Will ‘Change’ In Washington End DTC Ads?
That’s the question Bob Ehrlich, a former Warner-Lambert exec who now runs a consulting firm, mulls over in his weekly blog. In his view, the odds are against a big change in the use of mass media. For the moment, he ballparks the odds on a momentous shift at only 30 percent. But he doesn’t take much comfort in the age-old defense that the First Amendment will preserve DTC. And lobbyists won’t save the day, either. Here’s why…
“What if a ‘change’ election occurs, as seems entirely likely? With a likely expansion in Americans covered by health insurance and the resulting costs to do so, what changes might occur to limit cost increases? Hmm, let me think! Drug costs will be a key component. Drug marketing affects cost by emphasizing newer and more expensive drugs. So a scenario that greatly limits drug company marketing is entirely possible,” he writes.
“Free-speech issues are going to limit how draconian regulation could be. That does not mean government will not be able to restrict marketing. Courts will allow reasonable regulation to protect public health. A tweak here or there could make it much harder for drug companies to use mass media. Congress could also go after how drugs are detailed.
“Do I really think mass media is going to end? I would say it is 70 percent likely it will stay pretty much as is for the next few years. If Obama wins, he may succeed in his goal of greatly expanding medical coverage by the end of his first term. If that happens then I would place the odds of greater restrictive change at 50 percent or higher. After all, we have only had easy-to-do mass DTC for 11 years, so going back to pre-1997 is not a stretch in scenario planning. I would hate to see an end to mass media DTC, but thinking that first amendment protection guarantees it long term is a mistake.”
Hat tip to the WSJ Health blog
ol cranky
The funny thing is, most of my friend (the majority of which are in Pharma) agree that DTC needs to go. AZ supposedly d/c’d most DTC (which I think has negatively impacted their ability for symbicort to take any substantive market share from advair, despite the tachyphylaxis and steroid burden issues with advair), but they seem to be the only ones to have pulled back any DTC adverts.
As we all know, the “free speech” argument is a straw man that needs to be set aside already.
Justice in Michigan
Whatever else, there is at least a correlation between the boom of TV DTC and the beginning of the big slide in poll numbers for the industry.
My sense has always been that if you sell drugs like they used to sell cigarettes, there’s a loss of a certain amount of “gravitas.”
Atlex
Justice, while I don’t necessarily disagree with you, I think you may be leaping too far in drawing that conclusion. Just because two things happen around the same time, doesn’t mean that there’s a correlation. Many things happened in the last 11 years since DTC became common (1997 is generally considered the watershed year). In related healthcare areas, DTC advertising hasn’t led to the same decline in “gravitas”. For instance, the hospital industry regularly advertises, yet hasn’t declined like the pharma industry in public perception.
I would argue that DTC combined with a number of other factors–profitability, politics, the aging of the baby boomers (with unreasonable expectations for perfection in everything) and others issues–have all contributed to the decline.
Justice in Michigan
Atlex - I chose the word “correlation” in order not to suggest causality, just an association in time. The “my sense” part was, indeed, just my sense.
Phil Hilts, whose book on FDA you probably know (but probably don’t like) thinks the key was pharma’s initial balk at responding to the need for AIDS meds in Africa at that time (’97). I frankly think he thinks too much of us!
Atlex
Justice,
In my opinion, Phil Hilts gives Americans far too much credit. I frankly don’t believe that Americans care all that much about AIDS in Africa, certainly not enough to impact our thinking about health care in the US.
Overall, I think the decline is multi-factoral–increasing patient out-of-pocket expenses (this includes rising prices, increased utilization and increasing co-payments); the aging of the baby boom generation and the need to treat the conditions of middle age; a changing attitude and skepticism about corporate America; the pharma industry shooting itself in the foot with bad behavior; etc. DTC is part of that equation, but I don’t think it has any greater role than the other factors.
Atlex
Justice in Michigan
Atlex - Right. What you said about Hilts’ theory is what I wrote.
Also agree many factors, including other corporate arenas (Enron, etc.). Of course, this is one of those things that’s essentially impossible to pin down one way or other. We can track the correlation of DTC with scripts written (and speculate about possible causal links) but almost certainly not attitudes in the same way, which are more variously conditioned, less malleable once formed, etc.
You won’t be surprised if I think “shooting themselves in the foot” is a little mild for _some_ of the “bad behavior” (and those who also got shot in the process), but generally in accord. I would add that pharma is different from other industries because of how much most of us depend on their _avoiding_ “bad behavior_. That is, how much we essentially _have_ to trust the industry. To that degree, they are also in the position of docs - inevitably, our views our going to be fickle. And they should be. That’s part of what goes with taking on this work and not some other.
As I’ve often said, when a social scientist messes up, nobody gives a sh*t.
someone
Ol Cranky said ” As we all know, the “free speech” argument is a straw man that needs to be set aside already.” AMEN!!