Direct-to-consumer prescription drug ads get poor grades for educating consumers

November 30, 2000

Health policy experts suggest regulation may be needed

(SACRAMENTO, Calif.) -- Proponents of consumer drug ads say the promotions do more than sell pills, they also help educate people about medical conditions and treatments. But the controversial ads actually teach very little, according to a new analysis by researchers at UC Davis and UCLA. The researchers call on drug companies to voluntarily improve their advertising -- or face regulation. The analysis and recommendations appear in the December issue of The Journal of Family Practice.

"No English-speaking country other than the United States permits direct-to-consumer prescription drug advertising," says Dr. Richard L. Kravitz, director of the UC Davis Center for Health Services Research in Primary Care and a study author. "A leading argument in favor of allowing this advertising is that the ads are educational; however, our research shows that in practice this argument often falls short." Dr. Kravitz and his co-authors scrutinized 320 print ads promoting 101 drug brands. The ads appeared in 18 popular magazines between 1989 and 1998. On an 11-point scale of educational content, the average ad scored only 3.2 points.

Most ads failed to provide information about how a drug works, its success rate, how long it must be taken, alternative treatments, or helpful lifestyle changes. A few ads didn't even reveal the drug's name.

Among the study's findings:"These ads are designed to encourage patients to request the advertised drugs from physicians," Dr. Kravitz says. "That can have three outcomes. The patient can request the drug, and the drug can be appropriate, in which case the outcome is good. The patient can request an inappropriate drug, and the doctor can acquiesce and prescribe it, which could cause the patient's health to suffer. Or the patient can request an inappropriate drug, the doctor can refuse to prescribe it, and the patient and doctor can get locked in an argument that imperils the doctor-patient relationship."

In their article, the authors offer suggestions for physicians in dealing with patient requests. The article recommends that physicians keep on hand informational materials produced by such organizations as the American Academy of Family Physicians and the American College of Physicians. Then, when a patient asks about an advertised drug, the physician can provide a handout, saying, "This information is produced by the best experts in the field and provides a more balanced view than what you will find in profit-motivated advertisements," the authors suggest.

If the pharmaceutical industry does improve the educational content of its prescription drug ads, further research will be needed to assess the impact of that change on physician-patient interactions, the authors say.

Among the questions to be asked: Do educational promotions increase demands by patients for drugs that are not medically indicated, requiring time-consuming re-education by physicians? Or do better-informed patients take less time to treat and counsel? For now, the authors argue that prescription drugs ads should provide better information. "Providing complete and accurate information," they state, "is the right thing to do."

"The medical community should exert pressure on the drug industry to incorporate more information about conditions and treatments in its advertising... If such information is not provided voluntarily by the industry in future advertising, the medical establishment should lobby for regulation," the article argues.
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Copies of all news releases from UC Davis Health System are available on the web at http://news.ucdmc.ucdavis.edu

University of California - Davis Health System

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