Direct-to-Consumer Drug Advertising causes public harm

Published in the Public Library of Science Medicine

What Are the Public Health Effects of Direct-to-Consumer Drug Advertising?
Elizabeth A. Almasi, Randall S. Stafford, Richard L. Kravitz, Peter R. Mansfield

This paper can be accessed at: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030145

Almasi concludes: "There are two root causes of the problems with Direct-to-Consumer Drug Advertising (DTCA). The first is payment systems that reward drug companies for increasing sales of expensive drugs regardless of the impact on health. These systems should be redesigned. The second root cause is normal human vulnerability to being mislead. Few people have the time and advanced skills in drug evaluation, psychology, logic, economics, and semiotics, etc., required to evaluate drug promotion. Advertising can sneak in under the radar to influence even skeptical people without their awareness. Ideas that would be rejected if given attention get reinforced by repetition.

Almost all government, health professional, and consumer inquiries into DTCA have concluded that it causes net public harm. It is too difficult to regulate DTCA, so I believe that the logical conclusion from the evidence is that the best option for improving overall health and wealth is to ban all types of DTCA, including “disease awareness” advertising.

The public would benefit from reliable information and health promotion focused on public health priorities. Such information can be provided at no extra cost by copying, improving, and expanding policies and programs that are already successful in many countries. Governments and insurance companies who subsidize drugs currently pay for biased promotion indirectly via high drug prices. Instead, these agencies could fund information, education, and promotional services focused on public health needs. Such investments pay for themselves by reducing health-care costs. Universities and nonprofit organizations are well placed to compete for this funding. These organizations are more trustworthy than drug companies because they don't gain from drug sales. Where behavior-change promotion is justified, these organizations could collaborate with advertising agencies. This collaborative approach has already been successful for many health-promotion campaigns—for example, promoting smoking cessation. These improvements would not achieve utopia, but would improve health and increase wealth overall".

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