Direct-to-consumer advertising (DTCA) is the promotion of prescription drugs through newspaper, magazine, television and internet marketing. Drug companies also produce a range of other materials, including brochures and videos, that are available in doctors offices or designed to be given to patients by medical professionals or via patient groups.

The only two developed countries where DTCA is currently legal are the U.S. and New Zealand. (See Direct-to-consumer advertising in the United States and Direct-to-consumer advertising in New Zealand for more country-specific details). While banned elsewhere, the drug industry is mounting major lobbying campaigns to have DTCA allowed in Europe and Canada. (See Direct-to-consumer advertising: The Campaign To Overturn Europe's Ban and Direct-to-consumer advertising: CanWest's Bid to Overturn Canada's Ban for further details).

DTCA advertising is just one strand in the marketing and PR efforts of drug companies to promote brand-name prescription drugs. Some aimed at potential consumers are video news releases for use in television news bulletins and programs, the hiring of celebrities.

Other elements in the marketing and PR mix aimed at doctors include advertising in medical journals, the placement and promotion of favourable studies in medical journals, the visits of sales representatives to doctors, the provision of free samples of drugs for doctors to give to their patients, gifts for doctors and subsidised 'educational' events and conferences.

The Pros and Cons of DTCA

The drug industry argues that DTCA advertising helps 'educate' consumers of potential conditions and encourages them to see their doctor for diagnosis and treatment. While acknowledging that DTCA increases the amount spent on prescription drugs, they argue that in the long run early treatment and diagnosis reduces spending on other medical services, such as hospitalisation.

Critics of DTCA argue that the industry's advertising is primarily emotional in style and understates the adverse side-effects and as such is misleading. The imagery of the ads is appealing while the potentially serious side effects are buried in the fine-print. They also argue that the claimed health benefits are overstated. Surveys reveal that people who have seen DTCA ads will often request and be prescribed the drug. DTCA campaigns will usually aim to have pre-primed doctors via a parallel promotional campaign. Critics argue that this results in over-diagnosis of a condition and the inappropriate use of prescription drugs, even where non-drug treatments are as or more effective. As a result, DTCA unnecessarily drives up the overall cost of healthcare without necessarily improving the health of those treated.

A November 2006 report by the U.S. Government Accountability Office report noted that "studies we reviewed found that increases in DTC advertising have contributed to overall increases in spending on both the advertised drug itself and on other drugs that treat the same conditions. For example, one study of 64 drugs found a median increase in sales of $2.20 for every $1 spent on DTC advertising. Consumer surveys suggest that DTC advertising increases utilization of drugs by prompting some consumers to request the advertised drugs from their physicians, who studies find are generally responsive to these requests. The surveys we reviewed found that between 2 and 7 percent of consumers who saw DTC advertising requested and ultimately received a prescription for the advertised drug." [1]

The Narrow Focus of DTCA

In a review of DTCA spending between 1997 and 2005, the U.S. Government Accountability Office noted that "drug companies concentrate their spending on DTC advertising in specific forms of media and on relatively few drugs. Television and magazine advertising represented about 94 percent of all spending on DTC advertising in 2005. DTC advertising also tends to be concentrated on relatively few brand name prescription drugs--in 2005, the top 20 DTC advertised drugs accounted for more than 50 percent of all spending on DTC advertising." [2]

"Many of the drugs most heavily advertised to consumers in 2005 were for the treatment of chronic conditions, such as high cholesterol, asthma, and allergies," it noted. [3]

The Digital Age and DTCA

From Wikipedia:

The pharmaceutical industry as a whole has not been as quick as other sectors to jump on the digital marketing bandwagon, in part due to unclear guidelines from the FDA. Nonetheless, many DTCA marketers are beginning to recognize the opportunities that new media offers for reaching consumers. Though the vast majority of DTCA budgets are still allocated to traditional offline media, marketers are beginning to shift some of their spending to digital activities such as product websites, online display advertising, search engine marketing, social media campaigns, and mobile advertising.

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