Drug adverts are a haphazard approach to health promotion

Apr 26 2005

As California State Assembly Bill 95 (Koretz, D-West Hollywood), designed to reign in drug marketing costs in California by requiring manufacturers of drugs for life-threatening chronic conditions to pay the state a rebate equal to the drug marketing cost, moves to the Assembly Appropriations Committee, AIDS Healthcare Foundation (AHF) -- cites a study and accompanying editorial published today in the Journal of American Medical Association (JAMA) that demonstrates the influence that Direct to Consumer Advertising (DTCA) has on physicians' prescribing decisions.

The study, conducted by Richard L. Kravitz, M.D., M.S.P.H., and his colleagues from the University of California, Davis, involved a randomized trial using actors posing as patients. 55 % of the patients in the controlled study that walked into a physician's office with a brand-name prescription request, received a prescription for that drug. That is compared to 39% of the patients who made a general request for medication.

"The JAMA study makes it clear that Direct To Consumer Advertising is having a major impact on the way drugs are being prescribed to patients and is a driving force in the spiraling price of prescription drugs," said Michael Weinstein, President of AHF. "Because the treatment of HIV and AIDS is highly individualized, it is dangerous to rely on the influence that expensive advertising campaigns have on consumers and even doctors when it comes to patient care. For years, patient advocates, including AHF, have argued that DTC advertising has little or no beneficial impact and in many cases can actually cause harm to patients. AB 95 (Koretz) takes steps to reign in the cost of prescription drug marketing which will directly result in savings to the state and hopefully curtail potentially harmful DTC advertising."

Weinstein added, "Opponents to AB 95 claim that the bill is unnecessary because new laws and practices have already brought unfettered drug marketing tactics under control. This study clearly demonstrates that drug manufacturers are up to their old tricks."

According to an editorial accompanying the study entitled, "Direct to Consumer Advertising, A Haphazard Approach to Health Promotion," by Matthew F. Hollon, MD, MPH: "Direct to consumer advertising, by simultaneously advancing consumerism over shared decision making and providing pseudoeducational material to patients, can undermine choices patients and physicians make together and negatively impact the public's health. Decisions to advertise a specific product to the public do not necessarily reflect superior safety, efficacy or the interest of the public's health but rather calculations of return on investment."