Responding to such concerns, the AMA, at its July 2001 meeting, debated a proposal for the organization to encourage the federal government to ban all DTC prescription drug advertising (Tanner, 2001). While I agree that public exposure through advertising of the latest treatments for common conditions raises public awareness and prompts people to visit physicians, I nonetheless believe that direct- to-consumer pharmaceutical advertising does not adequately justify its social costs. In the case of overt maladies, such as allergies or depression, for which a large share of advertised drugs are indicated, a condition affecting a person's life to the point of warranting medication would certainly cause him or her to notice it and presumably to seek treatment. While many other products, such as cholesterol lowering drugs, are used to treat conditions of which an individual may not be aware and that may eventually adversely impact health, these conditions would, in nearly all cases, be uncovered during a routine examination. In both cases, the central benefit accomplished by these ads is getting people through the doors of doctors' offices, an end that can easily be achieved more cheaply without the use of DTC advertising. For example, less expensive public service campaigns encouraging people to have routine checkups and informing the public of warning signs of common conditions would achieve the same results without affecting the cost of healthcare. As the situation now stands, the benefits that do result from DTC advertising are purchased at the price of reduced healthcare quality for some.

As drug advertising drives up the cost of treatment, healthcare providers will be forced to cut costs in other areas and may find it necessary to compromise coverage by denying certain procedures or raising premiums. Increased premiums may drive people who fund their own health insurance out of the system by making personal insurance unaffordable. Additionally higher premiums may discourage large employers, which often independently provide their employees with health coverage, from continuing this practice. General Motors spent $900 million covering prescription drugs in 2000, a 19% increase over the previous year (Cassels, 2001). Escalating costs may render those without prescription coverage unable to afford necessary medications. Furthermore, the production of a drug is only possible when the disease it treats becomes understood through years of basic research, most of which is conducted by publicly funded academic investigators. Since public money lays the groundwork for pharmaceutical production, drug companies have a responsibility to the taxpayers not to engage in practices that will result in a reduction in the quality of healthcare.

The major problems underlying this situation is that, under our current insurance structure, the costs of increasing drug prices do not accrue to the consumer and thus do not decrease demand as they should in a free market system. As a result, the pharmaceutical companies are not given proper incentive to control prices. Insurance providers, rather than transferring rising costs to consumers through reduced care, need to restore the incentive to curb drug prices and hold the pharmaceutical companies responsible for their exorbitant budgets.