Dear AMA: You’re wrong about DTC marketing

UnknownKEY TAKEAWAY: The American Medical Association today called for a ban on direct-to-consumer advertising of prescription drugs, with physicians suggesting that TV and magazine ads could be contributing to the rising cost of expensive treatments however, they are wrong and need to look at the facts.

There are those that really believe that DTC advertising of prescription drugs leads to unneeded prescription drug prescriptions.   They believe, in an era of empowered patients, that patients, like sheep, are going to see an ad for a prescription drug and blindly go ask their doctor for the product.  That is a pure canard.

In fact, DTC advertising leads to patient-physician conversations that ordinarily would not happen.  In addition, physicians do not write prescription drugs that patients want without first identifying a need.  Then of course there are insurers who mandate which drugs can be prescribed and today more than 74% of those drugs are generic.
Diabnosos resulting from DTC visits

 

 

Then there is the data that show that patients who asked for a certain Rx is at an all-time low. Why? Because patients have Dr Internet available 24/7/365 and they do their research before they ask for a product they put in their bodies.
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53% of physicians, in fact, feel that DTC ads lead to better discussions with patients because patients are better educated and informed.

 

Benefits of DTC advertising

Some patients, in fact, are receiving a diagnosis as the result of DTC inspired visits which is very important considering that undiagnosed patients represent a potential heavy burden on our health care system.
Diabnosos resulting from DTC visitsAre there some drugs which are prescribed because of DTC marketing rather than an actual need?  Sure.  ED drugs, for example, are prescribed because it gives men confidence to have romantic intimate moments with their partners.  Most don’t understand that as men get older they need more stimulation (time) to maintain an erection but today who has the time?

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Then there are the staggering costs of “preventable diseases” like Type 2 diabetes. Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, and arthritis—are among the most common, costly, and preventable of all health problems. As of 2012, about half of all adults—117 million people—have one or more chronic health conditions. One of four adults has two or more chronic health conditions.

The majority of US health care and economic costs associated with medical conditions are for the costs of chronic diseases and conditions and associated health risk behaviors.

  • Eighty-four percent of all health care spending in 2006 was for the 50% of the population who have one or more chronic medical conditions.
  • The total costs of heart disease and stroke in 2010 were estimated to be $315.4 billion. Of this amount, $193.4 billion was for direct medical costs, not including costs of nursing home care.
  • Cancer care cost $157 billion in 2010 dollars.
  • The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. Decreased productivity includes costs associated with people being absent from work, being less productive while at work, or not being able to work at all because of diabetes.
  • The total cost of arthritis and related conditions was about $128 billion in 2003. Of this amount, nearly $81 billion was for direct medical costs and $47 billion was for indirect costs associated with lost earnings.
  • Medical costs linked to obesity were estimated to be $147 billion in 2008. Annual medical costs for people who are obese were $1,429 higher than those for people of normal weight in 2006.
  • For the years 2009–2012, economic cost due to smoking is estimated to be more than $289 billion a year. This cost includes at least $133 billion in direct medical care for adults and more than $156 billion for lost productivity from premature death estimated from 2005 through 2009.

Today DTC advertising leads patients to research health problems and stimulate discussions with their doctors.   Consumers are smart enough to research health problems first before asking for advertised products.  I am all for DTC ads because in the long run they actually lower health care costs.

 

 

 

3 thoughts on “Dear AMA: You’re wrong about DTC marketing

  1. Speaking as an individual, thanks for a quick and cogent argument in favor of DTC. I asked Jeff Aronin of MATTER, Marathon Pharma, and a PhrMA Board member. His take is that you can’t put the genie in the bottle. In addition, FDA has weighed in on the 1st Amendment issues. However, Jeff said that the industry needs to use this as an opportunity to better craft its message to the profession, the public, and the public sector. He also said that he is a strong believer in the concept of investment as a prerequisite to return, that ethical pharma involves R&D leading to value added, not exploitation of generic quasi monopolies.

    My personal opinion is that this is an outburst triggered by multifactorial physician anger over recent pricing controversies, availability issues, etc. and that DTC grabbed the headlines for better or worse. As an AMA alum, I am investigating the process, but it looks as if this was an unforeseen storm that arose from a fairly routine Council on Medical Services report to the House of Delegates. I would not anticipate that the contretemps will have any substantial de facto impact on the regulatory environment, even though it will make for an interesting demagoguery opportunity in the election cycle.

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