Is direct-to-consumer drug marketing a failure?

23. April 2008 William Davis (4)
According to the poll just completed by 80 participants on The Heart Scan Blog, 50% of respondents said they were less likely to take a drug after viewing an advertisement for it. A whopping 3 (4%) said that they would be more likely to take the drug after viewing an advertisement.

I find that interesting. If half the people responding are less likely to become customers of a drug company, then how does the drug industry justify running around-the-clock, every-few-minute ads? Spending by the drug industry for direct-to-consumer (DTC) advertising has ballooned over the past few years, and is now well over $30 billion dollars per year.

Unfortunately, despite the views of the highly-educated, curious, think-for-yourself, health information-seeking sorts of people who read this blog, drug companies still come out on top by DTC advertising. Estimates vary, with a 2006 U.S. Government Accountability Office study reporting that, for every $1 DTC advertising, sales are increased by $2.20. A 2000 Harvard study showed a higher return of $4.40 for every advertising dollar spent.

I'm sure the drug companies themselves have a very tight accounting handle on their own set of figures. We may not be terribly fond of these people and their often suspect tactics, but they're not stupid. They are certainly not stupid when it comes to making money.

Interestingly, 80% of the funds spent on DTC advertising focus on the 20 or so most popular drugs, all of which are used for treatment of chronic conditions like high cholesterol and high blood pressure, markets that are large and long-term. It pays very little to advertise drugs that may serve small markets for a short period. The implicit message is that this is not at all about informing the public. It is about advertising to grow revenues and profits--pure and simple.

It makes me wonder what the results of our poll would have been had we conducted it in 2000 before many people hadn't yet been brought to the brink of vomiting from the endless onslaught of commercial after commercial, complete with smarmy spokespeople (a la Lipitor's Dr. Robert Jarvik). What will it show in two years? Will the broader public join the more informed people who read this blog and become increasingly inured to the hard sell tactics?

For further discussion of this topic, click here for a reprint of an August, 2007 New England Journal of Medicine study, A Decade of Direct-to-Consumer Advertising of Prescription Drugs provides background, along with commentary on the impact of DTC drug marketing since the FDA allowed it 10 years ago. (Because it is a study and not an editorial, the editors fall short of making any recommendations for improvement or calling for a moratorium.)


Copyright 2008 William Davis, MD
Tags :

Comments (4) -

  • shreela

    4/23/2008 9:22:00 PM |

    I usually try to avoid taking a drug that hasn't been on the market for 5 years. One exception was when my knee doctor HIGHLY recommended Celebrex. It worked great at first, but the effectiveness wore off after a while, so I stopped taking it, and just took iced my knee when it swelled, and took ibuprofen if the ice wasn't enough. I also discovered later that biking brought down the swelling.

    Looking back on that, although I'm glad he gave me Celebrex instead of Vioxx (shudders), I'm glad I only took the Celebrex for a little while. Even though their commercial brag that they're the only prescription anti-inflammatory that hasn't been taken off the market, I recall reading about some severe side-effects I'd rather not have.

    If there's a natural way to decrease any ailment, I'd much rather try that, instead of taking a new drug, as long as there's studies that back up the natural treatment/diet. That's why I'm so grateful for your blog, and others like it from licensed health professionals; you and the others provide balance between the old school AMA way, and the 'alternative' methods that sometimes are a bit out there.

  • Anonymous

    4/24/2008 10:31:00 AM |

    It's all about supply and demand really. Make people believe they need it and they will want it. Marketing trumps truth a lot fortunately.

    But then there's those of us who realise that if a company's trying too hard to push something, they're trying to sell us off yogurt with a fragrance in it.

  • ethyl d

    4/24/2008 4:48:00 PM |

    Most Americans are not "highly-educated, curious, think-for-yourself, health information-seeking sorts of people," and many of them prefer taking a pill to control a health condition rather than changing what they eat and how they live, so the drug ads probably are influential. I also suspect that the bombardment of all those ads makes people more likely to worry about having or someday getting the diseases the drugs supposedly help with, and instilling the belief that prescription drugs are the best or even the only way to alleviate or cure the condition. "Don't worry, American public, if you get sick, we've got a pill to make you all better."

  • Anne

    4/26/2008 1:17:00 PM |

    I probably would have answered "more likely" 6 years ago before I got on the internet and met some very smart people. It was with their help I discovered that lifestyle changes, not more prescription medication, would do more to optimize my health. This is an ongoing journey. I am still learning.

    Sadly, I have found most people I meet are more interested in the newest drug for their symptoms than in changing lifestyle.

Add comment

Loading
The End of Medicine

The End of Medicine

14. September 2007 William Davis (0)



"It's not about staying young--it's about staying healthy. They say 60 is the new 50. If you stay healthy, got a good ticker lay off tobacco, are lucky enough to avoid some weird cancer, you can kick up your heels, keep running your company, or better yet, travel the world, hike a mountain, ski Zermatt--heck, Tony Randall even started a new family.




But that's a big if. We pump ourselves with cholesterol-lowering drugs as if that was the magic elixir. Not so simple.

Instead, our skin is getting peeled back for a quick look inside. This is the end of medicine as we know it. Don't guess that I might have hardening of the arteries. Open me up and take a look. Don't guess that I don't have cancer because I'm not spitting up blood or growing a tumor the size of a grapefruit out my side."


If you can get beyond some of the frat-boy joking in the book, you will see that the author, Andy Kessler, actually acquires some pretty canny insights into the future of medicine in his book, The End of Medicine.

It's a book not about the end of medicine, but about the end of medicine as we know it today: the doctor by the bedside, the treating-when-symptoms-appear approach that characterizes current practice.

Instead, Kessler predicts that new technology will supplant the role of doctor-as-gatekeeper and decision-maker. Early detection is key. He picked up on that right away, as his quote above shows.

Despite the sophomoric humor, I was impressed that much of the Track Your Plaque approach--online, self-empowered, based on the concept of early detection followed by practical and effective tools for correction, involving your doctor only peripherally--is what Kessler is trying to articulate.

In actuality, I would not necessarily recommend his book, unless you need a light moment and some fodder for thinking about our health future. But he does have some startling insights for a guy who just invests money and has no real health background.


Another excerpt:

CT Anxiety

I always feel a certain anxiety when I walk into the Hyatt Regency at the bottom of California Avenue in San Francisco. The cutsie Trolley car outside, the Embarcadero tile pattern on the sidewalk — they are all part of the package. But as I've done every time I've been there, I head straight into the lobby, tilt my head back and scan the Escher-like floors, starting at the top and then down and outwards to the bottom until I start feeling dizzy. I thank Mel Brooks for this.

This guy was zooming through someone's brain like it was a Sunday drive. More like a Sunday afternoon video game.

With my head spinning from this "High Anxiety" flashback, I stroll into the conference, half expecting to be given a barium enema by a cross between Nurse Diesel from Mel Brooks' flick and Nurse Ratched from One Flew Over The Cuckoo's Nest. I really gotta switch to decaf on days like this.

The 7th International Multi-Detector Row Computed Tomography Symposium sounded innocuous enough. I assumed it would be a bunch of technical papers on the future of scanning, where I would read the paper in the darkened hall until lunchtime and then head off for some hot Hunan and home.

Instead, the place was like a carnival for cardiologists.


Kessler has, in Silicon Valley style, left a wide wake of electronic content to get a better view of his ideas. There is a podcast located on the InstaPundit site that you can listen to at: http://podcasts.instapundit.com/AndyKessler.mp3, that provides some more of this irreverent but out-of-the-box thinker's thoughts.
Tags :

Add comment

Loading