The US Food and Drug Administration (FDA) has released results of its survey on direct-to-conumer (DTC) advertising for prescription drugs among 500 physicians. The results show that DTC advertising, when carried out correctly, can serve positive public health functions such as increasing patient awareness of diseases that can be treated, and prompting thoughtful discussions with physicians that result in needed treatments being prescribed - often not the treatment in the DTC advertisement. This study also demonstrates that most physicians view DTC advertisements as one of many factors that affect their practice and their interactions with patients, both positively and negatively.

Highlights include:

• Many physicians believe that DTC can play a positive role in their interactions with patients. For example, most agreed that, because their patients saw a DTC ad, he or she asked more thoughtful questions during the visit. Some thought that the ad made their patients more aware of possible treatments.

• Many physicians also thought that DTC ads made their patients more involved in their health care.

• Physicians also felt they had to provide additional information to patients beyond what patients retained from the DTC advertising. About 75% of physicians believed that DTC causes patients to think the drug works better than it did, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads.

• However, 8% felt very pressured to prescribe the specific brand name drug when asked about it. Instead, physicians suggested alternative courses of action for a variety of reasons: a different drug was more appropriate, there were side effects the patient did not know about, or a less expensive drug was available.

• According to the survey, one effect of DTC ads was to help educate patients about their health problems, and to provide greater awareness of treatments. The study demonstrated that when a patient asked about a drug, 88% of the time they had the condition that the drug treated. And 80% of physicians believed patients understood what condition the drug treats.

• Moreover, doctors believe that patients understand they need to consult a health care professional about appropriate treatment: 82% of physicians believe patients understand very well or somewhat that only a doctor can decide if the drug is right for the patient. This is important, because only 40% of physicians believe that patients understood very well or somewhat well the possible risks and negative effects of an advertised drug from the DTC ad alone.

This is the third survey conducted by FDA to help the agency assess the impact of DTC advertising. FDA will continue to analyse these data, and will continue its comprehensive evaluation of DTC advertising and its impact on public health, to ensure that current DTC policies maximize the positive benefit that DTC advertising can play in the public health arena.

Reference: FDA Talk Papers, T03-03 and T03-07 January 2003.