Direct-to-consumer advertising (DTC advertising) is a marketing tactic that bypasses affiliated health care organizations or professionals to specifically target consumers (Dumit 2015). The products that marked using DTC advertising are typically pharmaceutical products, though medical devices, consumer diagnostics, and some financial services can also be marked in this way (Dumit 2015). The methods used by the marketing specialists often involve media outlets, such as billboards, television commercials, newspaper and magazine articles etc. DTC advertising in the pharmaceutical industry is particularly interesting because it impacts both the industry’s success and the consumer’s health.
One benefit of direct-to-consumer advertising is that it provides health information and treatment to those who may not have access to appropriate healthcare. Individuals who may not know that they are suffering from an ailment may hear and connect with the symptoms listed on advertisements. The turn towards direct-to-consumer advertising has created an increase in “self-testing,” which is intended to raise awareness about a particular disease in order to grow the market for pharmaceuticals targeting that disease (Ecks 2006, 243). In DTC advertisements, marketers list the symptoms, benefits, and side effects of a drug so that viewers can assess their own symptoms individually and determine whether they want the drug (Ecks 2006, 243). This is can be advantageous for communities that would not be able to receive advice from a doctor regularly, because it can lead them to recognize health problems that they may have otherwise ignored. However, it also can be harmful to consumers’ health because it takes the responsibility of diagnosis out of professionals’ hands and into patients’ hands. The rhetoric that is used in these advertisements reinforces this idea of individual responsibility, using phrases like “my status” and “my body” to suggest that individuals are in charge of their own wellbeing (Ecks 2006, 243).
Before pharmaceutical companies introduced direct-to-consumer advertising, patients relied on physicians to recommend the drugs that best fit their symptoms. However, as the number of prescription drugs increased dramatically in the 1990s, pharmaceutical companies needed to create a more direct route to their consumers in order to bolster their revenues (FDA 2015). Companies consciously directed their drug advertisements towards patients rather than doctors (Conrad 2005, 4). As a result, patient became more knowledgable about the range of prescription drugs available for their specific ailments, and they have gained more power relative to their doctors (Conrad 2005, 4). While it is still necessary for actual physicians to advise and prescribe drugs, many citizens already decide on the drug they want before consultations (Fisher 2007, 203). This takes the power from the doctors and complicates the process of informed consent (Fisher 2007, 201).
In order to successfully reach the consumer, the pharmaceutical drug must go through an extensive “screening process” (FDA 2015). In-depth research is done on the product before it can be marketed directly to consumers (Dumit 2015, 36). Pharmaceutical organizations that rely on DTC advertising must be screened through the Food and Drug Administration, which is a governmental administration in the United States that supervises all advertising for prescription drugs under the Federal Food, Drug, and Cosmetic Act of 1938 (FDA 2015). The early requirements for drug approval were extremely strict, and discouraged companies from advertising directly to their consumers on broadcast media (Gellad et al. 2007, 476). Consequently, companies advertised for their drugs in print media (Gellad et al. 2007, 476). However, the FDA soon limited these outlets as well, so pharmaceutical companies were discouraged from advertising directly to consumers. However, in 1997, the FDA released new guidelines that lightened restrictions for companies (Gellad et al. 2007, 476). Companies would now only have to inform their consumer of risks and referring them to a reputable source for more information about the product, rather than going through extensive research and screenings (Gellad et al. 2007, 476).
Many drugs have become a part of popular culture as a result of direct-to-consumer advertising. One such drug is Sildenafil, also known as Viagra, which is used to high blood pressure and erectile dysfuntion (Viagra 2014). The popularity of Viagra has been directly linked to the high proportion of DTC advertising used to market the drug (Viagra 2014). Viagra commercials on television often feature women of all ages, sometimes in lingerie, talking about the benefits of Viagra in their personal lives. This advertisement scheme appeals to men who want to please their significant others. Any embarrassment the consumers may feel about erectile dysfunction is eased by advertisements communicating facts like, “over half of men over 40 have some degree of erectile dysfunction!” (Viagra 2014). This also serves to broaden the drug’s consumer base, because it makes physically-healthy men feel as though they need the drug to please their partners.
Direct-to-consumer advertising relates to the politics of health because it involves both medicalization and pharmaceuticalization, because these advertisements must handle the responsibilities of both providing healthcare to citizens and gaining revenue for the industry (Conrad 2005, 4). Pharmaceuticalization refers to the increase of the use of a certain pharmaceutical(s) as a result of the increased perceived importance of the associated disease (Williams et al. 2015, 20). Often times, the direct-to-consumer advertising interlinks the health of the patients and the capitalist nature of the pharmaceutical industry (Ecks 2006, 240). It is a balance to appropriately take into consideration the wellbeing of the consumer and the greed-filled money-making aspect of industry. Many say that DTC is beneficial to the health of the patient because patients are more likely to live a healthier life when they have more access to and knowledge about health care. On the other hand, opponents of DTC advertising say that it is targeting people too specifically and taking advantage of their anxieties and emotions. This can result in an intensified dependence on the pharmaceutical industry. As the industry grows, industry will continually be motivated by revenue as opposed to the health of consumers (Williams et al. 2015, 20). However, it is often seen that the increase of the prescriptions in relevance, the prevalence of the disorder, or at least the need for the prescription, will rise.
References
“The Impact of Direct-to-Consumer Advertising,” US Food and Drug Administration, last modified Oct. 2015, https://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm143562.htm
Peter Conrad. “The Shifting Engines of Medicalization”. Journal of Health and Social Behavior 46 (2005). Accessed February 2017 https://blackboard.vanderbilt.edu/bbcswebdav/pid-1301160-dt-content-rid- 3832985_1/courses/2017.01.SPR.AS.MHS.1920.03/Conrad_ShiftingEnginesofM edicalization%281%29.pdf
Jill Fisher. “‘Ready to Recruit’ or ‘Ready to Consent’ Populations? Informed Consent and the Limits of Autonomy”. Qualitative Inquiry 13(2007). Accessed February 2017 https://blackboard.vanderbilt.edu/bbcswebdav/pid-1354028-dt-content-rid-3936028_1/courses/2017.01.SPR.AS.MHS.1920.03/Fisher_ReadytoRecruit_ReadytoConsent.pdf
Ziad Gellad and Kenneth Lyles. “Direct-to-Consumer Advertising of Pharmaceuticals”. The American Journal of Medicine 120(2007). Accessed February 2017 http://dx.doi.org/10.1016/j.amjmed.2006.09.030
Steven Woloshin et al. “Direct-to-Consumer advertisement for prescription drugs: what are Americans being sold?”. The Lancet 358(2001). Accessed February 2017 http://dx.doi.org/10.1016/S0140-6736(01)06254-7
Stefan Ecks. “Pharmaceutical Citizenship: Antidepressant Marketing and the Promise of Demarginalization in India.” Anthropology and Medicine 12(2005). Accessed February 2017. doi: 10.1080/13648470500291360
Simon J. Williams et al. “The Pharmaceuticalisation of Society? A Framework for Analysis”. Sociolgy of Health and Illness 33(2011). Accessed February 2017. https://blackboard.vanderbilt.edu/bbcswebdav/pid-1301161-dt-content-rid-3832988_1/courses/2017.01.SPR.AS.MHS.1920.03/Williams_PharmaceuticalisationFrameworkforAnalysis.pdf
Dumit, Joseph. “Pharmaceutical Witnessing: Drugs for Life in an Era of Direct-to-Consumer Advertising” Technologized Images, Technologized Bodies, 37-64 by Peter Wade et al. Berghahn Books, 2010
Viagra (Sildenafil Citrate) Commercial, aired 2015
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