Biomedical Engineering Reference
In-Depth Information
22.6
Conclusion: Current Situation and Moving Forward
The current state of DTCA affairs seems to be consistent with the evidence on the
small and potentially constructive effect of DTCA: the debate now is much less
intense, DTCA (and drug) expenses have flattened after a period of high growth (IMS
Health
2011
), and DTCA is an accepted fact by most stakeholders as the prevailing
perception is that it is “here to stay.” The growth of Internet communications and
social media could have also contributed to the dampening of DTCA criticism as
much more, frequently unregulated, information regarding drug therapies is widely
available to consumers today. Hence concerns regarding the informational content of
consumer communications can no longer be solely focused on DTCA. All these points
lead to the realization that DTCA has probably reached a steady state.
However, there is still much to be learned about the effects of DTCA. In particular,
there is very little evidence on its welfare effects. Whether patients receive more
appropriate treatments as a result of DTCA and whether DTCA improves compli-
ance and leads to more timely diagnoses are all important issues that have been
severely under-researched. In order to facilitate such research, we need appropriate
databases that focus on the individual patient-physician interaction. This of course
requires that privacy issues will be addressed but questions regarding welfare effects
cannot be answered unless such data are analyzed at the individual level. Aggregate-
level research should also be useful in investigating this issue as some earlier studies
on physician-patient interaction through the examination of detailing-DTCA
synergies have shown. Narayanan et al. (
2004
) found a positive DTCA-detailing
interaction, suggesting that there is some balancing of information acquired by both
agents (patients and physicians) from different sources. A combination of individual
and aggregate-level studies would help researchers and public policy makers in
obtaining more insights and evaluate how patient-level DTCA effects produce
aggregate-level outcomes in terms of total prescriptions.
In addition, despite the proliferation of online communication and regulation
stipulation that TV DTCA should refer viewers to a Web site as part of the “adequate
provision” requirement, no research has yet attempted to link offline advertising and
online communication. Even if conducted at the aggregate level, research linking
offline and online communications should provide a good sense of the magnitude of
consumer search initiation due to DTCA. If the role of DTCA is to increase con-
sumer awareness and trigger further information search, a substantial amount of
online activity should be expected after exposure to DTCA. As previously dis-
cussed, information search potentially triggered by DTCA could ignite a hierarchy
of effects leading up to a doctor visit and the interaction between patient and physi-
cian. Thus a “deconstruction” of the DTCA effect and its mapping to the complex
prescription decision process is necessary in order to fully understand the extent of
DTCA influence.
As our empirical analysis has shown, along with the findings of Iizuka and Jin
(
2005
), it appears that firms are rather deliberate regarding their DTCA strategy. There
are still many questions to be answered related to this issue: (a) how did the
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