Drug industry advertising: Does it do any good?

Drug industry advertising: Does it do any good?

On the heels of the results of a national survey published yesterday in USA Today conducted by the Kaiser Family Foundation and the Harvard School of Public Health on the effects of direct-to-consumer drug advertising, the public discussion about the value of such advertising is sure to fire up.

As a practicing cardiologist and the frequent recipient of questions regarding various drug ads, allow me to express a personal opinion in response to the question:

"As a physician, would you rather have patients ask about specific drugs by name or trust you to prescribe the appropriate drug, if one is needed at all?"

Most of the time, I've received questions from patients regarding the value of a specific advertised drug that led to a productive conversation. Prompted by an ad, we discuss whether the drug is appropriate for the patient, what alternatives are available, and whether treatment is even advisable. Sometimes, the drug was entirely inappropriate for the specific patient. Other times, it was superior to a drug they had been taking. Or, a less expensive generic preparation or over-the-counter counterpart was available.

Advertising can never take into consideration all the factors that go into a decision to prescribe a specific drug or its competitor(s), a drug from an alternative class, or whether a drug prescription is indicated at all. One blood pressure medication, for instance, while it sounds great and trouble-free in the ad, might not be right for someone with a history of side-effects to a related agent. There's no way for the health care consumer to judge this from the advertisement. For this reason, I--and I believe most of my colleagues--welcome an opportunity to answer these sorts of questions in which the patient is looking for more information and to validate or refute the claims made in an advertisement.

I believe that this sort of conversation is potentially valuable and better care can come from it, regardless of whether or not the advertised drug is prescribed.

Rarely, a patient will come into the office insisting that the advertised drug is the right one for them. Unfortunately, the people who buy into the sales pitch wholesale also tend to be people who've been disappointed by other treatments and are desperate for an answer that the drug may or may not provide. This creates a potentially contentious situation, since the patient essentially assumes that the physician should simply comply with a demand, regardless of his or her opinion on the topic. This can create two unhappy parties: the physician, who might feel that trust has been lost, and the patient, who, if he/she fails to persuade the doctor is now disappointed, or if the prescription is received, may or may not be getting the best treatment strategy.

However, I do believe that the majority of viewers recognize that advertising is meant, to inform, but also to sell.