Page 358 - Battleground The Media Volume 1 and 2

Pharmaceut cal Advert s ng |

consumer confidence in the advice of doctors has dropped substantially in
recent years. Patients arrive at medical appointments knowing what type of
health care they want and how their doctor should provide it, and they fre-
quently request specific branded medications. Recent studies have revealed
that nearly half of all patients would try to persuade their doctor to prescribe
the specifically requested drug (A. Brown 2001, p. 22), sometimes even chang-
ing doctors to get the desired prescription. There is also troubling evidence
that doctors are not only experiencing, but succumbing to, consumer pressure
to prescribe the most heavily marketed drugs. In 2004, doctors wrote nearly
35 percent more prescriptions for the drugs promoted most heavily to consum-
ers than for others (Charatan 2000, p. 783). Even more worrying is the revela-
tion that almost half of all doctors surveyed in one study acknowledged they’d
“prescribed medicines they knew were ineffective, simply because they were
expected to” (“A Spoonful of Sugar,” 2004).
By scientific rationale, prescription medications are chemical compounds de-
signed to ameliorate a specific medical condition. Therefore, on a purely medi-
cal level, the choice of a prescription medication should be based on scientific
efficacy and not on the strength of the related advertising campaign. By intro-
ducing branding practices and intensive advertising to the decision-making pro-
cess, DTCA encourages consumers to pressure doctors for prescriptions based
upon emotional appeal rather than on chemical/medical sensibility; contributes
to the steady erosion of physician authority in the doctor-patient relationship;
and leaves little room for truly private, privileged decisions based solely on med-
ical authority.

ThE runaway monEy Train

When examined from the perspective of the pharmaceutical industry, the
DTCA trend has been phenomenally lucrative. When the same numbers are ap-
plied to the American health care system, however, it becomes apparent that the
DTCA trend may be contributing to ever-escalating health care costs and may
in fact threaten the long-term sustainability of the system.
There was a nearly 14,000 percent increase in DTCA spending between 1991
and 2005, and DTCA now ranks as the “fourth largest advertising category in
the U.S. market, behind only cars and trucks, restaurants and movies” (Roth
2003, p. 180). The pharmaceutical industry’s willingness to commit to such
enormous budgets is predicated upon the return on investment in the form of
drug sales and high-profit margins of both moderately advertised and so-called
blockbuster medications.
The pharmaceutical industry focuses on a select group of “blockbuster” med-
ications each year: those that receive both the bulk of ad spending and the
majority of subsequent prescriptions. In 1999, for example, just 10 medications
accounted for nearly half of all DTCA spending, the industry concentrating its
efforts on a few “blockbuster” medicines. A solid return on investment from
such targeted spending is clear: 65 percent of total prescription drug sales in
2000 were for the most heavily advertised drugs (Alleyne 2002, p. 107).