In this segment, we discuss what DTCA is, different types of pharmaceutical ads, and the role of marketing in the American, and New Zealand's, healthcare system, the only two countries in the world where DTCA of pharmaceutical products is legal.
[Ethan]: What is DTCA and how does it relate to marketing and healthcare? DTCA stands for direct-to-consumer advertising. It is when pharmaceutical companies are legally allowed to advertise directly to patients or consumers as opposed to marketing only to their physicians in the hope that it would lead to increased sale of their drugs.
The fight over who should have autonomy over patient prescription decisions has been ebbing and flowing for the last 200 plus years, and its history is marked by several national medical mishaps leading to policy changes. While the decision [00:01:00] regarding how much autonomy consumers should have over their healthcare decisions is important and warrants ongoing discussion, big business stands to benefit more from full consumer autonomy as consumers are more likely to be influenced by marketing than well-trained prescribers. Unfortunately, one policy change in the mid 1990s created a loophole for widespread direct to consumer advertising that led to two of the most egregious, reckless, and destructive drug advertising campaigns of all time—Purdue Pharmaceutical’s aggressive and manipulative marketing of Oxycontin and Merck's ruthless campaign promoting Vioxx.
With DTCA advertisements, there are essentially three different categories. One is help seeking advertisements, Ads that contain information about a disease or a condition with a recommendation to consult a healthcare provider.
[Michael]: I'll just give a couple of examples of it. [00:02:00] I've heard ones in the last couple years about non-24 hour or the idea that certain people's circadian rhythms are off as far as sleep in wake cycles. And so it doesn't talk about a specific medication, but it talks about getting to your doctor and getting information about that condition. The one I've heard in Kentucky, I've heard in Illinois, is exocrine pancreatic insufficiency or EPI as the ad says. And it doesn't tell you the product; however, you find out that the company that is putting it out, of course they've got a product that just so happens to be used for pancreatic insufficiency.
[Ethan]: Another type of advertisement is a product claim. This includes the name of the drug, the therapeutic claim, and includes information about safety and efficacy. That's going to be your typical drug ad that you would see on TV, marketing a specific drug for a specific condition.
The third type is a reminder ad. These are ads that contain a product [00:03:00] name or a condition, but not both of them. It helps to reinforce brand recognition, to help drive profit and drive the sale of the drug or the sale of a drug that is not mentioned but is obviously related to a specific condition.
Michael, what is the role of marketing in healthcare?
[Michael]: This is something that goes back well over a hundred years. You know, we hear phrases that we've used in our lexicon currently like “snake oil salesman,” somebody that has a product and they're trying to promote it, but it really has questionable benefits. You have so and so, you know, who would take a wagon and go all around the country touting this product that's good for everything—it helps the aging, it keeps vitality up. Even, you know, old episodes of the TV show, I love Lucy, this is Vitameatavegamin and she's getting paid to sell it on TV and it makes you happy and healthy and peppy and all of it. You could say these things, regardless about what was actually in the [00:04:00] product, whether it actually worked or not.
And you know, you would joke about going after the guy who sold it because he, you know, sold you a product that didn't really work or he pocketed your money. But you know, if we actually take a step back and think about it, there's some real concerns there and actual medication or something touted as a medication, which is talked about maybe to treat, prevent, or cure disease, And per the FDA, that's something to be regulated and to, think about what you're putting in the body and whether or not you understand the risks and the benefits and the safety and the efficacy. At one hand you have the ability, you know, they want to not be overbearing as far as regulating the economy and there's that free market approach. But at the same time, how do you balance that against protecting consumers from things that they may not be aware of within products.
[Ethan]: And our American system is very unique. For a long time, we were the only country that allowed pharmaceutical companies to [00:05:00] advertise directly to consumers. New Zealand was allowing it for a while.
[Michael]: They seem further along in getting rid of it than we are. I don't think they're there yet, but they're actually talking about it.
[Ethan]: We have to remember that the American medical system is comprised of, two schools of thought or two, sometimes at odds, entities. You have physicians and prescribers and providers of healthcare whose primary goal, at least ideally, is to promote better understanding and better treatment and better outcomes. On the other hand, you have the business side [and] their primary aim is to profit and to show their profits to their shareholders and to continue to grow as a business. That's why this is such an important topic to discuss so that Americans and the general public understand the [00:06:00] influence that comes from the pharmaceutical companies and understand that a lot of physicians don't agree with some of the medications or treatments that are FDA approved.