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Direct to consumer advertising: As drug sales climb, are we smarter or healthier?

Direct to consumer advertising is the promotion of prescription drugs through newspaper, magazine, television, or internet marketing.

Proponents of this advertising, including the drug industry, argue that direct to consumer advertising educates consumers about certain conditions and encourages consumers to see their healthcare provider for diagnosis and treatment. Although these ads clearly increase sales, evidence is lacking that it improves consumer knowledge or health.

Meanwhile, opponents believe that these promotional ads may overstate the health benefits of a medication while down-playing serious side-effects. This can result in ads that are misleading or just plain wrong.

Cost is another concern. Direct to consumer advertising has contributed to an overall increase in spending on both the advertised drug as well as other drugs used to treat that condition, according to a 2006 report by the U.S. Accountability Office. If these ads resulted in more appropriate, cost-effective prescribing, then the money might be well spent. But there’s no evidence that this is the case. Instead, these ads may lead to over diagnosis, overtreatment, and inappropriate use of medications when generic medications or non-drug treatments are just as good or better.

These ads are required to meet certain regulatory requirements, including the following:
o They must provide a fair balance of the risks and benefits of the medication.
o They cannot be false or misleading.
o They must state at least one approved use of the drug.
o They must provide the generic name of the drug.
o They must include all risks associated with the drug. However, they can meet this requirement by giving only the more important risks while providing sources where consumers can get the complete risk profile, such a 1-800 number, website address, referencing a print add that lists all the side effects, stating “ask your healthcare provider”.

If you think a prescription drug ad has violated a law e.g., it’s false, misleading, or lacks fair balance), then contact the FDA’s Division of Drug Advertising and Communications (DDMAC). Consumers can call DDMAC at 301-796-1200. Alternatively, a written complaint can be mailed to DDMAC at:
Food and Drug Administration
Center for Drug Evaluation and Research
Division of Drug Marketing, Advertising, and Communications
5901-B Ammendale Road
Beltsville, MD 20705-1266

Remember that direct to consumer advertisements are a blend of information and promotion. As such, view the information with a healthy dose of skepticism. If you think the information might apply to you, seek out other sources that are more balanced.

There are many good sources out there, but here are a few to consider:
o Talk to your healthcare provider.
o Check out your health plan’s website or Web MD.
o If you only want information about prescription medications, try the Drugs@FDA section of the Food and Drug Administration (FDA) website ). At Drugs@FDA, you can search for a medication, select the drug label icon, and get detailed information about the drug.
o If you’re willing to spend a little money, I like two commercial newsletters that are evidence-based and free of pharmaceutical company influence – Prescriber’s Letter and The Medical Letter. Prescriber’s Letter is more consumer friendly.

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