Direct-to-consumer advertising of prescription drugs: educational vs. promotional
DIRECT-TO-CONSUMER ADVERTISING OF PRESCRIPTION DRUGS: EDUCATIONAL VS. PROMOTIONAL Kuan P. Chiang, University of Rhode Island ABSTRACT
DTC advertising of prescription drugs is growing rapidly. The spending for prescription drugs advertising will reach at least $1.3 billion in 1998, an increase over 1997 of more than 50 percent. This record growth follows 42 percent increase reported for 1996 to 1997 (Medical Marketing and Media 1998). Despite regulations by the FDA that require, among other things that the advertisers disclose warnings and contra-indications about the product and voluntarily submit the ads for FDA review, the drug industry has embraced the concept. Generally, the advertisement of prescription drugs directly to consumers has taken three forms: (1) health education, (2) reminder without product claim, and (3) product specific (Borow 1993).
As American consumers take a much more proactive interest in their own health, pharmaceutical companies are taking an equally proactive interest in consumers, as evidenced by the recent explosion of DTC advertising. Yet, there are number of issues related to DTC drug advertising of concern to consumers, physicians, the health care industry, advertisers and legal and regulatory communities. Such issues include the accuracy of information within the advertisement, the increased knowledge level and consumer's influence role when discussing medical problems with physicians and the manufacturer's risk of liability if the ad is inaccurate or misleading.
The reaction to DTC advertising has been mixed and the issue of DTC advertising is still debated. Generally, the debate lies between two different perspectives - educational and promotional. It is the objective of this paper to delineate the issue of DTC advertising from both perspectives and review relevant literature in the use of such practice. It is hoped that the paper will provide some insights of debates as how the issue can be addressed.
The motives behind DTC advertising are many and varied. However, any kind of advertising activity involves the ultimate goal - profit. Therefore, DTC advertising can not be excluded from this purpose and clearly falls into the definition of promotion. Such promotion has resulted in a major opposition from health care professionals, namely, doctors and pharmacists. Traditionally, prescribing drugs is the sole authority of physicians and consumers have little or no knowledge of these prescription drugs. Therefore, physicians oppose DTC advertising for reasons such as the public's inability to understand complex medication. therapeutic indications, and drug interactions. The,~ also say such advertising undermined the doctor patient relationship by encouraging patients to make demands for drugs not medically indicated. In 1989. the AMA House of Delegates passed a resolution disapproving of DTC advertising and expressed concerns that the practice might increase the incidence of drug abuse and increase healthcare costs through unnecessary medical care and large marketing expenditures from pharmaceutical companies (Whyte 1993).
Supporters defend DTC advertising because it serves an educational purpose and provides an opportunity to achieve a greater number of better informed patients seeking early treatment. John Kouten, a spokesman for Bristol Myers-Squibb pointed out that DTC ads are valuable and they raise consumer awareness of prescription drugs (Vecchione 1997). This awareness can further initiate patients to seek necessary treatments. According to Miller (1998), many diseases such as diabetes and depression are significantly undiagnosed and under treated. Even when it is an acute disease like depression, many patients still do not pursue medical attention. In the case of depression, Eli Lilly & Co., the manufacture of Prozac claimed that two-thirds of estimated 17.6 million adults suffering from depression are untreated (Vecchione 1997). For this untreated population, DTC advertising can actually deliver awareness of disease and motivate them to seek advice from doctors.
The controversy of DTC advertising has drawn the attention of a number of researchers and the results have been published extensively. In general, the findings of these studies vary and not surprisingly, sometimes contradict each other. Despite these research findings, the appropriateness of DTC advertising will be continuously debated. Because of different perspectives and interests, the conflict between supporters and opponents of DTC advertising will not be easily solved. However, the battle of DTC advertising - promotion versus education raises a few interesting questions. First, is it possible to distinguish education from promotion in a manner that would allow us to classify these activities as either one or the other? Can one totally separate promotional elements from educational elements in these activities? Good promotion should be educational to the extent that it provides useful information about the product offered for sale. Promotion, however, even if it is educational, must be considered a very special kind of education. Apparently, in the broadest sense of words, promotion can involve education, and education can involve promotion. Furthermore, if DTC advertising "equally educates and confuses" consumers as previous research finding suggests, could consumers take the better part of education from DTC advertising and leave the worse part of confusion to health care professionals? Still, there is no easy answer.
REFERENCES
Borow, Wendy (1993), "The AMA Explains Its About-Face on Direct-to-Consumer Advertising," Medical Marketing & Media, 27, 12,14-22.
"DTC Advertising Predicted to Rise 50 Percent in 199 8 " ( 199 8), Medical Marketing & Media, Aug, 25
Miller, Susan (1998), "DTC Ads Provide the Right Prescription," Brandweek, June 29, 14-15.
Vecchione, Anthony (1997), "Direct Concerns," Drug Topics, July 21, 36-38.
Whyte, John (1993), "Direct Consumer Advertising of Prescription Drugs," Journal of American Medical Association, January 6, 142-146.