Wednesday, December 13, 2006

Online doc portal poll finds majority say "no" to DTC ads

Online doc portal poll finds majority say "no" to DTC ads
With new survey results showing that 84% of polled physicians say prescription drugs should not be advertised to consumers, the physician online community Sermo (ePharm5, 10/17/06) continues to be a hotbed for debate. Physicians who oppose DTC ads said that they feel pressure to prescribe new and more expensive medicines, and DTC ads interfere with their role as a "learned intermediary," according to Sermo. However, 28% of physicians who disagree with DTC ads say that they may change their opinion if the ads made clear the difference between individual risk and relative risk of drugs. Only 16% of surveyed physicians agreed that prescriptions should be advertised directly to consumers. These physicians cite DTC ads' educational benefits. They also point out that ultimately, it's up to the physicians whether or not a patient receives a drug.
Sermo Acts as Conduit for Physicians Nationwide to Hotly Debate Recommendations around Regulations for DTC Ads

Business Wire via NewsEdge Corporation :

Education about Individual Vs. Relative Risks of Prescription Drugs Business Editors/Health/Medical Writers CAMBRIDGE, Mass.--(BUSINESS WIRE)--Dec. 11, 2006--Sermo (, the fastest growing online community created by physicians for physicians, has quickly become the destination for physicians nationwide to share their opinions and insights about the latest trends in medicine -24/7. A recent hotly debated topic on Sermo is the American Medical Association's recommendations to regulate direct-to-consumer (DTC) prescription drug advertisements. The new guidelines include imposing a temporary moratorium on the advertising of newly approved drugs and guidelines for pharmaceutical companies to follow when preparing DTC advertising. In general, physicians on Sermo focused on one aspect of the AMA's recommendations - the delay of advertising until drugs have been proven effective.

Sermo is a new online forum where physicians from across the country are working together to improve patient care and save lives -- by instantly comparing notes about different medications, approaches to care, and changes in pathogen resistance. A Sermo member recently posted a question to ask other physicians: Do you think prescription drugs should be directly advertised to consumers?"

To date, more than 100 physicians across specialties and geography have weighed in and shared their opinion on this topic. Poll results span the spectrum of possibilities, though many respondents are voicing the same concerns and agreeing on opportunities for better education about risk and benefits and improved physician-patient interactions. Perhaps the most compelling finding from the poll is that many physicians who voted "no" to prescription drug advertising said they could be swayed if the difference between relative risk (the risk to the population) and individual risk (the risk to an individual) was made more clear to consumers.

Sermo Physician Poll Results:

84% of the physicians polled on Sermo have stated "NO", prescription drugs should not be advertised to consumers, citing the challenges they encounter in their practice. Respondents have indicated that:

-- Physicians feel pressure to prescribe new, expensive medications that patients will have to pay out of pocket for and may not realize it.

-- Direct advertising interferes with the physician's role as the "learned" intermediary. According to one physician, "Commercials on TV are intended to sell the product. Therefore, the product is presented as being desirable, at least to a person with a particular problem. There is no attempt to explain to the public the complexities of prescribing and why we may not wish to put a particular patient on that particular drug. I would very much like to see prescription drug advertising banned."

-- Patients come to a doctor's visit with unrealistic expectations of a drug's performance: Said one Sermo member, "The lay public sees only septuagenarians doing cartwheels in a field of daisies while their husbands sneer longingly in a bathtub with renewed sexual vigor. Patients allow their common mild ailment to be pathologized to the point of life-or-death, only to be rescued by this wonderful new drug."

16% have stated, "YES", promoting education benefits and underscoring physician's responsibility to refuse to prescribe:

-- Drugs require prescriptions. Physicians are unlikely to prescribe them unless they are indicated (to treat a condition.) One Sermo doctor encourages colleagues to, "Be strong in your knowledge of medicine. Be firm in your approach to patients. A solid, 'NO' works well. If I have done my job right, my patients know that I am honest and to be trusted."

-- The patient must buy into the treatment and take the medication. Advertising can support this. A Sermo physician explained, "The Physician is only one intermediary in a patient's treatment and all must come together. The prescriber is required to initiate the medication use ... but ultimately the patient must agree to take the medication recommended."

An unexpected, major finding among the practicing physician community: A large segment, 28%, could be swayed from their NO vote if a critical, physician-driven aspect is made clear in direct-to-consumer ads: the difference between relative risk and individual risk.

-- According to these physicians, there is no counter-balancing information that reminds people that relative risk and individual risk are two different universes for making treatment decisions and most of the data (patients) see on TV shows only relative risk.

Patients may not know that less costly alternatives often have as good if not greater efficacy than those advertised, and that new medications are often not reimbursed and expensive to pay for out of pocket.

Patients may be on another medication that is contra-indicated (might result in expected side effects that can be serious). Explains one Sermo physician, "It is impossible to fully inform someone in a 30-second TV spot to a degree sufficient for them to make an educated judgment. They are reacting only to hype and that is not the way we want to make our therapeutic decisions."

-- All agree that only physicians are in the position to correctly evaluate an individual patient's risk surrounding a medication, and this needs to be underscored.

"Sermo is a new and powerful medium by which physicians nationwide have a collective voice and the ability to influence major constituencies including the healthcare industry, financial industry and regulatory bodies," said Dr. Daniel Palestrant, founder and CEO, Sermo. "Here, physicians are taking stances on the latest issues, and getting feedback from their peers instantly. This is providing a strong "physician voice" to the industry that has not existed before -- and is already improving patient care."

About Sermo:

Launched September 2006, Sermo is the fastest growing online community, created by physicians for physicians. Its Web-based platform provides a medium for physicians to aggregate observations from daily practice then -- rapidly and in large numbers -- challenge or corroborate each other's opinions, accelerating the discovery of emerging trends and new insights on medications, devices, and treatments. Through Sermo, physicians exchange knowledge with each other the minute it is learned, and gain insights from colleagues as they happen instead of waiting to read about them in conventional media sources. Sermo harnesses the power of collective wisdom and enables physicians to discuss new clinical findings, report unusual events, and work together to dramatically impact patient care. For more information visit

Resources: For more information on Sermo visit: Credentialed physicians can join the discussion by joining the Sermo community, at no cost, and begin responding immediately to posts on this subject.

For more information on the AMA visit:

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peter said...

here's a video interview i did with daniel palestrant, founder of sermo: