Physicians prescribed a drug advertised directly to consumers 39 percent of
the time when patients asked specifically for that drug, according to the
results of a survey published on the Web site of the journal Health
Affairs. But physicians were just as likely to recommend that patients
change their lifestyle to treat a medical condition.
The survey results also showed that such encounters between physicians and
their patients led to new treatment for conditions more than half the time,
suggesting that while direct-to-consumer advertising (DTCA) may lead to
increased drug consumption, it also may have positive effects for patients"
that transcend merely prescribing a DTCA drug," the researchers
The survey was conducted by a team of researchers led by Joel Weissman,
Ph.D., an associate professor at Harvard Medical School.
Weissman and colleagues asked 643 physicians about how DTCA affected their
practices and about the results of their most recent experience in which a
patient specifically asked for an advertised drug.
While nearly three-quarters agreed "strongly" or"
somewhat" that DTCA helps educate and inform patients about
treatments available to them, about 4 out of 5 agreed "strongly"
or "somewhat" that DTCA also encourages patients to seek treatment
they don't need. More than 4 out of 5 agreed "strongly" or"
somewhat" that DTCA does not provide information on risks and
benefits in a balanced manner.
Depression and anxiety ranked sixth and seventh, respectively, among the
most common conditions for which patients sought a drug that had been
advertised directly to consumers. Depression was the condition in 5.8 percent
of cases; anxiety was the condition in 5.6 percent of the cases.
The other most common conditions were impotence (10.9 percent of all
DTCA-related visits), arthritis (10.5 percent), allergies (9.6 percent), high
cholesterol (8.7 percent), heartburn (8.4 percent), pain (3.8 percent),
diabetes (3.6 percent), and menopausal symptoms (3.3 percent).
Physicians reported that 25 percent of DTCA-based visits resulted in a new
diagnosis; the 10 most common were impotence (15.5 percent of new diagnoses),
anxiety (9.0 percent), arthritis (6.8 percent), menopausal symptoms (6.6
percent), allergies (6.0 percent), depression (5.7 percent), hypertension (4.7
percent), pain (4.6 percent), heartburn (4.1 percent), and high cholesterol
Physicians prescribed the requested DTCA drug in 39.1 percent of the cases,
but were just as likely to recommend a lifestyle change (39.1 percent). Other
actions included prescribing another drug (22.4 percent), referring to a
specialist (5.8 percent), recommending an over-the-counter drug (12.2
percent), and recommending a diagnostic test (9.3 percent).
In the cases when the DTCA drug was prescribed, 46.1 percent of physicians
said it was the most effective drug, while 48.4 percent said that it was as
effective as other medications and that they wanted to accommodate their
When asked about the impact of prescribing a requested DTCA drug on
patients' overall health, 22.6 percent of physicians said it would be a"
large positive," and 53.8 percent said it would be"
somewhat positive." Few said it would be "somewhat
negative" or a "large negative" (1.5 percent).
"When evidence exists on appropriateness, drug advertising may
produce a social good by reducing underuse," Weissman wrote. "On
the other hand, in different circumstances drug advertising may encourage
overuse of higher-cost drugs among patients who have little to gain. Our
research provides further insight into the health and health care effects of
DTCA, suggesting possible benefits, although it is by no means