every $1,000 spent on prescription drug ads, 24 new patients were added for the pharmaceutical industry. Additionally, a 2003 research report found that rates of prescription drugs with advertising were almost seven times bigger only for those without advertising.
In the controversy surrounding high drug prices, you often hear pharmaceutical companies claim that rising drug prices are a direct result of R&D spending. Apart from the negative effects on the doctor-patient relationship, it also has an impact on your wallet. With the spend misconception, there needs to be an industry-wide approach reassessment of priorities regarding DTC prescription drug advertising.
The advertisement you see
“Who wouldn’t want a chance? A chance to live longer.”
The advertisement published by Bristol-Myers Squibb for Opdivo, a drug for a type of advanced lung cancer, is full of flashy images of open skies and vast aircraft, suggesting a pave the way for a healthy future.
Drugs for life-threatening illnesses as serious as lung cancer cannot be explained or understood in 90 seconds. The side effects that range from fatigue to suicidal thoughts, which you or a loved one may experience while taking prescription medications, can be extensive and potentially debilitating. It is almost impossible for anyone to understand the full implications of taking a drug from this type of advertising.
For Opdivo in particular, the dramatic imagery and bold colors draw the viewer’s attention away from the tiny font at the bottom that reads, “Jit is for adults with non-small cell lung cancer previously treated with platinum-based chemotherapy.” This medication advertises itself as a cure for all types of cancer, but it is only used to treat a specific type of lung cancer. Most patients who see this advertisement do not fully understand the details when asking their doctor about a drug. Without a doubt, these companies know that patients want to find ways to live longer. For a person with cancer, it is not appropriate to give him false hope and be refused by his doctor if he does not meet the criteria. The responsibility for having this difficult conversation shifts to the doctor, which further strains the doctor-patient relationship.
The oversimplified message of the Opdivo ad is not unique; many ads follow the same plan. These advertisements may promote potential misconceptions. Consequently, there has been a significant decline in the American public’s trust in the pharmaceutical industry. Since 2018, the Edelman Trust Barometer indicates that 62% of Americans do not trust the pharmaceutical industry. Along with publicly debated topics like high drug prices and the opioid epidemic, advertisements for DTP drugs have contributed to this lack of trust.
The pharmaceutical industry aims to save lives through its drugs. Therefore, trust is an essential component that is important for the patient’s health value. The valueonline model of care disrupts typical “one size fits all” TTT advertising and engages with patients in a more relevant and transparent way.
A forward-looking alternative to DTC ads is Disease Awareness Campaigns (DACs) aligned to this value model of care. DACs are not product specific and allow patients to engage with their doctor without focusing on a particular drug.
One company that has used DACs is Gilead, a research-based biopharmaceutical company that commissioned a hepatitis C ad campaign. The ad successfully used the DAC model and encouraged people to get tested without mentioning its product.
Ads using this strategy aim to effectively educate people about their disease, empower potential patients to speak with their doctor, and eliminate the stigma surrounding the disease in question. While this alternative protects the doctor-patient relationship by allowing physicians to prescribe the best drug possible without pressure on the patient, there are concerns about the lack of FDA oversight surrounding this practice.
The pharmaceutical industry is a revenue-generating activity. While these companies will continue to promote their products to increase shareholder value and profitability, their ultimate responsibility is to people and patient health. The industry must engage in marketing strategies that will not only ensure a profitable future, but also promote one that is ethically sound.
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This article was written with contributions from Inayat Gill, Romina Gupta and Kate Meacham. These women are students at Mount Holyoke College and were highly recognized in the 2019 International Business Ethics Case Competition in Los Angeles, California.
 Schwartz, LM, Woloshin, S. Medical marketing in the United States, 1997-2016. JAMA. 2019;321(1):80–96. doi:10.1001/jama.2018.19320