Friday, May 22, 2009

DTC Perspectives: Anti-DTC Emotions Run High

By Bob Ehrlich, Chairman
DTC Perspectives, Inc.

I have been involved in DTC since 1996 and it still puzzles me why the drug ads get such a visceral negative reaction from critics. I ran across a blog from George Parker, a former adman who writes blogs on a site called Adscam. He wrote a contributor blog on May 12 for which blasted DTC in a way that illustrates the ire it causes. Let me quote a few lines from George.

DTC he says “is considered insane and outlawed in every other country in the world.” Allowing DTC, he continues, "has resulted in some of the crappiest advertising known to man.” DTC promotes products for illnesses “such as restless leg syndrome that didn't exist.” The good news for agencies says Parker is that “the giant tit is not going away.” He is referring to the pot of large media dollars for future DTC ads.

Ok so George hates drug ads. I refer to his blog because it represents a fairly broad consensus among critics. Why does DTC provoke such anger? I assume it is because critics feel DTC is something that interferes with a doctor's objective decisions on drug prescribing leading to inappropriate use for expensive brands. I remind critics that no one in our health care system is objective and all information a consumer gets is biased. In an imperfect world we need a whole bunch of imperfect competing information to arrive at our own conclusions about product value.

Is the doctor objective? They used to be before managed care, capitated drug coverage and physician owned diagnostic centers. Is our health insurance company objective? They never were since their goal has always been reducing cost of care. Our employer wants us well enough to work, but really does not want to fund more than the minimum to keep us at our desk. Is our government objective? They want acceptable affordable care for the broadest population, not premium care. So in our system all opinions must be heard about a health care service or product before an intelligent decision can be made about value.

DTC is one source of biased information. If we banned it, do we really think doctors would make the best drug decision while under the thumb of insurance companies, PBM's, government and employers? So like it or not, we need this “crappiest advertising known to man.” DTC may not be the most creative of ad categories but I am sure mankind has seen crappier categories. Look at some financial advertising!

The drug marketers are doing what they must in a biased world of health care special interest groups. I would love to have an objective bureau tell us the “truth” about branded drugs. Such a place does not exist. Consumers need to hear many points of view to see if a branded drug is best for them. DTC is an easy and accessible source of imperfect information. That is just one piece in the health information puzzle in our data rich society. I also remind critics that FDA looks at every syllable of DTC ads, something they do not do for alternative medicines. So George, I am afraid you will see the “crappiest advertising known to man” for many more years.

Another recent blog on the Huffington Post (May 20) by Brian Ross brings up another myth. That one is that drug ads cost so much that they increase consumer cost. The fact is drug ads spending is about 1% of total sales revenue. Banning ads will not noticeably reduce drug cost even if all of it was refunded to consumers. The critics always say drug companies spend more on promotion than R&D. This is true when you add the sales force salaries, sampling and medical meetings to the promotion cost. One could argue that these are as much educational as promotional. If one looks at advertising alone, costs are well below R&D.

Our PhRMA lobbying group needs to provide politicians the real data on promotion and explain which part is advertising and which is educational. This idea that drug companies are just big marketing machines needs to be countered more effectively. The visceral attacks will continue, and be fueled by an anti-profit mentality now growing in Washington. I'll admit once again drug companies have a significant bias to sell what they make, but banning commercial speech will not make it better for consumers.

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