Direct-to-Consumer Pharmaceutical Advertising

Introduction

In today’s society, there is a desire for instant gratification or a quick fix. People often look for the fastest and simplest way to fix their problems. They often look to medical devices, prescription drugs, and financial services for their answers. Direct-to-Consumer Advertising (DTC) is the general approach used by pharmaceutical companies to provide those answers and to directly promote prescription drugs to the public by advertising their products through various forms of media. While seemingly no different than other forms of marketing, DTC advertising has sparked a debate over the appropriateness of consumers engaging in self-diagnosis and the ethics of an industry promoting potentially dangerous and addictive drugs.

Direct-to-consumer advertisements are undeniably everywhere. Whether listening to the radio, watching television, or surfing the web, they assure relief from whatever may be ailing someone. Consumers are coaxed into believing the advertised medications are the magical answer to their problems. They are shown often misleading wonders of effortless weight loss, the ability to recapture youth, the way to a better quality of life, and everything in between. The advertisements validate the idea of quick, unattainable solutions that everyone yearns for. Also, the advertisements draw a red flag in concerns to the rushed verbiage of the possible life-threatening side effects in the advertisements. Due to this false outlook on reality, DTC advertising is neither a beneficial nor ethical way to educate the public with medical affairs. Therefore, I believe change needs to be applied to this form of advertising for it to be more trustworthy, or it should be banned altogether.

Background

An analysis of direct-to-consumer advertising regarding prescription drugs by Applequist (2018) provided a formal definition of direct-to-consumer pharmaceutical advertising as a form of marketing that is aimed toward consumers. The advertising may utilize print, social media, television, radio, and other forms of popular media to inform a customer (Applequist, 2018). The most ordinary example of direct-to-consumer advertising necessitates prescription pharmaceuticals but may include medical and diagnostic devices, services, and financial resources as well. Since consumers may not be able to obtain products displayed in direct-to-consumer advertising on their own, such as with prescription drugs, the objective is to create a dialogue between patients and their doctors with the ultimate goal of increasing sales.

For decades, prescription drug makers promoted their products exclusively to healthcare professionals. From there, the healthcare professionals were to elucidate drug information for their patients. During the time of some of the first prescription drugs advertisements, Scott (2016) shared that beginning in the early 1900s, some drug manufacturers began targeting consumers partially due to the aging population, known as the baby boomers, and to an increased number of patients participating in their own healthcare decisions (Scott, 2016). Since then, DTC advertising has become a popular promotional tool.

Regulation

The general argument made by Alves, Lexchin, and Mintzes (2018) was about the regulation of the promotion of medicines to healthcare professionals and the public (Alves, Lexchin, & Mintzes, 2018). More specifically, they argued for the improvement of the regulation of the promotion of pharmaceuticals. Alves et al. (2018) defined promotion broadly as, “all actions taken directly by pharmaceutical companies to enhance product sales” (Alves, Lexchin, & Mintzes, 2018, p.1169). In this passage, they suggest that pharmaceutical companies are doing whatever it takes to make a profit, and that might even include dangerous acts. Many of these advertisements have found that information on harm is often omitted, and inaccurate information was consistently favorable towards the promoted product. Direct-to-consumer advertising is overseen by the FDA under the Federal Food, Drug, and Cosmetic Act. That means the corporation must guarantee that prescription drug information provided by drug firms is truthful, equitable, and accurate. Alves et al. (2018) also shared, “in 1997, the FDA introduced an administrative policy allowing companies to list only major and frequent risks in broadcast advertising as long as sources of more complete information were provided” (p. 1170). The FDA directly regulated advertising content, and regularly finds advertisements to be illegal, unfortunately, because of inadequate risk information or exaggeration of benefits communicated.

Presently, direct-to-consumer advertising of prescription pharmaceuticals is permitted only in the United States and New Zealand. Ventola (2011) explained in an article how the U.S and New Zealand are the only counties that allow direct-to-consumer advertising that consists of product claims. Most other countries do not permit direct-to-consumer advertising under any circumstances, although Canada does allow advertisements that mention either the product or the symptom, but not both (Ventola, 2011). The pharmaceutical industry and lobby groups have tried unsuccessfully to overturn bans. Overall, since direct-to-consumer advertising is solely permitted in two countries and the regulation is poor, changes need to take place.

The Outcome of Poor Regulation and Morals

Ever since the U.S. Food and Drug Administration decided to relax its interpretation of advertising regulations in 1997, it has made it enormously feasible for manufacturers to broadcast prescription drug advertisements illegally. The impact of this legislative change on societal health has been detrimental. A current example of the relationship between direct-to-consumer advertising and the current opioid crisis is the Purdue Pharma opioid scandal. Purdue Pharma is a privately held pharmaceutical run by the Sacker family. In a discussion of such a crisis, Zee (2009) explained the controversy behind Purdue Pharma and its immoral actions to promote a highly addictive drug. More specifically, Zee further showed the tactics used by the industry to promote, sell, and manufacture such a drug.

The wildly successful opioid Purdue Pharma utilized is called OxyContin. OxyContin is a drug used to treat moderate to chronic pain. Zee explained, “OxyContin can be abused by crushing, chewing, snorting, or injecting the dissolved product. These ingestion methods create a significant risk to the abuser; they can result in overdose and death” (Zee, 2009, p.221). In this passage, Zee shows how there is a high risk for physical dependency and addiction for patients that are prescribed them. Purdue Pharma had many marketing strategies to push OxyContin further in the drug industry. According to Zee, one of the most popular schemes Purdue Pharma had was to utilize and take advantage of doctors and their position in the healthcare industry (Zee, 2009). The pharmaceutical company aggressively pressured doctors to prescribe the drug, bribing them with free vacations to many of Purdue’s drug seminars and conferences. Zee further explains how OxyContin was advertised to doctors and consumers. He wrote, “The drug was marketed to smooth and sustain pain control all day and all night when taken on a 12-hour schedule” (p. 221). In agreement with Zee, Van Way (2019) confirmed in an additional scholarly journal, that the drug was marketed as having lower abuse potential because of the 12-hour time-release properties (Van Way, 2019). There was no scientific evidence of either of those claims. Due to the false advertising, misleading information, and lack of regulation of OxyContin, it has caused more than 200,000 overdose deaths, with another roughly 200,000 dying from other opioids after using the opioid painkiller previously. In conclusion, the Purdue Pharma case is a prime example of the harm and dangers direct-to-consumer advertising can cause. Zee believed that changes and modifications of marketing and regulation need to take place by the pharmaceutical industry. It is essential that the Food and Drug Administration closely monitor large pharmaceutical industries like Purdue Pharma to better the health of the population.

Harms of Direct-to-Consumer Advertising

Many believe that direct-to-consumer advertising is a negative form of marketing. Critics of direct-to-consumer advertising contend that direct-to-consumer marketing tactics increase the rates of clinically inappropriate prescriptions, produce hypochondriacs, provide false hope for consumers, and create an overmedicated society. For these reasons, direct-to-consumer advertising is seen as a detrimental educational tool for promoting unsafe drugs to the public. To begin, an argument made against direct-to-consumer advertising is that advertising increases the cost of products. When discussing the risks of direct-to-consumer advertising, Weinmeyer (2013) shared a concern of direct-to-consumer advertising contributing to rising healthcare costs in the U.S., which are currently the highest in the world (Weinmeyer, 2013). Doctors more than ever have prescribed brand-name drugs because the patient requested the brand name medications rather than prescribe the identical and inexpensive generic drug. Also, in an article discussing costs, Taurel (2003) displayed statistics bearing brand name pharmaceuticals cost 30% to 80% more than generic drugs (Taurel, 2003). To provide an example, the cost of Lyrica, a prescription medication for diabetic nerve pain, is about $400 for 60 capsules. Because generic drugs are not advertised and do not require research and development (R&D) expenses, they are cheaper than brand-name drugs.

To continue, hypochondriacs tend to be the product of direct-to-consumer advertising. When constantly hearing about symptoms, treatments, and corresponding medications, one is bound to diagnose themselves. Arnold and Oakley (2013) validated that this form of advertising reinforces that “quick fix” so many desires, instead of the lifestyle changes necessary to address some diseases (Arnold & Oakley, 2013). Direct-to-consumer advertisements are made to be extremely personable, therefore consumers can relate themselves to the advertisement when they might not be so universal. Furthermore, an additional argument against direct-to-consumer advertising is the false outlook on life it portrays. Consumers are tricked into believing the medications advertised are wondrous and the answer to their problems. Imagine a scenario with cheerful people with bright smiles on their faces, in a picture-perfect setting, claiming that by taking a supernatural prescription pill their lives were immeasurably improved. As the advertisements dissipate, all that remains is a monotone voice quietly informing the potential risk factors. These may consist of potentially catastrophic consequences that could result from taking the magical pill. One cannot but wonder if the cure is worse than the ailment. For example, prescription eye drops that could potentially cause blindness. In short, there are alarming and disappointing realizations about direct-to-consumer advertisements. Whether it is an unreliable overview of side-effects or the near impossible so-called life-changing drug.

Finally, the main argument brought upon critics is that direct-to-consumer advertisements can create an overmedicated society. Americans are overmedicated. Today, there is a prescription medication for just about every condition imaginable. People look for a quick fix to their problems and often turn to medication for help. In some cases there can be a quick fix, for example, taking a Tylenol or an Advil to alleviate an ache or pain. But in other cases, that quick fix can turn into a quick problem. Consumers are being manipulated into thinking the pill being advertised is the answer to all their problems. This causes viewers to diagnose themselves. Furthermore, the self-diagnosis can cause the demand for advertised drugs from doctors, even though the consumers may not have the full knowledge to do so. In brief, the advertisements and corresponding drugs should be regulated to prevent further abuse and manipulation from pharmaceutical companies.

Why Direct-to-Consumer Advertisements are Legal in the United States

After being introduced to the negativities on direct-to-consumer pharmaceutical advertising, one may ask why they are still being used to this day? As stated previously, direct-to-consumer advertising is legal only in the United States and New Zealand. The reasons why these undeviating advertisements are so-called “lawful” is because it is believed that they better inform the public about medical concerns, encourage people to seek medical advice from health professionals about conditions they may have neglected to bring up in previous appointments, and promise for a healthier public. For these reasons, direct-to-consumer advertising is seen as a legitimate act and therefore legal.

Proponents of direct-to-consumer advertisements, Robinson, Hohmann, Rifkin, Topp, Gilray, and Pickard (2004), believed that this form of marketing produces educational information about newly founded drugs. They argue in their work that the main purpose of direct-to-consumer advertising is to provide awareness about a company’s product. More specifically, they believe that campaigns provide knowledge of the uses of medicine and its possible side effects. Robinson et al. (2004) shared, “Direct-to-consumer advertising prompts people to ask questions, research the products being used, and the symptoms or issues they are trying to alleviate” (Robinson, Hohmann, Rifkin, Topp, Gilray, and Pickard, 2004, p.437). This passage suggests that these advertisements increase awareness of diseases and treatments, but it also expands the understanding of the benefits of new medicines. In brief, direct-to-consumer advertising is displayed as a medical education tool.

Additionally, prescription drug marketing encourages people to seek medical advice from health professionals. They also generate a better physician-patient connection and allow people to be more involved in their healthcare. Additional advocates, Yang, Lee, Jeong, Kim, Han, and Choi (2018), argued in their work that the broadcasts empower patients in their relationship with their healthcare providers (Yang, Lee, Jeong, Kim, Han, & Choi, 2018). More specifically, direct-to-consumer advertisements provide an opportunity for patients to talk to providers about various medical conditions and lead to improved health outcomes. In short, the advertisements ignite patient-physician relationships and make appointments knowledgeable. Due to these beliefs, direct-to-consumer advertising is considered legal to create an overall healthier community.

Solution

Based on the information I have presented, I can confidently say that the harms and disadvantages of DTC advertisements are real and a danger to society. I do not believe that they are a beneficial, ethical, or costly way to inform the public about health-related topics. I do like the idea of informing customers about their medical options, but not to this extent. In all, DTC advertisements are not healthy themselves. They are misleading, manipulative, dangerous, and expensive. Direct-to-consumer advertisements need to fully and indefinitely be banned across the world. This situation can be partially resolved by mandatory payment for the advertisements. For the public to view, listen, or read DTC pharmaceutical advertisements, payment must be made. The billing process can be part of a cable bill, a payment one would make to receive the newspaper or just a general DTC advertising bill. Therefore, the people who desire to receive direct-to-consumer advertisements can do so as they please. Besides, there is no need for pharmaceutical or advertisement companies to worry about their money flowage because of the payments being made to view medical commercials. Due to this plan, the public may slowly become less interested in the advertisements because they are not broadcasted as publicly or continuously. Regulation of this unfair and unbalanced market, educating the consumer, putting a price tag on advertisements, or eliminating this form of marketing all together could all be potential answers to this problem.

In conclusion, DTC advertising is a controversial mechanism in which professional companies provide awareness of their products by utilizing various forms of media, By doing so, DTC advertising ignites contentious arguments about the ethics and honesty of the advertisements. The favoring side argues that DTC advertising better informs the public and encourages patient-physician relationships. On the contrary, the opposing arguments state that DTC advertising provides unrealistic and therefore false hope to patients. Direct-to-consumer advertisements are the base of an overmedicated society and are not a beneficial way to educate the public. To solve this problem, the advertisements should be replaced. A start would be to have people pay to view the advertisement, tighten the FDA’s role, or remove the advertisements altogether. Hopefully, in the future, the controversy is settled with a reasonable solution.

References

Alves, T. L., Lexchin, J., & Mintzes, B. (2018). Medicines information and the regulation of the promotion of pharmaceuticals. Science and Engineering Ethics, 25(4), 1167–1192.

Applequist, J., & Ball, J. G. (2018). An updated analysis of direct-to-consumer television advertisements for prescription drugs. The Annals of Family Medicine, 16(3), 211–216.

Arnold, D. G., & Oakley, J. L. (2013). The politics and strategy of industry self-regulation: The pharmaceutical industry’s principles for ethical direct-to-consumer advertising as a deceptive blocking strategy. Journal of Health Politics, Policy and Law, 38(3), 505–544.

Robinson, A. R., Hohmann, K. B., Rifkin, J. I., Topp, D., Gilroy, C. M., Pickard, J. A., & Anderson, R. J. (2004). Direct-to-consumer pharmaceutical advertising. Archives of Internal Medicine, 164(4), 427.

Scott, D. (2016). The untold stories of television’s first prescription drug advertisements. Stat News, 12(2), 12–14.

Taurel, S. (2003). The other drug war. Retrieved from https://www.pbs.org/wgbh/pagees/frontline/shows/interviews/taurel.html

Van Way, C. W. (2019). Bashing big pharma. The Journal of the Missouri State Medical Association, 116(2): 80–82.

Ventola, C. L. (2011). Pharmacy and therapeutics. Direct-to-Consumer Pharmaceutical Advertising Therapeutic or Toxic. 36(10), 669–674, 681–684.

Weinmeyer, R. (2013). American medical association journal of ethics. Direct-to-Consumer Advertising of Drugs, 15(11), 954–959.

Yang, Y.-M., Lee, J.-J., Jeong, E., Kim, S. Y., Han, M. A., & Choi, E. J. (2018). A survey of perceptions and attitudes about direct-to-consumer advertising of prescription drugs among college students in South Korea. Plos One, 13(7).

Zee, A. V. (2009). The promotion and marketing of OxyContin: commercial triumph, public health tragedy. American Journal of Public Health, 99(2), 221–227.