DTC Advertising Going Global, but Not Without Controversy

Although direct-to-consumer (DTC) advertising of prescription drugs is legal in only the United States and New Zealand among industrialized countries, proposed legislation in the European Union (EU) and Canada may open the door to this type of marketing. Meanwhile, spending on DTC advertising in the U.S. market is expected to remain flat or decline in the near future.

The European Commission, the executive branch of the EU, recently announced a proposed law that included provisions to lift the current ban on DTC advertising and allow drug companies to provide prescription drug information to the public through television, radio, and print media, the U.K. newspaper the Guardian reported on April 8. The report cited concerns and objections from consumer groups about the proposal.

In an April 7 press release from the European Federation of Pharmaceutical Industries and Associations (EFPIA), which represents 43 major pharmaceutical companies and industry associations in 32 countries, stated that it was not pushing for legalizing DTC advertising in Europe. In fact, the federation's position is that “such mass media would not be an appropriate means for the industry to communicate information on specific prescription medicines to European citizens,” Arthur Higgins, president of EFPIA and CEO of Bayer Healthcare AG, said in the release.

Instead, EFPIA proposes a model that will actively disseminate general health information on diseases and prevention to the public without mentioning specific medicines.

Members of EFPIA include U.S.-based companies such as Amgen, Bristol-Myers Squibb, Eli Lilly, Johnson and Johnson, and Pfizer.

The Pharmaceutical Research and Manufacturers of America (PhRMA), the drug-industry trade group, however, considers DTC advertising beneficial to patients and the public. In a voluntary “Guiding Principles” document, PhRMA states that “DTC advertising of prescription medicines can benefit the public health by increasing awareness about disease, educating patients about treatment options, motivating patients to contact their physicians and engage in dialogue about health concerns, increasing the likelihood that patients will receive appropriate care for conditions that are frequently underdiagnosed and undertreated, and encouraging compliance with prescription drug treatment regimens.”

It is not surprising that these two industry organizations with overlapping members take apparently different positions on DTC advertising, then-APA President-elect Nada Stotland, M.D., told Psychiatric News. She pointed out that the European health care and drug pricing systems are very different from those in the United States.

“Physicians behave differently in these systems,” she explained. “Companies have to charge less for prescription drugs in other countries.” Therefore, the return from DTC advertising may not be worth the investment. In the United States, however, “there are few settings in which it actually costs the doctors to prescribe more expensive drugs, except in public health care and a few managed care settings like Kaiser,” Stotland said, referring to the third-party-payer system of the U.S. health care market, in which most prescribers have no financial incentives to limit prescription drug costs.