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Nov 9
Are Drug Firms Wasting Their Money On DTC Advertising?
Last July, CommonHealth released an intriguing study focusing on direct-to-consumer advertising (DTC).  According to a company press release, the research “challenges many of the assumptions of both academic and policy critics of DTC.”

According to CommonHealth, some of  the main criticisms of DTC advertising include:

- It increases requests for branded medications
- It decreases the odds that physicians will discuss the benefits and risks of advertised drugs with patients

CommonHealth conducted a linguistic analysis of 440 conversations between physicians and patients about allergies, hypertension and cholesterol.  In its press release CommonHealth said it found:

- Patient-initiated prescription drug requests are not driven by DTC advertising

- DTC advertising is rarely referenced by patients (0.6% of visits) and never as "I saw/heard this ad and want this prescription drug"

- DTC advertising does not harm the balance of risk-vs.-benefit discussions in observed visits, regardless of DTC spend in the given category 
CommonHealth’s study left a number of people scratching their heads.  If patients are not asking for branded medications after seeing an advertisement, what are pharmaceutical companies paying for?
John Mack Digs Deeper

John Mack, who writes the popular Pharma Marketing Blog, was confused by the study as well.  He asked CommonHealth for more information about its research, but his request was denied.  However, the company told him that it submitted more information about the study to the Food and Drug Administration (FDA).  However, no information was available on the FDA’s Website about the study.  In the end, Mack filed a Freedom Of Information Act request to get more information about the study. 

In a post about the materials he received from the FDA, Mack argued that CommonHealth “selectively released” information about the study and incorrectly characterized the results.  He said: 

“Mentioning DTC ads vs. mentioning drugs by brand name; that's a big difference. But the trade press . . . is spinning the study to prove a point rather than to help understand how DTC works. The point they want to prove is that DTC does not cause consumers to ask for more expensive medicines. The study proves no such thing, yet CommonHealth is aiding and abetting the misinterpretation of its study by denying us access to their data.”

I think what got people confused about the study results was the first point in the CommonHealth press release.  They said the study shows that  “patient-initiated prescription drug requests are not driven by DTC advertising.”  I read this sentence to mean that patients are not asking for drugs because they saw them advertised on TV.  

Another interesting fact is that CommonHealth’s Joe Gattuso appears to go out of his way to reassure us that DTC advertising is working.  In an interview he conducted with Pharmaceutical Executive (PE) that was published in October, Gattuso addressed this issue.  During the interview, PE asked: “So, is DTC advertising not working?”  Gattuso replied:

“Look at it from a marketing point of view. If you say, ‘If I invest X amount of dollars, do I get a return?’ the answer in many successful campaigns is yes, it does move the needle in terms of brand prescribing.  We're simply saying that it doesn't appear that a high percentage of patients are going to the doctor and directly saying, ‘I saw X brand on TV and that's what I want.’ And a lot of the critics of DTC have suggested that that's the case."

So, the question remains: Are drug companies wasting their money on DTC advertising?  According to Gattuso, the answer is no because DTC commercials increase prescriptions. 

Clearly, there is a disconnect here.  If patients aren’t asking for advertised drugs then why/how is DTC advertising increasing prescriptions?  CommonHealth does not have an answer to this question.  DTC works, but they don’t know how. 

Unfortunately for CommonHealth this study does little to refute opponents of DTC advertising.  Imagine this dialogue between critics and CommonHealth:

Critic: Does DTC advertising increase drug prescribing?

CommonHealth: Yes, but not because patients are asking for drugs.

Critic: Really? I’m annoyed that DTC drives scripts for advertised drugs.  I don’t care how it happens.  Whether or not a patient asks for a drug is irrelevant to me.  The commercials are increasing prescribing and I want to put a stop to them. 

Until CommonHealth can show that DTC advertising does not drive uptake it will have a hard time rebutting critics of this marketing practice.  Right now it appears that pharmaceutical companies are not wasting their money on DTC commercials.

2 Comments/Trackbacks

I’ve seen ads on TV for Caduet. It has two ingredients. One is Amlodipine and the other is Atorvastatin. With my RxDrugCard I can get 30 tablets of Amlodipine for $9 and 30 tablets of Simvastatin for $9. I’ll bet they are charging more than $18 for this new drug! The unthinking public is going to pressure their doctors into giving them something just because it’s new when something old or generic would do the job for cheaper.

Published on
Your Television Never Went To Medical School
Often, usually on television, one viewing will often at times see an advertisement for some type of medication- usually one involved in a large market disease state. Such commercials are sponsored by typically large pharmaceutical corporations for particular networks on television. This is called direct to consumer advertising, and both doctors and citizens largely prefer that they do not exist.
Since 1997, when the FDA relaxed regulations regarding this form of advertising, the popularity of the creation of such commercials has greatly increased. The pharmaceutical industry spends around 5 billion annually on this media source now. The industry ranks number two on their spending of media campaigns. Normally, the creation of such a commercial becomes visible to the consumer within a year of the drug’s approval, which raises safety concerns typically associated or possible with newer medications.
The purpose of DTC ads are not education for the viewers, in my opinion, as others have claimed. Any advertising of any type shares the same objective- which is to increase sales and grow their market for a particular medication and, in this case, for a particular perceived medical condition or disease state. The intent of DTC advertising is to generate an emotional response from the viewer, such as fear or concern, believing upon research that the viewer will then question as to whether they need to seek treatment for what may be an unconfirmed medical condition suggested with such advertisements. Furthermore, the FDA has admitted that they are ignorant as far as the content of such DTC ads before they are presented to the public, in relation to their accuracy and clarity, as well as possibly their effect on the health care system.
DTC advertising is also a catalyst for and similar to disease mongering.
Disease mongering is the creation of what some believe to be medical flaws, and illustrated by the creators through exaggeration and embellishments through such media sources as an avenue for what appears to be propaganda often, as is often seen with DTC advertising. The content of the advertisements appear to be medically accurate, yet realistically they are in fact corporate creations of these questionable human ailments that do not or may not require treatment, possibly, and may be attempts by the makers of certain drugs to develop or embellish a particular medical condition to acquire additional profit. One of my favorite DTC advertisements is the new concept for the use of an anti-depressant for a social disorder. Social disorders appear to be another phrase for what are known as introverts- a term created by Dr. Carl Yung. And it is a personality trait, not a medical disease, many believe. There are other questionable medical conditions claimed in the contents of DTC commercials, as the creators of these commercials again wish to grow the market for a particular, and possibly fictional, disease state. Then there is also baldness treatments advertised, as another example by the advertisers who attempt to create a need for treatment. Lifestyle medications are not treatment options for illnesses, and should not be portrayed as such in certain direct to consumer advertisements.
Also, DTC ads discuss only one treatment option normally, so it seems, when likely there are several treatment options that exist for authentic medical disorders. The options for treatment should be left to the discretion of the health care provider, as they are the ones who assess your health, not your television or another media source. That’s why most of the world does not allow DTC advertising, with the exception of our country and New Zealand.
Finally, DTC advertising and its ability to influence viewers to make their own assessment instead of a medical professional remains largely unregulated, yet apparently effective for the creators of direct to consumer advertising. People are prone to believe what they see and hear, regardless of whether or not it is actually true. Many, after viewing a DTC ad, seek out a doctor visit and request whatever product that was advertised, which makes things cumbersome if not awkward for the health care provider chosen by the viewer of a DTC ad for such a visit. So the doctor and patient relationship is altered in a negative way, because most DTC ads require a prescription. Also, in some situations, the sponsor will speak and acquire a dormant/inactive actor, perhaps, or a former athletic celebrity, to fuel their intent.
Medical information and claims of suggested health ailments should come from those in the medical field instead of the corporate world utilizing media outlets such as television. Perhaps this will save some over-prescribing that progressively has been occurring recently, which will benefit everyone in the long term. And the Health Care System can regain control of their purpose, which should be far from financial prosperity acquired by others.
“Ignorance is not innocence but sin.” --- Robert Browning
Dan Abshear
Author’s note: What has been written was based on information and belief

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