Pitts on DTC and Older Americans

Peter Pitts, senior vice president of global health affairs at Manning Selvage & Lee (a PR firm with many pharmaceutical clients), former FDA Associate Commissioner for External Relations, and fellow blogger (see DrugWonks), is an unabashed defender of the pharmaceutical industry and opponent of drug re-importation. At the recent CBI Forum on Customer Relationship Management (CRM) for the Bio/Pharmaceutical Industry in Princeton, New Jersey, Pitts was preaching to the choir and defending DTC advertising.

Lack of DTC Breeds Mistrust?
Pitts started his presentation by referring to polls purporting to show that "older Americans" are "more distrustful of the pharmaceutical industry than the general population." [The only poll I came across was a 2000 Kaiser Family Foundation survey that found: The elderly were less likely than the non-elderly to trust [drug] advertisements (35% vs. 51%).] Why is this? Pitts asked.

Pitts dismissed factors such as:

• "familiarity breeds contempt" (i.e., seniors take more medications than younger people). Older Americans are more likely than their younger counterparts to regularly use prescription drugs. According the Kaiser Family Foundation survey: Americans over age 65 are much more likely than adults under age 65 to say that they are regular prescription drugs users (82% vs. 49%); that they take three or more prescription drugs regularly (55% vs. 17%); that they currently have more than five drugs in their medicine cabinet (40% vs. 28%); and that they spent $1000 or more out-of-pocket on prescription drugs last year (19% vs. 6%).
• the AARP's "Jihad" (his term) against Big Pharma (funny, I thought AARP did Big Pharma a Big Phavor by supporting the Medicare Modernization Act, Part D), and
• price/value debate (another presenter suggested that all seniors, like his aunt who flew first-class to a family reunion, had enough money not to quibble about a few bucks here and there). According the Kaiser Family Foundation survey mentioned above: Among the elderly 16% say they have not filled a prescription because of the cost, about 1 in 5 (21%) say they have had to give up things to buy prescription drugs, and 9% say they have had to give up basic necessities like cutting down on food to pay for their medicines. And, 23% of the elderly say that paying for prescription medicines they need for themselves or their families is a "serious problem."

No, the main reason, Pitts claimed, was that older Americans grew up in the age before DTC. His implication being that DTC empowers consumers with information and that this information helps them understand better the risks as well as the benefits of drugs. Older Americans, not having the benefit of DTC in their formative years, are just too dependent on their "learned intermediaries" (i.e., doctors) and don't know enough to trust pharma and challenge their docs if necessary.

The argument is: Lack of DTC leads consumers to distrust "the miracles that are modern medicines" (Pitts repeated this phrase several times).

Of course, this is not a scientific or even logical argument. I could argue just as convincingly that DTC ads cause younger Americans to trust Big Pharma more (and their doctors less) than older, wiser Americans do. Besides, most DTC ads I've seen on TV and in print are definitely aimed at older Americans. After all these years of being exposed to DTC targeted to them why haven't older Americans become more trustful?

[I would note that PhRMA's Guiding Principles for DTC clearly places more emphasis and trust in the doctor as a valued learned intermediary than does Pitts. See "PhRMA Finalizes DTC Principles."]

Pitts had a lot more to say about DTC that I plan to summarize in a future issue of Pharma Marketing News.