Page 361 - Battleground The Media Volume 1 and 2

0 | Pharmaceut cal Advert s ng

classified according to measurements of “highest potential lifetime value,” “ap-
propriate performance metrics,” and “value per patient (return per script mul-
tiplied by duration of use).” Just as the weakening of physician authority in the
patient relationship can cause an imbalance in quality of care, the inflation of
the patient’s economic value over his or her physiological health is a real and
important byproduct of the DTCA trend.
There is evidence that even physicians have begun to refer to patients from
within an economic framework. Surveys have found that many doctors have
prescribed medications in order to satisfy patient demands and not to meet the
specific physiological demands of the medical condition. In part, this acquies-
cence on the part of physicians can be attributed to the desire to maintain a
positive working physician-patient relationship. Doctors do not wish to alienate
patients or to lose business, and emphasize that there is a desire, as “with any-
one else who provides service, to keep the customer happy” (D. Brown 2004).
The designation of patients as “customers” is indicative of the ways in which the
physician-patient relationship has adapted to the discourse of the DTCA trend.
In this sense, the evolution—or degradation—of the relationship can be seen
as: doctor-patient, to doctor-patient-advertiser, and finally to doctor-consumer-
advertiser.

CornFLakEs, aCuPunCTurE, anD
aLTErnaTivE viEwPoinTs
With advertising budgets for DTCA campaigns approaching or surpassing
those for other categories such as consumer goods and food products, it is use-
ful to compare both the type of advertising and its potential effects on consum-
ers. It can be asked of DTCA, “If we start advertising [prescription medications]
like corn flakes, does it trivialize medicine?” (Elliott 1998). Consumer products
are generally harmless—the choice of one breakfast cereal or wrinkle-reducing
cream over another isn’t likely to cause physiological harm to the consumer—
while medications can seriously harm or kill patients if not prescribed or taken
properly. Indeed, there is a substantial gap in the magnitude of the decisions
involved in assessing risk and reward of, for example, a breakfast cereal, as com-
pared with a prescription medication.
This serious difference raises legitimate and important concerns about the
advisability of treating prescription medications as if they were general, casual,
and benign consumer products, and promoting them as such. Furthermore, a
sense of “needing” a specific consumer product can be inspired by creative ad-
vertising, while “needing” prescription medications should ideally be based on
physiological factors and physician recommendations. The similar advertising
methods between prescription medications and general consumer goods en-
courage the stimulation of popular demand for products whose use should be
based solely on medical need.
It is also worth noting that, as a product of the pharmaceutical industry with
financial interests in the return on investment of DTCA campaigns, prescrip-
tion medications tend to be favored in the media over other health alternatives.