Measuring DTC Advertising’s Impact

Ever since the FDA eased restrictions on pharmaceutical companies’ direct-to-consumer (DTC) advertising in the 1990s, commercials for prescription medications have become frequent comedic targets, what with their stilted dialogue, lengthy lists of side effects, and less than subtle references to the drugs’ benefits (such as the onetime ED sufferer who now hurls footballs through hanging tires with ease). Of greater interest to those in the pharmaceutical industry, however, is whether the ads actually work.

As Joe Gattuso and Brad Davidson of MBS/Vos, a part of CommonHealth, observe in a recent NextGen Pharmaceutical Magazine article, supporters of DTC advertising argue that these commercials provide a public service, informing the public about symptoms and health conditions while encouraging dialogue with physicians and proper use of prescribed medications.

On the “con” side, critics believe that the ads negatively affect physician/patient interactions, encourage doctors to write prescriptions for medications without first thoroughly discussing risks and benefits, and direct care away from individual patients medical needs.

In an effort to move beyond the speculation, and determine precisely what impact DTC advertising may have on exam room interactions, CommonHealth conducted a study of 440 individual patient visits to 172 health care providers, recorded between 2001 and 2005. Patients were chosen among appointments with participating physicians, but were not specifically recruited, and the visits were captured on video with no outside observers present.

Researchers were surprised by the results, which seem to indicate that, in fact, DTC advertising has only a minimal impact on discussions between physicians and patients. The specific findings were:

• Patient initiated requests for advertised medications were infrequent. Only 16 of the 440 patients (3.7 percent) made overt references to DTC ads they’d seen while another 25 (5.7 percent) made ambiguous references to such commercials and the products advertised.
• Patients almost never follow the direct, “I saw/heard this commercial and want this Rx” approach.
• DTC advertisements do not appear to increase the frequency or volume of benefit discussions versus risk presentation by physicians.
• Overall, there were very few references to DTC advertising, and primarily health care providers made them.

These results aside, say Gattuso and Davidson, it’s a well established fact that DTC advertising does drive prescription medication sales. If that’s the case, but DTC advertising is not impacting direct patient requests for DTC-supported medications, they wonder then what accounts for the impact on prescription sales? They offer five hypotheses, suggesting that DTC advertising may increase:

• The number of visits from a “pre-selected” patient population
• Patients’ overall receptivity to a discussion of DTC-supported medications
• Physicians’ top-of-mind awareness of specific medications
• Patients’ discussion of advertised pharmaceutical products with friends and family, online and health care professionals outside the exam room
• First fill of prescriptions and subsequent adherence

Gattuso and Davidson understand that this CommonHealth study does not resolve, but merely moves the research into the impact of DTC advertising on physicians and patients one small step down the path to understanding. More research is needed, they suggest, and will help illuminate the role such promotions can play in improving patient care.

“These data present the Life Sciences industry with great opportunities,” Gattuso and Davidson say. “First, they point the way for new research that can more clearly define the real impact of DTC advertising on physician/patient interactions. And secondly, based on these insights, an expanded view of how DTC advertising can serve the needs of both physician and patient can be conceived and acted upon.”