It’s Time to Shine the Light on Direct-to-Consumer Advertising

Tim K. Mackey; Bryan A. Liang

doi:10.1370/afm.1711

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Shedding light on DTCA
Shahram Ahari, MD, MPH

Published on: 05 March 2015
DTCA and Tranparency - Level the playing field
Chris Fletcher

Published on: 14 January 2015

Published on: (5 March 2015)
Page navigation anchor for Shedding light on DTCA
Shedding light on DTCA
Shahram Ahari, MD, MPH, EM Resident
Drs. Liang's and Mackey's excellent article touches on a core element of pharmaceutical marketing: leverage the physician's prescribing practices innocuously. DTCA allows a form of delivering proxy sales pitches that echo closely the marketing messages delivered by more common practices (drug representatives, journal ads, paid academic speakers) but come from an unexpected and seemingly safe source. As a physician, I rec...
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Drs. Liang's and Mackey's excellent article touches on a core element of pharmaceutical marketing: leverage the physician's prescribing practices innocuously. DTCA allows a form of delivering proxy sales pitches that echo closely the marketing messages delivered by more common practices (drug representatives, journal ads, paid academic speakers) but come from an unexpected and seemingly safe source. As a physician, I recognize the pressure that puts on me to try to accommodate my patient. As a former drug representative, I recognize the subtle reinforcement of the idealized perception of the drug in question. Furthermore I'm aware that any cognitive adjustment I may make to compensate is merely a guess against the insidious nature of drug marketing. Such reasoning was part of the impetus to advocate for the Sun Shine Act in the first place.
Indeed, as the authors suggest, shedding light on DTCA would allow us to acknowledge both the risks and benefits. Such first steps would be imperative to draft more meaningful policy to regulate DTCA. Or would it? What does the world know that New Zealand and the USA do not? From a drug industry perspective the benefits are commonly measured and easily quantifiable through return-on-investments analyses, the details of which are largely held as proprietary secrets. It is a safe assumption, however, that if such a marketing modality that costs billions of dollars in a collectively successful industry continues to generate sales then that means its working to influence doctors. The implication is that either our physicians are sorely in need of education by the drug industry or that we need better safeguards against forces that would impose a conflict-of-interest.
I agree that shedding light on DTCA will be insightful to understanding the effects of marketing on medicine. If prior advocacy efforts are any indication, the pharmaceutical industry will take great pains to undermine passage of meaningful policy, delay its compliance, or understate its significance. One can expect to hear arguments that extol the value of DTCA to the patient and, in the same breath, describe the industry's ability to self-regulate. Yet, it seems that we already have a compelling ethical reason to change DTCA that has convinced 192 other countries.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (14 January 2015)
Page navigation anchor for DTCA and Tranparency - Level the playing field
DTCA and Tranparency - Level the playing field
Chris Fletcher, FP
Since DTCA has morphed so far from its original intent, which was to be strictly limited to patient education and health benefits with no branding or specific product promotion, and has become nothing more than brazen, name-brand promotion and marketing to a vulnerable patient population, leveling the playing field is long overdue. Requiring supporting studies that demonstrate improved patient outcomes and lack of patie...
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Since DTCA has morphed so far from its original intent, which was to be strictly limited to patient education and health benefits with no branding or specific product promotion, and has become nothing more than brazen, name-brand promotion and marketing to a vulnerable patient population, leveling the playing field is long overdue. Requiring supporting studies that demonstrate improved patient outcomes and lack of patient harm due specifically to the DTCA product, prior to allowing its release on the vulnerable public, would be reasonable. We require this of the manufacturers of the products prior to approval for use/sale of their products, and the same standard should be applied for the approval and release of DTCA products. There is no doubt that DTCA can cause harm through its selective presentation of information both positive and negative about the product. The negative is presented at the end in a undecipherable listing while the positive is presented at the beginning in a multimedia paradise of hyperbole. As physicians we are legally and morally held to the "do no harm" standard, those who would sell/promote and profit through any person or patient, must be held to the same standard. Transparency just means a level playing field and the same rules for all, I can hear big pharma screaming in protest and whining about their stockholders already. For the good of everyone who has been or ever will be a patient, DTCA in its current unregulated and non-evidence-based form is a health risk we cannot allow to continue.
Competing interests: None declared
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Competing Interests: None declared.