Direct-to-consumer (DTC) advertising, however, seems like another issue entirely. The most impressive thing about the commercials that appear on network television is the speed with which the narrator can read off a relatively complicated list of medical conditions with perfect pronunciation. Even when I am listening to these commercials, I can barely absorb all the warnings and cautions mentioned. I cannot believe that a patient, without medical training, could keep up.
I will say that I have reaped an ancillary benefit from these ads. Introducing a patient to the concept of a biologic agent is often fraught, and I find the discussion is sometimes lubricated by mentioning one of these ads, which they might have seen on television, in which a B-list celebrity proclaims how a biologic has changed his life. If that is a goal of these advertisements, then I believe they are performing a general service to our community by providing patients with reassurance when our reassurance is not enough.
Just as often, however, I have to dolefully explain to a patient why an ad’s promise of relief does not apply to their condition. As a patient, I doubt I would be any more successful parsing the difference between osteoarthritis and rheumatoid arthritis from an advertisement.
Most of you agree with me. I know this because in 2004 the U.S. Food and Drug Administration (FDA) surveyed 500 physicians regarding DTC advertising. Three-quarters of the physicians surveyed indicated they “strongly believed” that DTC ads make drugs seem better than they actually are. The surveyed physicians also believed these ads were not equally good at discussing the drug’s risks and benefits. Of those physicians, 78% felt the ads conveyed the potential benefits of the drug, but only 40% of those physicians felt the ads also conveyed the risks. Sixty-five percent of physicians felt the ads confused patients about the relative risks and benefits of the drug in question. At the same time, most of the physicians surveyed noted that DTC advertising made patients feel more involved with their healthcare and made physicians more aware of potential treatments.1
As much as we all feel we can resist the effect of ads, DTC advertising is effective. In a study using actors who depicted patients with an adjustment disorder associated with a depressed mood, 10% were offered pharmacotherapy when they presented, anonymously, to a primary care provider. That number increased to 39% if the patient requested treatment with a drug in a specific class. Patients who asked for a drug by name were prescribed that drug in 55% of cases.2
