What is the Future of DTC Advertising?

By Steve Dubansky, MD

Are you ready for 10 minute long DTC commercials?

The seemingly never-ending debate about the risks and benefits of DTC drug advertising continues to rage between Pharma and the concerned, self-designated protectors of the public health. Do prescription drug ads educate consumers, improve the quality of care, and contribute to better patient adherence, or do they lead to inappropriate prescribing and portray nonmedical problems as treatable medical illnesses?

The latest salvo in the argument landed on the pages (actually e-published at this point) of the American Journal of Public Health, in the form of a study entitled “A Decade of Controversy: Balancing Policy With Evidence in the Regulation of Prescription Drug Advertising.

The lead author, Dominick Frosch, PhD, an assistant professor of medicine at UCLA, claims that Americans view 16 hours of prescription drug ads on TV each year (I thought it would be much more), and these ads fail to help TV viewers make better health-related choices. The raw data are not yet available, but I am interested in seeing how the primary endpoint (“better choices about their health) is truly defined, and how the study was powered, performed, analyzed, etc. While I have no personal bias in this contentious debate beyond my strong desire to see all patients and families educated and empowered, I am always a bit concerned when investigators, who may have a predetermined leaning, perform studies in the medical or social science arena.

Dr. Frosch states, “If the pharmaceutical industry isn’t willing to change the ads to make them more useful to consumers, Congress should consider passing legislation that will regulate the ads to improve the information provided in order to help patients make more informed choices.” If wholesale changes are determined to be necessary, is it possible to first to sit down like adults and develop meaningful, evidence-based guidelines before opening up Congressional hearings and legislating?

Claiming that the evidence clearly shows that there is significant risk and potential harm associated with present-day DTC drug ads, the authors state (as reported in a summary statement online):

1. The majority of ads fail to provide enough information so consumers can identify whether the drug is right for them.
2. The over-dramatization and emotional portrayal of a drug’s benefits can also be misleading to viewers, while the messages about its risks are often diluted by positive or distracting imagery.

The answers? As supplied by the authors:

• Ads should help consumers identify whether treatment is right for them by explaining how prevalent the relevant conditions are
• Ads should describe who may be at risk for conditions that don’t present obvious symptoms
• For conditions that are symptomatic (ED as opposed to hypercholesterolemia), ads should describe what those symptoms are
• Ads should provide accurate and specific information about the potential benefits of advertised drugs, and should help consumers realistically judge those benefits by providing precise quantitative information
• Ads should state how the drug compared to placebo or other available treatments, including generic drugs
• Ads should provide specific quantitative information about the potential risks associated with drugs without other visual or audio distractions, so consumers can better understand the risks associated with the prescription drugs

Essentially, it appears to me that the solutions proposed preclude any possibility of continuing DTC drug ads on TV. In order to satisfy the above requirements, even the most creative advertisers would need to produce 30-minute infomercials rather than 30- to 60-second TV spots. Unless, that is, they are still able to find this guy

What do you think? Isn’t there a better way to get consumers the information they need?