Another physician group raises concerns about DTC

The nation's second-largest physician group has raised concerns about the role direct-to-consumer advertising plays in contributing to prescription drug costs and influencing physician prescribing patterns.

In doing so, the American College of Physicians (ACP) joins a growing chorus of political leaders and provider organizations that have questioned the value and potential risks of DTC advertising. The American Medical Association in November called for an outright ban on DTC, while Rep. Rosa DeLauro (D-Connecticut) in February introduced legislation that would limit the launch of DTC campaigns until three years after a drug is approved by the FDA.

See also: Politics led to DTC uproar, but curbs unlikely in current climate

The ACP, which is made up of internists, reiterated its unease about DTC in a new policy paper, describing the advertising practice as both “inappropriate” and “concerning.” The paper was published Tuesday in the Annals of Internal Medicine.

“The ACP understands and acknowledges that marketing costs are inherent to the ability of a company to recoup the cost of investment into drugs and remain in business,” wrote Hilary Daniel, the paper's author. “However, many of the largest pharmaceutical companies are spending more on marketing and administration than they are on research and development.”

The paper addresses a number of trends and practices that the ACP's health and public policy committee believes are contributing to escalating drug prices. The U.S. is the only country out of 34 that participates in the Organisation for Economic Co-operation and Development that does not allow government oversight of drug pricing. It also spends more money on drugs than the 13 other countries considered high-income.

See also: Bill to ban DTC adds to industry's woes

What factors are contributing to rising drug costs? According to the ACP, it's a lack of transparency about how products are priced, a shortage of comparative clinical data looking at cost-effectiveness and value, the structure of health benefits, and a patent system that limits competition.

“All of these issues must be dealt with to achieve meaningful change,” Daniel wrote.

The ACP issued seven recommendations, including making pricing practices more transparent,, allowing reimportation of drugs from outside the U.S. and establishing a biosimilar policy that informs patients about the difference between biologics and biosimilars.

See also: The FDA wants to study DTC tactics

PhRMA, the drug industry's lobbying group, criticized the ACP's recommendations, arguing that purchasers like PBMs and high rates of generic drug utilization will help keep drug spending in line with overall healthcare spending during the next decade. It also said that programs like the 340B drug discount program, which requires drug manufacturers to provide steep discounts on certain outpatient drugs purchased by healthcare providers, are the drivers of healthcare costs.

“Discussions about the cost and affordability of medicines — and healthcare more broadly — are important, but we need to concentrate on pragmatic proposals that increase competition, modernize the FDA, remove barriers that limit paying for value, address market distorting programs like 340B, and empower and engage consumers with information to make better informed healthcare decisions,” a PhRMA spokesperson said.