David Forbes
Founder and CEO,  Forbes Consulting Group

The advent of direct-to-consumer (DTC) advertising in the pharmaceuticals industry a little over 30 years ago brought about a sea change in the relationships between drug manufacturers and patients. It also spawned a debate about the ethics of marketing prescription products to patients who lack a medical education, and about the impact of DTC marketing on the practice of medicine and on the quality of healthcare in the US.

In this debate, voices against DTC are as loud or louder than those in favor of it. Concerns about the “danger of a little information” in the hands of the layman and issues over “patients picking out their own treatments” are voiced. In many countries, these arguments have prevented DTC advertising.

I’ve had much contact and conversation with patients who are addressed by this advertising, and doctors working with the new population of DTC-exposed patients. Viewed in aggregate, my experiences suggest a strong case for the value of DTC advertising in modern medicine.

The new information age in which we live has made it unnecessary for patients to “live in the dark” with respect to a disease from which they suffer. It is also clear than in many disease conditions, doctors can be reluctant to raise and discuss potentially “intimate and embarrassing” issues with a patient. In these situations, the patient armed with even small bits of information gleaned from a DTC ad may feel permission to raise a topic proactively with a doctor.

Meanwhile, the American Medical Association’s vision of a doctor-patient partnership commits doctors to: “encourage my patients to work with me,” “explain medical options open to my patients,” and “educate my patients about their health condition and treatment options.” It is hard to see how DTC advertising would interfere with this.

Finally, it seems that DTC advertising does not “brainwash” patients and incite them to demand the latest, most advertised nostrum. Patients inclined toward such intemperate trust are more likely to leave medical decisions to their doctors.  

DTC advertising is laced with marketing rhetoric. However, I would suggest that its value lies in creating a stimulus for research and learning, in imparting “starter” ideas to get patients taking responsibility for participating in important medical decisions, and in validating the patient’s initiation of discussion about difficult topics.