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Direct-to-consumer pharmaceutical advertising (DTCPA)?

Direct-to-consumer pharmaceutical advertising (DTCPA) has grown rapidly during the past several decades and is now the most prominent type of health communication that the public encounters. DTCA for pharmaceuticals was legalized in 1997. Despite its relatively short 22-year existence, it has heavily impacted the advertising landscape for U.S. healthcare and stands in stark contrast to forms of legal advertising for drugs in other countries around the world. In the face of controversy and questions surrounding the ethics of DTCA, the U.S. and New Zealand remain the only two countries in the world that allow this practice. The U.S. may remain the only one if the draft of the Therapeutic Products Bill in New Zealand manages to include a ban on prescription drug advertising.

Channels used to distribute Direct-to-consumer most commonly include television, print (magazines, newspapers), radio, the Internet, and other forms of mass media (billboards and direct mailings). Promotional brochures that are supplied to health care professionals to distribute to patients can also be considered DTCPA, even though they aren’t provided directly to the consumer by the manufacturer.

Despite regulations and challenges, DCTA has thrived – as DCTA marketing budgets show. In 2019, Forbes reported on findings of the Journal of the American Medical Association (JAMA) that highlight this trend. Most notably, it reported a 361% increase in DCTA budgets from 1997 to 2016, from $1.3 billion to over $6 billion.

While one may identify many reasons for this trend, a key factor is likely simple; it works. Forbes continues, citing a House Commerce Committee’s findings that “for every $1,000 spent on prescription drug ads, 24 new patients were added for the pharma industry”. It then concludes by highlighting a highly critical report that found that “rates for prescription drugs with ads were almost seven times greater than for those without ads”.

As DTCA constitutes marketing, critics hold that branding and presentation may lead to misinformed decisions. They argue that patients may be wrongly convinced that more expensive pharmaceuticals may offer more benefits than cheaper alternatives. Studies find that such ads may omit risk factors, prevalence, and other critical information. Coupled with language and messaging clarity, they argue that patients may be insufficiently informed on relevant pharmaceuticals.

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