Drug Risks: Consumers Less Concerned than Docs

On March 31, 2006, the Coalition for Healthcare Communication (CHC) -- comprised of major advertising, marketing and PR organizations, including the American Association of Advertising Agencies, the Association of National Advertisers, and the Public Relations Society of America -- filed a Citizen Petition with the FDA seeking new prescription drug advertising rules and specifically calling for simplifying the communication of risk information in broadcast, print, and Internet DTC ads (see "DTC without the Risk" and "Communicating Risk: Let the Dialog Begin").

CHC's main argument was that the physician, as learned intermediary, was the best resource for patients and consumers to learn about specific risks of the drugs they are taking. CHC contended that all the risk information currently in DTC ads scare consumers away from the advertised brand.

Perhaps the CHC and pharmaceutical DTC advertisers believe that doctors are more willing to advise patients that the benefits outweigh the risks. It turns out, however, that physicians are more concerned about drug risks than consumers are. This was a conclusion of the recent Medco Monitor(TM), a national commissioned survey conducted by Forrester Consulting on behalf of Medco Health Solutions, Inc., which is a pharmacy benefit manager (PBM).

The Medco Monitor research was conducted in the first-quarter of 2006 by Forrester Research, an independent technology and market research company. The data collection was done telephonically and captures the perception and attitudes of 3,200 Americans including 2,000, consumers, 300 practicing physicians, 450 retail pharmacists and 450 health benefit administrators. [See "Survey reveals seven out of 10 doctors concerned about safety of prescription medicines; risk/benefit thinking supports generics".]

Specifically, the survey revealed that 55% of consumers indicated they were more concerned about the safety of the medications they take. Compare that with physicians, seven out of 10 of whom (70 percent) said they were more concerned about the safety of the drugs they prescribe due to recent issues affecting several prescription drugs on the market.

If these results can be believed, pharmaceutical marketers may not benefit from the CHC's approach to communicating risk. The industry, it seems, stands a greater chance of convincing consumers than physicians that the benefits of new drugs outweigh the risks. Or, you can look at it another way, namely that the industry got some work to do to convince physicians of the same.

It's interesting that this is exactly what the industry is setting out to do under Guideline #6 of PhRMA's Guiding Principles for Direct to Consumer Advertisements About Prescription Medicines, which states:

In order to foster responsible communication between patients and health care professionals, companies should spend an appropriate amount of time to educate health professionals about a new medicine or a new therapeutic indication before commencing the first DTC advertising campaign. In determining what constitutes an appropriate time, companies should take into account the relative importance of informing patients of the availability of a new medicine, the complexity of the risk-benefit profile of that new medicine and health care professionals'’ knowledge of the condition being treated. Companies should continue to educate health care professionals as additional valid information about a new medicine is obtained from all reliable sources.

Not only is this good PR, it's a wise tactic considering the survey results mentioned.

The survey revealed a few other contrasts between physicians and consumers regarding drug safety:

• One in three physicians (33 percent) feel that new or recently approved prescription drugs are less safe than drugs that have been on the market for 10 years or more. One in four consumers (29 percent) share that view.
• If costs were equal and provided a choice, 68 percent of physicians would prefer prescribing a drug that has been on the market for 10 years or more; on the other hand, 57 percent of consumers would prefer to take an older-generation drug.

Consumers of drugs, like consumers of automobiles, prefer the newest model! Drug DTC ads, just like car ads, encourage -- some say create -- that preference.

Here's a scary tidbit from this survey: The survey found that physicians trail consumers regarding their knowledge of and confidence in the safety and effectiveness of generic drugs which could have broad implications for the forthcoming boon in savings from the expected drug patent expirations of branded drugs worth over $40 billion in U.S. sales:

• One quarter of the physicians surveyed stated that they do not believe generic medications to be chemically identical to their branded counterparts; more than 8 percent said they were unsure. This despite FDA rules that require generic versions of the drug be bioequivalent to the brand medication
• Nearly one in five physicians believes generic drugs are less safe than brand-name medications, and more than one in four doctors (27 percent) believe generic medications will cause more side effects than brands

The information I have does not include results for consumers on this issue -- I will try and get that info later. But physicians "trail" consumers on this issue means to me that consumers are smarter than many industry pundits give them credit for. According to the CHC, for example, "the patient is the decision-maker only with respect to whether a practitioner should be approached." Hmmmm....