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Direct-To-Consumer Advertising by Pharmaceuticals
By Sunny Sambhara

In 1997, the Food and Drug Administration relaxed its restrictions on direct-to-consumer marketing of pharmaceuticals. Prior to this ruling, drug manufacturers were prohibited from mentioning both the name of the drug and its indications in consumer-directed advertisements without also including a large amount of technical information about the drug, including all known side effects, contraindications, and dosage recommendations (Stevens, 1998).

In addition to interfering with the appeal of the advertisements, such requirements rendered broadcast ads infeasible due to time constraints, and hindered ads in print media due to cost and space availability. These requirements were abolished in the 1997 FDA policy changes, and pharmaceutical companies were permitted to market drugs by name as treatments for specific conditions, with the minimal requirement that ads give mention to major risks identified in clinical trials (Melillo, 2001). As a result, manufacturer expenditures on direct-to-consumer advertising, which totaled $791 million in 1996, rose to $2.6 billion for the year 2000 (Mitchell, 2001). Television, radio, and print media became saturated with ads promoting treatments for conditions ranging from depression to high cholesterol.

Names such as Zoloft, Claritin, and Lipitor, which were previously known mostly to health professionals, quickly became part of the national vocabulary. Consequently, spending on prescription drugs has increased significantly over the past several years as consumers are enticed to seek advertised medications (HealthBizNews.com, 2001). This new face of drug marketing has sparked a raging debate about the accompanying effects on the health of the American public: does direct to consumer marketing benefit the public by providing education about available treatments, or does it diminish the quality of healthcare by raising costs and causing unnecessary treatment? Proponents of direct-to-consumer, or DTC, pharmaceutical advertising, most prominently the drug companies themselves, argue that DTC marketing results in improved public health by increasing consumer awareness. According to this view, direct marketing to the consumer alerts the public of the availability of treatment for a given condition, a fact of which it may not otherwise be aware. This knowledge may prompt people to seek medical help rather than unnecessarily accepting their ailments (Miller, 1998). Furthermore, supporters claim that ads raise awareness of undiagnosed conditions by providing information about symptoms.

Since countless Americans suffer from undiagnosed disorders-only half of the estimated 16 million Americans with diabetes know they have the disease-the motivation to seek treatment provided by these ads is a valuable public benefit (Health Matters, 1998). Similarly, by prompting people to visit a doctor, ads may help identify conditions unrelated to the specific area of concern. For example, according to Mike Magee, a medical adviser for Pfizer, a large proportion of consumers seeking Viagra would not otherwise see a doctor, so visits seeking help for erectile dysfunction often uncover conditions warranting medical attention, such as diabetes (Shapiro and Schultz, 2000). Some doctors support DTC ads as well, claiming that they make their jobs easier by resulting in better informed patients. Many ads, particularly for diabetes, stress the importance of self-management of disease, which may increase compliance with doctors orders and result in reduced need for more extensive medical care (New York Times, 2001).