Tuesday, October 04, 2005

DTC & Prescribing: Conventional Wisdom Challenged

With all the hoopla about direct-to-consumer (DTC) advertising and diminishing return on physician detailing, physicians are being surveyed more and more about their attitudes towards the promotion of prescription drugs to themselves and their patients.

The results of these surveys are used to support one side or the other of issues like the banning DTC and whether or not eDetailing is more effective than traditional sales rep office visits.


Conventional Wisdom
Certain study data get translated into conventional wisdom, which is cited over and over again.

Take, for example, the bit of conventional wisdom that says DTC advertising has a positive impact on the prescribing habits of physicians. That is, DTC causes physicians to prescribe more of the advertised product and hence raises the costs of health care.

The basis for this bit of convention wisdom actually comes the FDA! An oft-quoted 2002 survey of physicians by the FDA indicated that 75% of the time physicians prescribed an advertised brand name drug when patients (who said they saw the drug ad) asked for the prescription (see "
Results from FDA Physician Survey on DTC Advertising").

From this, I would conclude that if I paid a visit to my doctor and asked for Cialis, the odds are in my favor that I would get the prescription.


A recent HRA Research online study of doctors' attitudes on DTC advertising of prescription drugs, however, might discourage me from even trying.


The Challenger
This survey revealed, for example, that a majority (60%) of physicians said they prescribed the requested advertised drug less than 25% of the time. In fact, only 18% of the physicians in the study prescribed the requested drug more than 50% of the time.


If I were to go by this study, I would anticipate a much lower chance of succeeding in my quest for Cialis. The odds are that my physician is not one of the 18% that prescribe requested drugs more than 50% of the time. I might increase my chances, however, if I found a friendly online physician!


Of course, the studies asked different questions, used different methodologies, and had different sample sizes. But let's not get into that.


Which study gives a true picture of the impact of DTC on physician prescribing? The answer is: truth is not important, especially not to a marketer (see "
Is Pharmaceutical Marketing BS?"). The main point is that the two studies are useful for different purposes. The FDA study could be used to put DTC in a bad light (too much interference in the patient-doctor relationship) by DTC critics whereas the HRA study could be used to argue the opposite by proponents.

In fact, with these two studies, a pharmaceutical company can have its cake and eat it too. Marketers in the company can use the FDA data internally to support the current strategy of spending lavishly on DTC, whereas the corporate communications people can cite the HRA study to say that DTC does not unduly interfere with the patient-physician relationship -- that is, physicians clearly do not prescribe products simply because patients ask them to.


[Actually, pharma companies don't need no stinking FDA data; they know that DTC works. Many ROI studies show that there is a positive return on DTC investment in terms of increased scripts written. See "
eDetailing ROI Better Than DTC?" Or is this just another case of unchallenged conventional wisdom?]

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