Drug Advertising

Assessing the Controversy

The advertising of drugs has been controversial in many quarters, with opponents arguing that marketing campaigns create unnecessary desire for high-cost new drugs when low-cost and generic drugs will suffice. Opponents decry such ads as helping create a drug culture in North America, where the solution to a problem is always swallowing a pill. Proponents of DTC advertising, on the other hand, argue that ads help consumers identify symptoms that could signal an underlying disease and prompt visits to physicians where illnesses can be better managed. Ads inform consumers and thus educate patients about illnesses and treatments, and some mental health advocates have argued that the ads reduce the stigma surrounding conditions such as depression.

The controversy over advertising has played out on pharmaceutical company Web sites, in medical publications, in the U.S. legislature, and on consumer advocacy blogs, with scant attention in popular media. For example, in a study of news and editorial coverage of the DTC issue from 1997 until 2004, researchers found about 216 stories in eight major daily U.S. newspapers—fewer than five articles per newspaper each year. Opponents of drug marketing argue that consumers have been subjected to the onslaught of advertising without being invited to participate in the discourse surrounding the issue. In other words, [Page 234]advertisements began appearing in 1997 with little input from the individuals most affected by the ads: patients.

While consumers are pivotal in the drug marketing culture, physicians claim they are being bypassed in the decision-making process. As a result of DTC advertising, some doctors say patients demand drugs. Since the advent of drug ads, researchers report that patients are much more likely to ask their doctors for a specific brand name drug they have seen on TV. Although some drugs may not be suitable for some patients, many physicians feel pressured to bow to such requests and fear that patients will find avenues to obtain drugs regardless of whether they are warranted. Rather than lose a patient, some physicians say they feel compelled to prescribe unnecessary medicines.

The Shifting Balance of Power

Drug advertising resulted in a sea change in the medical field when pharmaceutical companies began to target patients directly, changing how consumers think about health information and altering their relationships with physicians. One perspective is that patients' approaches to their health care have become more consumer focused or market driven. In other words, competition for patient dollars and attention has intensified as power has shifted from a physician-centered medical system to one that pivots on the needs and choices of the patient. Medical sociologists refer to this as the countervailing powers theory in which patients, physicians, hospitals, insurers, and state and federal agencies vie for power and authority in a complex health network. Much like John Kenneth Galbraith's theory of checks and balances in the economic system, countervailing powers theory in the medical field posits that authority will shift as one group in the system gains a greater financial footing over the others.

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