Biomedical Engineering Reference
In-Depth Information
Firm DTCA strategy
Drugs to advertise
DTCA allocation
DTCA/DTP mix
Patients
Visits
Requests
Compliance
Public Policy
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DTCA (de)regulation
Physicians
Prescriptions
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Academic Research
Fig. 22.1
Chain of DTCA influences
change is the deregulation of direct-to-consumer advertising (DTCA) in the USA,
prompted by the “reinterpretation” of the Food and Drug Administration (FDA)
rules in 1997 (e.g., Pines
1999
).
1
The arguments of DTCA proponents and critics
are well-documented (e.g., Gellad and Lyles
2007
for an overview). Briefly, propo-
nents suggest that DTCA increases awareness for new treatments and under-
diagnosed conditions, empowers consumers by providing more information, and
strengthens the patient-physician relationship by providing a basis for a more
meaningful interaction during visits. Critics counter by supporting that DTCA does
not educate the consumer since it does not provide clear information about indica-
tions and risks and may over-state the benefits of a treatment, adds to the workload
of physicians who may have to accommodate additional visits triggered by DTCA
and address patient questions regarding information received by DTCA, and can
lead to higher prices. Naturally, proponents predominantly identify with the phar-
maceutical business community (e.g., Holmer
2002
), while the medical and health
community (Hollon
2005
) contains a fair amount of critics (see also recap in Gellad
and Lyles
2007
). In economic terms, proponents of DTCA support a “constructive”
or informative effect, according to which information availability and potentially
welfare are increased through DTCA, whereas critics advocate a “destructive” or
combative effect, according to which DTCA increases sales and prices of margin-
ally innovative drugs. It is worth noting that the extent of the debate is rather dispro-
portionate to DTCA's budget allocation by drug manufacturers, who still focus
predominantly on direct-to-physician (DTP) activities.
The potential influence of DTCA on firm strategy, patients, physicians, and fur-
ther possible policy changes, depicted in Fig.
22.1
, will be the topic of this chapter.
Figure
22.1
captures the chain of potential influences due to the introduction of
DTCA and encapsulates main issues to be discussed in this chapter. Public policy
1
Interestingly, Lyles (2002), in his historical perspective on DTCA, notes that prior to 1930 direct-
to-consumer communication was rather the norm in the USA.
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