# Presentation: 502554

## Direct-to-Consumer Advertising of Prescription Drugs:Physician Survey Preliminary Results

- Kathryn J. Aikin,  Ph.D.
- Division of Drug Marketing, Advertising
- and Communications, FDA
- January 13, 2003

## FDA Physician Survey

- Look more closely at impact of direct-to-consumer advertising (DTCA) on doctor-patient relationship

## 2002 Physician Survey: Methodology

- Random Sample from American Medical Association Physician Masterfile
- 250 General Practitioners
- 250 Specialists
- Dermatology
- Allergy/Pulmonology
- Endocrinology
- Psychiatry

## Patient-Initiated Questions about Treatments

## How frequently do patients initiate questions about...

- 	N = 500

- Percent

- “Seldom”		    “Often”		“All the time”

## Frequency of Questions Over Last Five Years

- N=500

- Percent

- “Stayed the same”			“Increased”

## Impact of DTC Advertising on Patient Interaction

## Now think about the most recent interaction you’ve had with a patient who initiated a discussion about a prescription drug and told you he or she saw it advertised.

- Can you think of a patient who initiated a discussion about a prescription drug they saw advertised?
- Yes		92%
- No		8%

- N = 500

## How representative was this patient encounter?

- Compared to other encounters with patients who have initiated a discussion about a
- prescription drug they saw advertised, how representative was this patient encounter?
- 								N=459

- Percent

## Beneficial Effects

- N = 459

- Did the fact that this patient saw an advertisement have any beneficial effects
- for your interaction with this patient?

## What beneficial effects did it have?

- 								N = 187

- Percent

## Problems

- N = 459

- Did the fact that this patient saw an advertisement create any problems
- for your interaction with this patient?

## What problems did it cause?

- 								N = 187

- Percent

## Patient Rx Inquiries, Requests, and Perceived Pressure to Prescribe

## Brand Rx Inquiries and Patient Condition

- Did the patient ask *about* a specific prescription drug by brand name?
- (N = 459)

- Did the patient have the condition
- the drug treats? (N = 390)

## Brand Rx Inquiries and Patient Condition

- Did the patient ask *about* a
- specific prescription drug by
- brand name?      (N = 459)

- Did the patient have the condition
- the drug treats? (N = 390)

## Rx Requests and Prescribing Behavior

- Did the patient ask you *for* a prescription? (N = 459)

- Did you give the patient a
- prescription at this visit? (N = 237)

## Brand Rx Requests and Prescribing Behavior

- Did the patient ask you *to* *prescribe* a specific brand name
- drug? (N = 359)

- Did you prescribe the brand name
- drug the patient asked for? (N = 211)

## Reasons for not prescribing

- Why didn’t you prescribe the drug the patient requested?			N = 98

- Percent

## Patient Influence on Interaction

## Perceived Patient Influence

- Did the patient try to influence the course of treatment in a way that would have been
- harmful to him or her?						N = 459

## Perceived Pressure to Prescribe

- To what extent did you feel pressured to prescribe a drug for the patient at this visit?
- 								N=459

- Percent

## Rx Requests and Perceived Pressure to Prescribe

- Did the patient ask you *for* a prescription? (N = 459)

- To what extent did you feel pressured
- to prescribe a drug at this visit? (N = 237)

## Rx Requests and Perceived Pressure to Prescribe

- Did the patient ask you *for* a prescription? (N = 459)

- To what extent did you feel pressured
- to prescribe a drug at this visit? (N = 237)

## Rx Requests and Perceived Pressure to Prescribe, con’t.

- Did the patient ask you *for* a prescription? (N = 459)

- To what extent did you feel
- pressured to prescribe a drug
- at this visit? (N = 219)

## Brand Rx Requests and Perceived Pressure to Prescribe

- Did the patient ask you *to prescribe* a specific brand name drug? (N = 359)

- To what extent did you feel pressured
- to prescribe a drug at this visit? (N = 211)

## Brand Rx Requests and Perceived Pressure to Prescribe

- Did the patient ask you
*to prescribe* a specific
- brand name drug? (N = 359)

- To what extent did you feel pressured
- to prescribe a drug at this visit? (N = 211)

## Brand Rx Requests and Perceived Pressure to Prescribe, con’t.

- Did the patient ask you *to prescribe*
- a specific brand name drug? (N = 359)

- To what extent did you feel
- pressured to prescribe a drug
- at this visit? (N = 148)

## Branded Rx Requests and Perceived Pressure to Prescribe

- (N = 237)

- To what extent did you feel pressured
- to prescribe a drug at this visit? (N = 237)

## Unbranded Rx Requests and Perceived Pressure to Prescribe

- (N = 237)

- To what extent did you feel pressured
- to prescribe a drug at this visit? (N = 148)

## Attitudes About Impact of DTCA on Patient Interaction

## Because this patient saw the advertisement...

- N=459

**Usefulness **
**of time was**
**increased**

**Patient asked**
**thoughtful**
**questions**

**Patient was **
**confused about **
**appropriate**
**treatment**

**Patient was **
**more aware of**
**potential side**
**effects**

**Patient was **
**confused **
**about **
**effectiveness **
**of drug**

**Patient had **
**unnecessary**
**worries about **
**health**

## Attitudes About Impact of DTCA on Patient Understanding

## What patients understand about advertised drugs...

**Possible **
**benefits &**
**positive**
**effects**

**Possible**
**risks &**
**negative**
**effects**

**How to **
**get more**
**info about**
**drug or**
**condition**

**What **
**condition**
**drug **
**treats**

**Who **
**should**
**not use**
**drug**

**Who **
**could**
**use drug**

**Drug **
**avail**
**only by**
**Rx**

**Only Dr**
**can decide**
**if drug is**
**right**

- N=500

**Limitations**
**of drug**
**efficacy**

## Attitudes About Potential Negative Effects of DTCA on Patients and Practice

## Problems DTCA Creates for My Patients and Practice...

- Exag.
- Benefits

- Create
-  Anxiety

- Seek
- Unnec.Rx’s

- Seek
-  Adv. Rx’s

- Dr-Pt
- Tensions

**Confuses **
**relative**
**risks &**
**benefits**

**Think **
**drugs**
**work **
**better **
**than they **
**do**

**Anxiety**
**about **
**potential**
**diseases**

**Anxiety**
**about **
**potential**
**side effects**

**Ask for**
**unnec. **
**Rx’s**

**Expect **
**Rx for **
**every**
**condit.**

**Want adv. **
**drugs **
**over any **
**others**

**Want adv. **
**drugs **
**over less**
**expens.**
**treatments**

**Tension **
**btwn **
**you &**
**patients**

**Question/**
**second **
**guess**
**diagnoses**

- N=500

## Attitudes About Potential Positive Effects of DTCA on Patients and Practice

## Benefits DTCA Creates for My Patients and Practice...

- Increase
- Awareness

- Increase
- Involvement

- Increase
- Compliance

- Extend
- “Reach”

- Dr-Pt
- Interaction

**Aware of**
**problems**
**earlier**

- N=500

**Aware of**
**possible**
**treatmts**

**More**
**involved**
**in health**
**care**

**Avg. **
**patient**
**more **
**concerned**
**about **
**health**

**Likely to**
**use meds**
**properly**

**Adhere **
**to **
**treatmt**
**regimen**

**Hard-to-**
**reach**
**patients**
**come in**

**Seek **
**treatmt**
**for **
**potentially**
**serious**
**condits.**

**Ask**
**better**
**questions**

**Better**
**discussions**
**about**
**health**

## Overall Impact of DTCA on Patients and Practice

- Overall, how would you say DTC advertising has affected your patients and your practice?
- 							 	       N=500

- Percent