If you want a balanced analysis of the pros and cons of how the U.S. public thinks about direct-to-consumer (DTC) drug advertising, yesterday’s testimony to the House Committee on Energy and Commerce by Mollyann Brodie, Vice President and Director of Public Opinion and Media Research at the Kaiser Family Foundation, is the place to start.
DTC drug advertising is a prototypical good-versus-good conflict. Kaiser Foundation surveys show that the public is torn about DTC. Everyone has an opinion, since 91% of adults have seen or heard prescription drug ads!
53% see DTC as mostly a good thing. 40% see it as mostly bad. 67% agree with Pharma’s claim that “prescription drug ads educate people about available treatments and encourage them to get help for medical conditions they might not been aware of.” But 66% think DTC encourages people to take drugs they don’t need, and 77% say that DTC makes drugs too expensive.
Surveys tell us what the public thinks about right and wrong, not what is right and wrong. But the Kaiser Family Foundation findings have important practical implications.
I believe that if we could study the actual impact of drug advertising we would find it to be largely bad, with relatively little accurate education of consumers about health conditions and treatments, and much unnecessary medication use and cost without benefit. But we won't be able to do those studies - it's too hard and too expensive.
Free speech is as deeply held as any American value. That's why the first amendment prohibits "abridging the freedom of speech." Pharma's claim that freedom of speech protects DTC will prevail, and even though I don't like DTC, I think it should prevail.
But the first amendment doesn't prevent regulation of how DTC is conducted, and the public is moving towards readiness to endorse tighter controls. 43% believe the government should do more to “make sure statements about benefits and side effects made in Rx drug ads are not misleading.” Whereas in 1997 33% trusted DTC most of time time, in 2005 only 18% did so, and 34% hardly ever or never trusted ads.
In good-versus-good conflicts like this one we could continue arguing until the cows come home without reaching a consensus. Some will make free speech the top value. Others will give preference to the public's health. But the polls point towards a potential compromise that would respect both key values. With good leadership we could tighten regulation so that truly educative DTC was allowed but duplicitous DTC was not.
This isn't the direction the Bush era FDA has been going in. (See previous posts here and here.) But along with free speech, the right to chuck out an administration is another deeply held American value!