Articles by Levick Experts

For over a decade, Direct to Consumer (DTC) advertising of prescription medications has sparked often acrimonious debate among the pharmaceutical, physician, consumer, and legislative communities. Yet America continues to be inundated with messages touting the latest prescription drugs for arthritis, allergies, cholesterol, heartburn, erectile dysfunction, and any number of fairly obscure illnesses.

The more effectively Big Pharma advertises, the more, unfortunately, it heightens expectations and, therefore, creates greater exposure. As one blogger wrote, “it's hard to tell the difference between pharmaceutical commercials and car commercials.” Competitive pressures presumably demand slick ads but, the slicker the ad, the more outraged the response by health watchdogs and consumer advocates. In turn, pressures by these critics may lead to renewed regulatory oversight. As of this writing, for example, lawmakers have asked Amgen and Johnson & Johnson to suspend all consumer advertising of their anemia medications until U.S. regulators do an additional safety review.

Issues involved in the controversy include disagreements over the role of consumers in medical decision-making and – disclaimers notwithstanding – concerns about the mass promotion of potentially dangerous drugs.

The blog quoted above – it’s the health channel of newstarget.com – features well over 100 experts, including doctors testifying to the evils of direct-to-consumer advertising. Among their many recurrent themes, the new drugs being hyped offer no real improvement over what’s already on the market. Doctors are, they say, being seduced as well. Over and over, lax oversight by the FDA is blamed for this “self-medicating society,” which raises an ever-present possibility that the regulators will react strongly and start controlling ad content more aggressively.

As critics, watchdogs, interest groups, and lobbyists work the hill and the media, promoting various agendas, Big Pharma has not apparently taken this bull by its proverbial horns. It’s a delicate balance in any event. Too much back-and-forth public debate might further highlight the issue to the industry’s disadvantage. That said, it would seem that stronger position papers will at least balance the other side’s unremitting attack. At a strategic level:

• Recognize the seismic changes that have occurred in the consumer’s role in health care and the doctor-patient relationship and frame the discussion in historical terms, i.e. as a continuation of the patients’ rights movement that began in the 1970s. The key message remains: “informing and educating the consumer.”
• Avoid any reliance on First Amendment arguments, which in this context do not address the overriding public safety issue.
• Select teammates with immediate goals that match yours. For example, a 2006 survey by the National Medical Association (NMA) documented that DTC advertising has led to increased doctor visits by minority and underserved populations. As the National Health Disparities Report points out, African-Americans tend to have a lower use of routine care and a subsequently higher rate of avoidable admissions to both emergency departments and hospitals.
• Help the public understand the economic facts and political realities of the pharmaceutical business and that profit due to advertising equals more R&D. Use all appropriate print and online tools to provide simple summations of costs related to research, clinical trials, and FDA approval.