The DTC Debate

Kevin, M.D. links to a story regarding Pfizer's study that shows internet ads are equally effective as TV and radio ads in conveying "a distinctive and memorable message and influence viewers." Kevin shows his disgust:

Great, just what we need - more ways for pharmaceuticals to connect with consumers. Expect to see more, not less, direct-to-consumer advertising - along with all the problems that go along with it.

Later, he expresses his joy that the FDA has pulled the plug on the recent Viagra adds entitled "Wild Thing:"

Pfizer Inc. has been asked to pull two television advertisements for its Viagra impotence drug by U.S. officials who say the "wild thing" ads make unsubstantiated claims about a return of sexual desire.
The Food and Drug Administration, in a letter released on Monday, said the 30- and 15-second ads also failed to mention major side effects and why some patients should not take Viagra.

I will echo the sentiment that those adds were supremely annoying. But annoying does not merit censorship (and God help Justin Timberlake if it did). But are the claims fraudulent? It is definitely true that the drugs do nothing to physiologically improve sexual desire (and the news media helps perpetuate this myth with their recent reports on the search for a "women's viagra"). But one could argue that the ability to physically perform sex adequately improves sexual desire psychologically. I'm sure some would find that questionable, but I always give the benefit of the doubt to the speaker when discussing freedom of speech/fraud.

Anyway, the other point that needs to be made is this: even if you think that direct-to-consumer advertising of pharmaceuticals needs to be restricted, it is extremely disingenuous for physicians to make these claims. For they are direct beneficiaries of such restrictions. As I have discussed before in detail at my old digs, physicians benefit when you enforce their claims to information gatekeepers with regard to prescription drugs:

DTCA and detailing (direct-to-physician advertising) are substitutes, meaning when DTCA goes up, detailing goes down. Consequently, if DTCA is banned, doctors will be a big beneficiary, as they will see increased competition for their prescriptions. More pens, I guess.

...For physicians to ask the government to give them a total monopoly as the information gatekeeper...will be harmful to the patient/consumers for which they are supposed to advocate.

Now, I'm not impugning the motives of Kevin; but, I do impugn the motives of physicians as a group who call for such restrictions. If it walks like rent-seeking, and quacks like rent-seeking...

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I am sure that doctors, even

I am sure that doctors, even as a group, truly believe that they are more qualified than patients to make decisions about which drugs are best, just like priests believe they are better qualified to interpret the Bible for their flock.

Even if it is true in a general sense that doctors are better equipped than most people to interpret medical information, it is not possible for a doctor to be an absolute expert in every drug and condition, whereas a patient has every incentive to learn as much as possible about a drug that they are thinking about using. Meanwhile, the doctor is getting most of his or her information on drugs from the Physicians' Desk Reference, which is put out by the drug companies.

Even if it is true in a

Even if it is true in a general sense that doctors are better equipped than most people to interpret medical information, it is not possible for a doctor to be an absolute expert in every drug and condition, whereas a patient has every incentive to learn as much as possible about a drug that they are thinking about using. Meanwhile, the doctor is getting most of his or her information on drugs from the Physicians’ Desk Reference, which is put out by the drug companies.

I hope doctors do know more about how to interpret medical information than the average joe, just like plumbers know more about fixing pipes, lawyers know more about the law, and wedding planners know more about planning weddings. In each of these cases, the consumer has incentives to learn about pipes, law, and planning weddings. But division of labor is a good thing. It allows people to not worry about everything that could possibly happen in their lives because they know they can go to people who specialize in the sorts of things that come up.

Doctors do get a lot of information from the PDR, but they also have (or at least should have) a good idea of how the information in the PDR applies to their patients unique medical conditions based on their evaluation of the patient.

The issue is more about actively preventing information being transmitted between two willing parties and less about whether doctors know better than their patients how to best use that information.

On a completely unserious

On a completely unserious note, what always bothered me about those ads was the way the "V" appears behind the guy's head; the tips of the "V" are placed to look like cuckold's horns.

I completely agree with all

I completely agree with all that Jonathan said.

Diana