Over the past decade, the world of pharmaceutical communications has changed significantly. In the late 1990s, drug companies spent hundreds of millions of dollars on direct-to-consumer (DTC) advertisements that made drugs like Viagra and Prilosec household names.
Today, the threat of government regulation and widespread criticism has forced the industry to change its marketing tactics. Drug companies are currently shifting marketing dollars from product promotion to education. In this article, I ask and answer five tough questions about current and future trends in pharmaceutical marketing.
Q1: Should pharmaceutical companies be allowed to market their products?
A1: Yes. Drug companies have a responsibility to deliver value to their stockholders, investors and other stakeholders. In an ideal world companies would make products that sell themselves. You don’t need an advertisement to sell a cure for cancer. However, most products are not cure-alls. Rather they represent incremental advances in a number of conditions. Companies also invest research dollars into medications that are for purely cosmetic or lifestyle uses (e.g., Viagra, Ambien). In short, drug firms have every right to promote their products. However, it should be done responsibly. This means companies should:
– Adhere to the industry trade group PhRMA’s voluntary guidelines on direct-to-consumer DTC advertising (no reminder ads, wait an appropriate period of time before starting advertising for a new medication).
– Highlight the benefits and risks of medications in ways people can understand and act on.
Q2: Should the FDA ban direct-to-consumer advertising?
A2: I don’t think that the FDA would be able to ban DTC advertising due to 1st amendment concerns. However, I do believe that the FDA can do more to regulate drug advertising. Most importantly, the agency needs to figure out a better way to monitor and regulate pharmaceutical advertising.
Although companies submit advertising to the FDA’s Division of Drug Marketing, Advertising and Communications (DDMAC) when they first appear, the agency does not vet all promotional material. In fact, a December 2005 Pharmaceutical Executive article noted that the FDA has 35 staffers in the DDMAC office who are responsible for reviewing 53,000 promotional items a year.
Perhaps one solution is to dramatically increase funding for DDMAC by implementing a user-fee system similar to the one the FDA introduced to speed approval of medications. To prevent backlogs, the agency could focus on reviewing advertisements for drugs or devices that will be used in significant numbers of patients.
Q3: Should medical journals ban advertisements from drug makers?
A3: In an article published in the June 2006 edition of PLoS, Adriane Fugh-Berman, Karen Alladin and Jarva Chow suggest that “medical journals should not accept advertisements from pharmaceutical companies, medical device companies, or other industries ‘relevant to medicine.'”
This an interesting idea, but it is neither feasible or appropriate. Journals have well-established policies governing how they handle advertising from drug companies and how to separate the marketing and editorial departments. Not all publications are perfect. Some journals are not very credible because of a weak peer-review process or a perception that they do not have the resources (or reputation) to attract excellent scholarship.
In addition, anecdotal evidence indicates that many healthcare providers learn about new medications or devices via journal advertisements. If something is not advertised, a physician won’t know about it. Rather than focusing on drug advertising, journals should continue to shore up their peer-review and editorial review processes.
Q4: Does the pharmaceutical industry engage in “disease mongering”?
A4: This is not a new complaint. Critics of the pharmaceutical industry have long maintained that companies have turned ordinary aliments into diseases in order to turn a profit. My short answer is “yes and no.” Like many others, I believe that certain conditions are more legitimate than others. I’d rather companies spend less time promoting some “cosmetic” conditions and more time focusing on life threatening conditions like diabetes, cancer, high blood pressure and drug-resistant bacterial infections.
Q5: Do we need more or less safety information in drug labels?
A5: Yes, yes, yes. In this era of “consumer-driven healthcare,” people need more information about the risks and benefits of medications. More risk information may lead to better informed patients and better decision-making.