Do consumers need protection from drug ads? 

A group of 69 health insurers, several large employers, labor unions, and advocacy groups (such as the AARP) have formed a coalition called the Rx Health Value, whose goal, according to the New York Times, is to slow the surge in spending on prescription drugs.

One of the coalition's main strategies for slowing such spending is to counteract - and apparently to stifle, if possible - the Direct to Consumer (DTC) marketing that drug companies have been engaged in since it became legal in 1997. Rx Health Value maintains that the money drug companies spend on DTC marketing is a major factor in the increasing cost of prescription drugs.

It is estimated that the pharmaceutical industry spent $14 billion in 1999 on marketing; $2 billion of this was spent on DTC marketing efforts.  The amount of money spent on drugs last year was $125 billion.

DrRich comments:

Is Rx Health Value (and others who complain about DTC marketing) really concerned about the cost of prescription drugs?  The organizations that formed Rx Health Value are all organizations that run health plans themselves, and they all pay for prescription drugs under those plans.  Because these organizations buy prescription drugs in bulk, they all receive significant price breaks on those drugs. (Only the 20% of prescription drugs are paid for in cash by the consumer.  It is only this unfortunate minority that truly pays the high prices.) 

The reason health plans and other groups that buy prescription drugs are concerned is NOT because the cost of individual drugs is too high -  it is because the overall consumption of drugs is growing.  Their true objection to DCT marketing, therefore, is not that such marketing raises the price of individual drugs - it is that DTC marketing increases the overall demand for prescription drugs.

One must therefore ask why DTC marketing increases demand.  Does it increase the inappropriate demand for drugs by consumers who really don't need drugs at all? Certainly there is some of that.

But the truth is DTC marketing increases the overall demand for prescription drugs, to a much larger extent, by increasing the consumers' awareness of conditions that can now be treated with prescription drugs.  Such conditions include high cholesterol (treatment of which is now proven to significantly reduce mortality in many patients); the treatment of depression (a condition that is systematically under-diagnosed in a majority of sufferers); and arthritis (with newer drugs that have significantly fewer side effects than older drugs). 

If all doctors - or even a sizeable majority of doctors - were able to truly advocate for their patients today, then perhaps it wouldn't be so important for patients to have the means to educate themselves as to their options for medical therapy.  And DTC marketing, while hardly the most objective form of consumer education that could be devised, nonetheless imparts information - occasionally important information - that is not readily available by any other means.  If nothing else, DTC marketing can act as a catalyst for stimulating meaningful exchanges between doctors and their patients. If the drugs advertised in these commercials are truly not appropriate for a patient, then the doctor simply ought to explain why that is the case.  But the more patients are aware of their treatment options, the less "rationing by omission" will take place.

Stifling DTC advertising - or any other form of health care information aimed at consumers - is wrong.  If health plans, employers, trade unions, or advocacy groups were truly more concerned about the welfare of their constituents than about their overall drug bills, they would stop trying to do so. 

10/21/2000

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