Biomedical Engineering Reference
In-Depth Information
The effect of physician initiatives to empower patients is a key area of enquiry that
remains virtually unaddressed in marketing and medical literatures.
When patients take the initiative to become more empowered, many physicians
still react negatively because they feel uncomfortable with the meaning of such
changes to their role in the patient-physician relationship. Despite the ongoing
trend towards patient empowerment, many physicians still adopt a paternalistic
approach during medical encounters (Young et al. 2008 ). Pharmaceutical firms can
also promote patient empowerment by allocating more resources to direct-to-patient
marketing. Nevertheless, firms need to consider the risks to ensure that they do not
damage their relationship with physicians in the process of empowering patients.
Tensions between the industry and the medical profession have a long history.
In his overview of the evolution of American medicine, Starr ( 1982 ) discusses how,
in the early nineteenth century, pharmaceutical firms used to promote their drugs
directly to patients, which was seen as a challenge to doctor's authority. With the
increasing professionalization of the medical professional, doctors became increas-
ingly reluctant of these direct-to-patient marketing efforts. Founded in May 1847,
the American Medical Association, which embraces the mission of promoting “the
art and science of medicine for the betterment of the public health,” has always
voiced opposition to pharmaceutical firms' marketing efforts to patients. In the
1920s, the opposition was so strong that academic marketing journals, such as the
Journal of the American Medical Association , refused to publish (direct-to-
physician) ads from firms who advertised their drugs directly to patients (Starr
1982 ). The criticism, which still prevails today, is that doctors are biomedical
experts who undergo strict training to be able to interpret and apply medical knowl-
edge on behalf of the patient. Therefore, firm actions (such as DTCA), capable of
giving more information and power to patients, are often seen as a threat because
they have the “potential to fundamentally alter the roles of doctor and patient”
(Wilkes et al. 2000 , p. 122).
The goal for pharmaceutical firms should be to increasingly consider the patient
as a key stakeholder and try to demonstrate to patients, physicians, and payers how
their brands are able to create more value for the patient. Strategies aimed at
promoting active interaction between the firm and patients and between patients,
payers, and healthcare providers have the potential to streamline market access and
improve reimbursement conditions (Bridges and Jones 2007 ). Hence, patient
empowerment will soon become the dominant paradigm in medical decision-
making and the main focus of pharmaceutical firms' marketing strategies, which
I discuss next, starting with DTCA.
14.4
Marketing to Empowered Patients
After the FDA's relaxation of regulations on DTCA, the investment in the United
States in such direct-to-patient channels exploded from less than $1 billion in 1996
to $4.2 billion in 2005 (Donohue et al. 2007 ). Despite the significant rise in DTCA
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