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Commentary

The Truth About the Drug Ads
John Calfee, The American, 2-7-07

Calfee examines growing Congressional criticism of direct–to–consumer prescription drug advertising and finds that the critics consistently underestimate the benefits of DTCA.

The real question is how DTCA affects patient care. Here, a key point is that a lot of DTCA focuses exactly where you would expect: on underused drugs for under–treated or even under–diagnosed conditions. This creates the potential for DTCA to accomplish a lot of good. In the only published experiment on the effects of DTCA, Richard Kravitz and several co–authors found that seriously depressed patients were much more likely to receive recommended treatments (drugs, therapy, follow–up visits) if they asked about advertised drugs.

Despite its prominence, DTCA may exert its greatest effects indirectly. DTCA is a natural tool for battling drug therapy noncompliance, one of the most intractable problems in medicine. No one knows how many lives are saved by those cholesterol drug ads that rouse wives to pester their husbands to stick with the program. Another DTCA effect is completely invisible. As of now there is no DTCA at all for some of the most important new drugs for cancer and other devastating illnesses like age–related macular degeneration, the leading cause of blindness in the elderly. But there could be, and this is something that healthcare payers have to bear in mind when deciding whether to cover breakthrough drugs. In Europe, where DTCA is prohibited partly to save costs, uptake of the most innovative new drugs is typically slower than it is in the United States. The prohibition also hurts R&D by severing the natural link between aggressive marketing and the payoffs of costly innovation.

Congress should seek a little perspective on DTCA before trying to fix it.



Project FDA.
  
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