Direct-to-Consumer Advertising of Pharmaceuticals: An Integrative Review - Innovation and Marketing in the Pharmaceutical Industry - page 628

21.3.1.2 Patient Requests for Advertised Drugs

Mintzes et al. ( 2002 , 2003 ) collected data in Sacramento, CA, where DTCA is legal,
and Vancouver, British Columbia, where DTCA is illegal, using a matched set of
patient-physician questionnaires, each of which covered a single consultation. With
this creative design, they examined how DTCA affects patient requests and physician
prescribing decisions in two different policy environments. They found that advertis-
ing leads to more requests for advertised medicines, and that requests drive more
prescriptions. They also found that physicians were often ambivalent in these cases
about the choice of treatment (i.e., the particular drug they prescribed), suggesting
that appropriateness of treatment may suffer due to patient requests.
Herzenstein et al. ( 2004 ) analyze data from 1,081 adults surveyed by the FDA in
1999 to understand the effects of consumers' attitude towards DTCA. They fi nd that
consumers with more favorable attitudes towards DTCA are more likely to search
for information about the advertised drug and also more likely to ask their physician
about the drug. Importantly, they also fi nd that physicians are more likely to prescribe
the advertised drug to these patients. Wilson and Till ( 2007 ) analyzed survey data
from about 2,300 household respondents to develop a structural equation model of
DTC advertising effectiveness. Confi rming the results of Herzenstein et al. ( 2004 )
and others, they fi nd that consumers who are greatly involved in their healthcare
and possess positive attitudes towards DTC advertising are more likely to contact a
doctor about the prescription drug after viewing a DTC advertisement.
Using data gathered by a market research company from a physician panel in which
physicians report patient requests they received, Liu and Gupta ( 2011 ) fi nd that own-
brand DTCA expenditures increase the number of patient requests for two leading
brands in the cholesterol-lowering category but do not benefi t a smaller share brand.
They also fi nd that competing drugs' DTCA expenditures have a positive spillover
effect on the number of patient requests for the leading brand in the category.
Not unexpectedly, multiple studies confi rm that DTCA encourages patients to
talk with their physicians about their ailments and to request specifi c drugs. Such
patient behavior also infl uences physicians' prescription behavior (more on this in
the next section).

21.3.2 Physicians

Although DTCA is not intended to infl uence physicians directly, they are obviously
affected by it. Literature on how physicians perceive DTC advertising is relatively
scarce, is based entirely on surveys, and leads to ambiguous fi ndings. Gönül et al.
( 2000 ) fi nd that more experienced physicians, physicians who see more patients, or
those who have more exposure to pharmaceutical advertisements (brought by
patients) are more accepting of DTC advertising. Murray et al. ( 2003 ) conducted a
cross-sectional survey of a nationally representative sample of US physicians to
determine their perceptions of the effects of patients discussing information from