Is Banning DTC Advertising a Good Idea?

Brandon Cohen


December 10, 2015

Television is full of commercials for prescription drugs. From pills drawn to look like a cartoon selling constipation aids, to sports legends hawking anticoagulants, to the discreet romance of ubiquitous erectile dysfunction drugs, pharmaceutical companies target patients directly, pushing them to push their doctors.

A recent news article on Medscape reporting on the American Medical Association's (AMA's) recent call for a ban on these direct-to-consumer (DTC) advertisements spurred a lively discussion on this robust stance by the AMA.

Overwhelmingly, respondents saw the AMA vote as a positive development and viewed DTC ads with profound distaste. Many chimed in with full-throated support of the AMA: "DTC [ads] help crazy malingerers to know exactly what symptoms to lie about so that they can get that specific medication," wrote one physician.

A colleague agreed, adding, "The power of advertising... dangles bright and shiny objects in front of TV viewers with no meaningful educational or informational content. Most patients see only the razzle-dazzle."

A respiratory therapist set it out in broad strokes:

The practice of DTC advertising of pharmaceutical products is purely money driven, not patient care driven. This is a no brainer. There is a reason that it is illegal in most countries, and the US should follow suit. Healthcare costs are indeed high enough. Why intentionally make it higher just in the name of making more money? It's misleading and unfair to the patients and an absolute mistake for the economy

A physician bemoaned the misplaced faith of the American people:

Why the public invests trust in [celebrity endorsements] rather than their physician is the real casualty in the DTC advertising policy. Slick advertising exaggerates the perception of yet another medical need, unlimited wants in an era of limited resources, and coupled to costly health insurance plans in the healthiest and youngest segments creates customers and healthcare product consumers rather than true patients.

But there were some who pushed back against the tide of bashing DTC ads. One healthcare professional wrote:

How quick so many are to abandon the First Amendment. Pharmaceutical [companies] are simply engaging their right to free speech. Were they making false or unsupported claims, I'd agree to some restriction.... Objective healthcare experts advocate having patients become better informed and more involved in their own healthcare. As a lobbying group, the AMA realizes that this could, over time, decrease the number of patient visits and thus decrease the earning of their members.... Just because a patient may have more information on drugs, devices, and services does not mean that their physician's professional responsibilities are any different. But it could mean that physicians might have to take a little more time to discuss treatment and wellness approaches with their patients. Would that be a bad thing?

But many others found this line of reasoning unconvincing. One Medscape reader wrote:

With the access that patients have for researching symptoms on the Internet, it's unnecessary to have DTC advertising and causes patients to ask for drugs that may not be appropriate for their medical treatment.

And a physician took issue with the idea that information was being conveyed clearly:

The whispered verbal warning about possible death [in a DTC ad] makes no sense when an elderly gentleman is seen playing with his grandchild.

Another physician agreed and added:

Patients don't hear or understand the complications of these drugs as they are rattled off at the end of each TV ad. All those caveats may absolve the drug companies, but they also make things more difficult and time-consuming for the doctor.

But another reader was having none of it:

How is it more time consuming? You just have to talk to patients. They are not stupid. It's your job to educate your patients by forming a relationship with them and talking to them.

A healthcare professional took it one step further:

It is very interesting that just about every response here assumes that all patients are stupid—certainly too stupid to understand the disclaimers at the end of the ads. But the era of just taking the doctor's word really is over.

That opinion was not without detractors, however, as noted in this response:

Big Pharma is fully capable of educating about illness, disease, and symptoms without promoting specific drugs or medical devices, which would fully allow physicians to recommend what they believe are their patient's best treatment alternatives. Direct marketing of specific drugs and devices is unneeded and a separate issue from educating patients.

Even a pharmacist who claimed to be a "supporter of the big research drug companies," was in favor of the ban on DTC ads: "On balance, the DTC ads generally throw unnecessary cost, confusion, and chaos into the patient-care pot."

Another physician had a different take, challenging colleagues to examine their own behavior:

How about we go a lot further and ban all of the goodies these drug reps give docs/staff to listen to their sales pitches about drug products. No more trips to Aspen, no more lunches for entire office staffs, no more ad spec items, etc.! Now that's a real conflict of interest, ya think?

The final word goes to a healthcare professional who saw the debate as a chance to explore wider difficulties in the field of medicine:

[DTC] ads are not ethical—agreed. But don't the doctors and patients have a role in this too? It would be nice to see doctors offer many other things for the patient to try (diet, exercise, nutritional supplements, etc.) before just quickly offering meds for many common... ailments.... Patients need education on lifestyle issues and how these cause or worsen their conditions.

The full discussion of this topic is available online.


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