Role of direct-to-consumer advertising in the recent Vioxx controversy
With the big controversy related to Vioxx and Celebrex (two heavily advertised drugs), more facts are now emerging about how slick advertising can have a role to play in blockbuster drugs. Most physicians now agree that none of these two drugs (or for that matter any drug in the whole family of Cox-2 inhibitor drugs) actually did anything more than an over-the-counter painkiller does that you can buy for pennies in Costco. Vioxx was already a heavily advertised drug prior to its recall. And once Merck withdrew Vioxx, Pfizer started another aggressive marketing campaign for its drug Celebrex, until it was disclosed in December that Celebrex may too have adverse side effects, and at the insistence of the FDA, Pfizer pulled all direct-to-consumer advertising for just Celebrex.
Why do drug firms love direct-to-consumer advertising for prescription drugs?
As I already said above, the ROI is very high. But they never admit to this one. In fact the official position that PhRMA, the association of pharmaceutical companies, takes is that advertising increases awareness about diseases and motivates Americans to visit their doctor earlier. This helps in improving the overall health of the Americans.
Not everyone, including me, agrees. Dr. Eric Topol, the world-famous cardiologist and an early critic of Vioxx as an effective drug, writes in the Journal of American Medical Association that the government should take a second look at direct-to-consumer advertising because "Unbridled promotion exacerbated the public health problem." Indeed it is true that when Vioxx class action lawsuits are tried in courts around the country, attorneys will use this as a strong weapon in their argument that drug firms marketed deadly products.
Developing a better advertising strategy for prescription drugs
- Shift focus from drugs to public education. The thrust of the message should be to increase awareness of the diseases and let the decisions about what drugs will solve the problem to people who know best (i.e. the doctors). The net effect will still be the same and the ROI may even go up if drug companies (who make specific drugs) pool their resources and focus on specific illnesses for which drugs are available.
- Completely eliminate messages like "Ask your doctor about X." No doctor that I know of likes to hear from her/his patient what drugs to prescribe. In fact, doctors tell me, that this is a big problem for them. They admit that they have often prescribed the drug that their patients wanted (even if they would not have prescribed it if the patient had not asked for it by name) because trust and faith (in a drug) can often assist in healing and doctors (after all they run a business) do not wish to disappoint their customers.
- Reallocate advertising dollars to doctor education. It is indeed true that many doctors do not always have the time and the resources to learn about all the new medications. That is one reason why they simply prescribe the medicine that their patients want. If drug companies spend the money to educate the doctors about new treatment options, they will do what is best for their patients.
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