Direct-to-consumer advertising (DTC advertising) is referred to as any promotional effort done by pharmaceutical firms presenting the prescription of drug information to the overall public using the mass media (Wilkes 47). This marketing strategy blurs disorders by portraying such conditions as common. DTC advertising leads people to believe that they are suffering from certain diseases or disorders by simply relating to the way advertisements portray these uncommon disorders or diseases through their acts. Though these drugs assist those who are actually suffering from the diseases they are designed to treat, the advertising of the drugs is done in a way that makes them look like these disorders affect anyone who feels restless at night or during the day, or is tense or shy while in a public place. This makes people who have seen and heard such advertisements worry and feel that they are affected, especially if some of the symptoms described in the advertisement are present in them. After hearing and watching the advertisement, people have an urge to do self-diagnosis or feel that they are in serious need of the drug. DTC advertising has increased substantially at an annual rate of 30 percent, as cited by Ian Morrison in his book Health Care in the Millennium. According to Gary Null, the author of the Death by Medicine, pharmaceutical firms had tripled their budget allocation for consumer-directed advertisements by 1995.The pharmaceutical advertisement has since grown to a pop, new and culture-savvy level (“IBM Institute for Business” Value 1).
Today, it is not easy to differentiate between car and pharmaceutical commercials, as both look cool by using the same modes of advertisement, such as good acting, popular music and lofty promises as strategies to hook and reel customers to these products. Advertisements of pharmaceutical companies pose a far graver danger to consumers than, for instance, car commercials. By taking powerful drugs consumers expose themselves to numerous risks, ranging from the possibility of getting sick to dying. However, despite the risks involved, the number of pharmaceutical advertisements continues to increase (“U.S. Department of Health and Human Services, Food and Drug Administration” 1).
In his book Facts or Fiction, Mike Fillon says that pharmaceutical firms spent $2.5 billion on mass product advertising in 2000 alone. This figure rose to $3 billion in the year 2003, as stated by Dr. John Abramson in his book Overdosed America. Ray D., the author of Death by Prescription, analyses these high figures and poses the question, “Why do pharmaceutical firms spend billions of dollars on direct-to-consumer advertisement, while consumers can get these prescriptions from the doctor?” Consumers should have no direct access to drug prescription and these adverts should exclusively target doctors. According to Fillon, average prescription number per person in the United States rose from 7.3 in 1992 to 10.4 in the year 2000, coupled with the increase in demand for more expensive medications witnessed in serious advertising (“IBM Institute for Business” Value 1).
The hoax of direct-to-consumer prescription drugs advertising: How patients and doctors are influenced by dangerous drugs advertised by the pharmaceutical industry. .
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How does direct-to-consumer prescription drug advertising create a hoax? How are patients and doctors influenced by dangerous drugs advertised by the pharmaceutical industry? What can be done to solve this problem?
According to Herper, three quarters of those who have access to direct-to-consumer advertisements and ask their doctors for a specific drug they saw advertised, receive the prescription they had requested (Herper, 12). Hirsch ascertained that this implies that they are prescribing their own drugs for what they believe to be suffering from. These factors increase the advertising budget, as well as boosts customer demand (Hirsch 58).
Moreover, Wilkes postulated that “direct-to-consumer advertising has reflected screwed priorities, as companies are spending large amounts of money on advertising at the expense of researching and developing new drugs, and improving the old and current drugs in the market’ (Wilkes 12). This further prompts pharmaceutical companies to look for new blockbuster drugs at the expense of developing effective drugs for treatment of common diseases and disorders. This forces the firms to extend the patents to continue enjoying the monopoly on production of certain drugs. Herper emphasized that by extending patents, they have to find new uses for the drugs, hence this marketing involves large-scale promotional campaigns. In the majority of cases, the drugs are directed to those who do not need them, while those who desperately need the drugs cannot afford them (Herper 23). He further claims that the power of human urge to save and cure is replaced with the need to earn more money, while the life of those who desperately need help is jeopardized. Ethically, the corporate structure that mandates maximization of profits should undergo drastic reformation (Herper 14).
Effects of Direct-to-Consumer Advertising on the Pharmaceutical Industry
Detecting misleading advertisements with no emphasis on the side effects of the drugs
Television advertising follows the same old prescription. First, the commercial portrays a bleak health condition of an individual prior to taking the medicine being advertised. The individual then tells how greatly his life has changed after he/she started taking the drug. Finally, the voiceover lists the side effects of the drug, always speaking too quickly and leaving the listener enchanted by the effectiveness of the drug. A good example would be the Paxil commercial that has become very popular of late. It shows a 30-year old woman who is depressed and lonely. Her condition touches the heart of every listener and viewer, leaving them wondering what could be wrong with her. But the voiceover says next that she is suffering from the social anxiety disorder, a condition that is easily cured by the Paxil drug. The next moment the now medicated lady presses the door bell with a broad smile on her face and ready to join a party. The voiceover hurriedly goes through the list of the expected side effects, which surely escapes the attention of the listener or the viewer who is still happy and rejoicing the improved condition of the initially depressed woman. He will then go ahead and do his/her own prescription, or even recommend the drug to a relative deemed to be in the same situation of social anxiety (“U.S. Department of Health and Human Services, Food and Drug Administration” 1).
Doctors Prescribe Patients’ Names
Members of self-medicated societies do not actually write down their own prescriptions but rely on the drugs they have seen advertised. Strand writes that surveys in the medical literature show that seven out of ten medical prescriptions done by the doctors are the exact ones said by the patients who have seen them advertised in the mass media. For example, a consumer, who has recently felt depressed, sees an advertisement for antidepressant medicine Zoloft, which makes him/her feel that he/she is indeed depressed and needs the drug. This shows how pharmaceutical companies influence consumer behavior, while claiming that they are only educating without persuading as to what to buy. However, the naked truth is that their advertisements greatly affect the way their potential customers behave and think.
Drug Companies Easily Manipulate Doctors.
Pharmaceutical companies use advertisements as a strategy to persuade doctors to accept the prescriptions requests of their patients who have no training in medical (Kessel 24).
Burton Goldenberg in Alternative Medicine explains how advertisements funded by pharmaceutical firms form the main source of income for journals published by the American Medical Association and the American Psychological Association (APA). 15 to 20 percent of their earnings come from pharmaceutical firms’ advertisements in their journals (“U.S. Department of Health and Human Services, Food and Drug Administration” 1).
In Innocent Casualties by Elaine Feuer, advertisements are shown as intentionally misleading, because they exaggerate the benefits of drugs, fail to mention their potential side effects and provide information on drugs in small print in the form of addendum. This is similar to the way side effects are cited at the end of television commercial advertisements (“IBM Institute for Business” Value 1). Neither doctors nor consumers give this final voiceover or the final faint print much attention (“U.S. Department of Health and Human Services, Food and Drug Administration” 1).
When advertisements published in the Journal of the American Medical Association (JAMA) have not succeeded in persuading doctors, the pharmaceutical firms enlisted the help of sales agents by having them promote the drugs through door-to-door giveaways and giving out free samples. In Health Care in the New Millennium, Morrison states that Pfizer alone has a sales force of close to 4,500 sales executives and agents, whose salaries have not changed in comparison to the increased revenue they have generated for the company (“IBM Institute for Business” Value 1).
Proposed Reforms of DTC Advertising
Suggestions for improvement of the quality of direct-to-consumer advertisement are directed to the key players of the pharmaceutical industry, medical community and government. DTC is here to stay but general and drastic improvement needs to be done. It will be supported by technological advancement, such as the Internet, desire of people to access information on health and political power that has come in force to control the operations of DTC. These three factors will ensure that consumers were exposed to ethical and quality advertising (U.S. Department of Health and Human Services, Food and Drug Administration” 1).
The Pharmaceutical Industry
The industry is to develop the culture of honesty and put in place a long-term strategy of communicating with their customers. This can be achieved by providing honest, transparent and accurate information for the customer, while placing more emphasis on the side effects of the drug in the final fine print and the voiceover at the end of any advertisement. They should also offer detailed clarification of the risks and benefits consumers are exposed to from taking the drug, while encouraging discussion on the cost of the drug (Dani, 8). Other suggestions for the industries include: the use of simple and easily understandable language without heavy reliance on technical graphs, charts and scientific jargons; clearly labeling products for the convenience of the majority of users; advertisements focusing more on medical conditions than on the drug itself; non-proprietary relationship with health researchers to enable them understand how their consumers understand DTC advertisements. All these will assist pharmaceutical companies in putting in place strategies to better and effectively communicate with their customers.
The FDA can increase the government’s involvement in the self-regulation of pharmaceutical firms through well-funded, strong and assertive oversight team. The FDA should also take the forefront in providing unbiased information to the consumers. They should also make clear to the public the purpose of promotional items and drug evaluation, as well as the need for the consumers to form partnership with the medical community (“IBM Institute for Business” Value 1)
The Congress must ensure that the FDA has the necessary resources to effectively monitor and regulate DTC advertisements. It particularly applies to TV advertisements which are known to mislead consumers to a far greater extent than the printed media. The FDA should adopt the following rules: enforcing all advertisement to stress that the pharmacist or the physician is the best option to provide prescriptions; all advertisements are required to mention success and failure rates of each drug, whilst comparing them to other easily available products; to mention by name an alternative treatment, if available; to set up an independent source of drug information for all advertisements to refer consumers to (“IBM Institute for Business” Value 1).
The Medical Community
The medical community should respond aggressively to DTC advertising, with individual medical associations and physicians monitoring the contents of DTC advertisements to ensure there is balance and accuracy of the information given on the drugs. They also need to do counter-advertising which involves providing information on the use of the drugs, as well us elaborating and stressing the limitations of any given medication. The medical health community needs to provide the public with undefiled information on drug therapies, drug-related risks, indications, alternatives and benefits. All this should be done in the context of providing medical education to vulnerable customers who can fall prey to direct-to-consumer advertisements of pharmaceutical firms (Dani 9).
They also need to put in place a program aimed at increasing awareness of customers about possible dangers of DCT advertising. Clinics and other health care institutions should offer reminders to customers that advertisements are promotional and do not necessarily give the objective advice. They also need to lobby the Congress for release of research funds to determine the detrimental effects such promotions cause to the pharmaceutical industry and health care sector. This is necessary to establish equilibrium between the public health and profit motives that drive pharmaceutical companies to participate in these promotions.
These suggestions will not hinder development of new drugs or even disrupt the process of scientific research involved (Dani 13).
Research will be conducted through the proposed in-depth interview method. 600 people will be selcted randomly from those who have been influenced by direct-to-consumer advertising for the purpose of data collection. The data collected through recorded interviews will be transcribed verbatim and analyzed using both the qualitative and quantitative research methodology (Wilkes 72).
The research’s philosophy and stance focus on the relevance of DTC to the pharmaceutical industry rather than the interpretive stance and reality. It is assumed that the subject under study is not observable in direct-to-consumer advertising, but can be measured to some extent. The research intends to carefully isolate facts and attempts to identify a link between DTC, consumer behavior and doctors’ prescriptions (Hirsch 24).
In the first six days, the research, will focus on the formulation of literature and data collection through the proposed interview method to accurately understand the problem under study and further refine the research problem. More resources will be directed to the formulation of interview questionnaires to be used in the study (Wilkes and Kravitz, 29). A comprehensive view will facilitate the conceptual framework and research hypothesis to be used for the study.
In the second six days, the attention will be directed to the pre-testing and the administration of the questionnaire interview to be used in the study. The activities carried out at this stage include collection of interview-related data, as well as evaluation and analysis of data. Importantly, a pilot study is also conducted during this stage (Hirsch 24).
In the third six days, presentation and reporting of the findings are done. The report is further refined to meet the academic standards (benchmarks), followed by the defense of the report findings on the impact of direct-to-consumer advertising on consumers (“Health Action International” 1).
There are various research designs available for this study, but this research will done in the form of a case study. The focus will be on how direct-to-consumer prescription drug advertising affects the pharmaceutical industry. Direct-to-consumer advertising is chosen because it is among major areas of concern, and therefore, more representative. The researcher’s in-depth familiarity with DTC also played a role in choosing the topic (Hirsch 68).
The primary data was collected through structured interview questionnaires that were administered to respondents by the phone, via one-on-one interviews and the Internet, and posts.
Possible problems include inadequate funding to complete the research, time constraints and opposition from pharmaceutical firms who may find the research results too revealing.
Results & Conclusions
DCT has become the major tool of promoting pharmaceutical products. Its advantage lies in the fact that it encourages the consumer to seek more information on a given disease or a product. The study has established the impact of DTC on health care, with the available empirical outcome being clinical experience. The long-term effects of DTC on patients will require extensive investigation, involving substantial investment.