Physicians urged to help patients evaluate direct-to-consumer drug advertising

NEW YORK (Reuters Health) – Direct-to-consumer prescription drug advertising continues to grow faster than other types of promotion, and physicians should help patients assess its value, according to a report in The New England Journal of Medicine for February 14.

Dr. Meredith B. Rosenthal, from the Harvard School of Public Health, Boston, and colleagues collected data on promotional spending on prescription drugs.

From 1996 to 2000 annual spending on direct-to-consumer prescription drug advertising increased 212% to almost $2.5 billion. However, direct-to-consumer promotion represents only 15% of total drug promotions and is concentrated within a small group of products, the researchers found.

Consumer access to this information may result in "improved diagnosis, better matching of therapy to the needs and preferences of patients, and possibly enhanced compliance," Dr. Rosenthal's team says. On the down side, direct-to-consumer advertising may cause "inappropriate prescribing driven by the demands of misinformed patients and time wasted by physicians in explaining why a particular therapy or product is not appropriate."

"The challenge, then," they add, "is to create mechanisms for facilitating the efficient exchange of information between doctors and patients."

"Direct-to-consumer advertising does not replace the physician-patient relationship; its purpose is rather to encourage an informed discussion between patient and physician," Alan F. Holmer, from the Pharmaceutical Research and Manufacturers of America, Washington, DC, comments in a journal editorial.

Dr. Sidney M. Wolfe, from Public Citizen Health Research Group, Washington, DC, responds in his editorial that "the education of patients–or physicians–is too important to be left to the pharmaceutical industry, with its pseudoeducational campaigns designed, first and foremost, to promote drugs."

Dr. Wolfe stresses that government agencies, medical schools, and residency programs "must move much more forcefully to replace tainted drug company 'education' with scientifically based, useful information that will stimulate better conversations between doctors and patients and lead to true empowerment."

"We need to remind our patients that what they see and hear in the mass media is simply advertising," Dr. Jeffrey M. Drazen, editor of the journal, notes in another editorial. "Although advertising does inform patients, it should not be confused with medical advice given in the best interest of the patient by a learned intermediary."

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