Recognizing Consumer Issues in DTC Pharmaceutical Advertising

As one of the most controversial modern business practices in history, direct-to-consumer advertising of prescription medications is a critical topic for consumer advocates, but the current body of literature falls short of providing practical guidance for the eminent policy change. The current article reviews the existing perspectives on direct-to-consumer advertising and offers directions for answering important questions that focus on the consumer's interests. ********** Direct-to-consumer (DTC) advertising continues to be one of the most controversial modern business practices, and when one of the most heavily advertised drags of 2000 was forcibly recalled from the marketplace, the debate escalated toward acrimony. The result is an extensive body of literature from the medical, consumer, and corporate perspectives, but this eclectic body of research provides limited direction on how to ensure consumers' interests and leaves numerous questions unanswered. Over thirty years ago, Wilkie and Gardner (1974) noted that "policy changes are going to be made, with or without research evidence" and that researchers need to "conduct studies that are more relevant to public policy decision making" (p. 46). DTC advertising regulation is in the midst of change, and consumer advocates need to better understand the relevant issues and existing data rather than reacting to a negative image of advertising's power over consumers. TWO COMPETING PERSPECTIVES There is considerable evidence that the direct marketing of prescription medications can be both beneficial and potentially detrimental to consumers. While each side of the debate has received considerable attention, the majority of published studies focus on either the benefits or the harms to the exclusion of the other. If we apply the consumer rights advanced by President Kennedy (the fight to be informed, to choose, to safety, and to be heard) as a starting point in evaluating current policy (Brobeck 2006), we recognize that both the positive and the negative positions focus on consumer interests from different perspectives, but a true resolution must balance information and safety. Proponents of DTC advertising cite the increased availability of information as the greatest benefit (Auton 2004; Meek 2001) because it allows consumers to make educated decisions. According to supporters, DTC advertising is necessary to inform consumers about health problems, treatment options, and medical advances (Peyrot et al. 1998). Supporters also claim that DTC advertising encourages consumers to seek medical attention for conditions that would otherwise go unidentified and untreated (Rubin 1991). In short, the positive view of DTC advertising suggests that the educational value of the information provided is in the consumers' best interests and outweighs any potential negative consequences. Additional support for DTC advertising comes from a series of surveys that the Food and Drug Administration (FDA) commissioned (Aikin, Swasy, and Braman 2004). For example, nearly half of the respondents in both the 1999 and the 2002 surveys who recalled seeing DTC ads indicated that the ad motivated them to seek additional information from their doctor, pharmacist, the Internet, friends, or other sources providing evidence that DTC advertising informs consumers. Calfee (2002) argues that by motivating consumers to seek additional information, DTC advertising increases the salience of the risk of prescription medications, brings consumers' attention to nondrug health alternatives and improves compliance in individuals already taking the medication. In contrast, DTC advertising opponents feel that prescription drugs differ from other products, and, therefore, should not be advertised in a similar manner. Critics maintain that DTC advertising intrudes into the physician-patient relationship and confuses patients by representing promotional messages as educational (Wolfe 2002). …