by Tammy Tillotson

“I dare you to call your doctor.”

Quoted from a Commercial for Diflucan viewed on PAX Channel 47

In 1997 FDA rules cleared the way for pharmaceutical companies to begin what has become a vehement advertising campaign for prescription drugs. Direct-To-Consumer ads are obviously working considering the fact that pharmaceutical companies are investing billions in ads that reach consumers via their televisions and nearly every other form of mass media.

Truth or Dare
The issue of Direct-To-Consumer advertising has been received with much controversy, as this new marketing strategy currently lacks enough information to elaborate its specific effects on consumers. Considering today’s age of information, the primary argument for the positive effects of these ads is that they promote public health through actively involving patients in making informed decisions about their health.

It may be too early to tell what negative effects these ads have on the public, though it is nice to know that grants are currently being distributed to intellectual medical experts so the American public can once again be guinea pigs for research. If pharmaceutical companies are already going to such great lengths to ensure that consumers remember the names of specific drugs, it seems to reason that knowing how these ads effect humans might be a nice topic to understand. Those answers would only make it easier to convince more people to rush right out and ask their doctors about those fabulous little pills that will work miracles within the human body.

As a consumer who chooses to play an active role in personal health care, I have viewed the advertisements as little more than a nuisance until recently. A Diflucan commercial particularly disturbed me, in which the actress directly dares the consumer to pick up the phone and call the doctor and ask about the pill. Do pharmaceutical companies need the money so badly that they are resorting to “daring” consumers to behave in a particular fashion?

Not only am I offended by this form of extortion, it degrades any sense of intellectualism the public possesses. I’m not quite sure I understand why it is legal for pharmaceutical companies to dare people to try their drugs, yet it is simultaneously illegal for people to try specific other drugs. If I take the wonder pill from the television I will feel better, yet if I am caught with these other drugs I go to jail. If I remember correctly the D.A.R.E. program I attended in grade school encouraged people to avoid peer pressure and DARE to say NO to drugs. This inadvertent commercialized peer pressure overwhelmingly confuses me, and I am obviously missing something.

In my search for drug advertising enlightenment, I extend the invitation of truth – void of peer pressure and I will not dare you to read any further.

Coughing It Up
A survey by the Menlo Park-based Kaiser Family Foundation released statistics on November 29, 2001, which cited pharmaceutical advertising expenditures at nearly $2.5 billion in the past year. The Foundation reported that one in three adults has asked their doctor about a drug they saw advertised, and they estimated that one in eight Americans receives a prescription as a result of seeing an ad.

National expenditures for prescription drug coverage for 2000 were reported as up almost 300 percent since 1990 at nearly $116.9 billion. Connect that with the fact that a record number of prescriptions are being written in the United States – almost 3 billion annually – and it would certainly seem logical that the increase in advertising spending could account for at least part of the increase in prescriptions and drug sales. Pharmaceutical companies are in the business to make money, and it seems ridiculous that they would spend billions of dollars on an unprofitable advertising strategy.

Advertising Another Migraine
In order to understand the latent strategies of Direct-To-Consumer drug advertisements, it is important to be aware of another view of advertising. Through understanding different perspectives, consumers can decipher how the advertisement’s agenda presents favorable conditions for it to achieve its purpose.

All advertising has an agenda.

It is not necessarily intended to be beneficial for the people that the message reaches. Advertisements help to incite and increase demand, and in regards to drug advertisements, this is apparently working. For this reason it is becoming increasingly important for consumers to be aware.

Hard to Swallow
According to Michael J. Phillips manipulative advertising “tries to favorably alter consumers’ perceptions of the advertised product by appeals to factors other than the product’s physical attributes and functional performances” (B&B 486). By accepting this definition, one must first accept that advertising is a mixture of strategies implored to alter consumer perceptions.

It is also necessary to accept that the pharmaceutical companies are trying to alter consumer perceptions on the existence of a “need” for people to seek medical attention or further information from a physician. Since these types of advertisements have only recently surfaced, it should be noted that there has previously not been a need for consumers to conveniently participate in self-diagnose during their favorite primetime program.

Advertising’s primary objective is to promote something in a way that makes it beneficial to the person it’s being promoted to, as well as beneficial to anyone else who has an invested interest in the product. In fact, one could argue that it’s impossible for a consumer to act autonomously as our society is so overwhelmed by coercion, that buying decisions are made without our being aware of the influences we have become so accustomed to.

Direct-To-Consumer drug advertisements rely heavily on a manipulation strategy, as the physical attributes of a little pill are pretty insignificant, yet the functional performances of the pill are another important factor to consider. Drug advertisements make emotional appeals to consumers, and encourage them to believe that medical conditions could be responsible for a list of certain symptoms. The information provided in these commercials is at best vague, and the commercials present the sentiment that the medical condition should urgently be addressed by a physician, which is in essence relying on fear extortion.

Is it not possible that individuals are seeking medical attention in response to these commercials because for the first time the issue of fear has been presented to them from their own television? Would it stand to reason that this is what the pharmaceutical companies are relying on to happen? The doctors make more money because there are more patients making office visits because they think they need medicines, even if they don’t. In return for the pharmaceutical companies sending in more patients, the doctors prescribe more of the advertised drugs when they can determine the drug beneficial in some way, even if another less expensive drug might yield similar results for a patient. The patient already has knowledge of the advertised drug and believes it will help them, so little persuasion can yield a prescription because if something is on television it must be beneficial to public health. Seems like a win-win situation for everyone. Everyone, that is, with an invested financial interest.

Easy to Swallow
The drug companies claim that there is no evidence between increased sales and prescriptions and the increase in advertising. The companies account for the increases due to improved and more effective medications.

Perhaps they are the ones with the altered perceptions if they expect educated consumers to believe that is the truth.

Before hurrying to the phone to dial a doctor, stop to think about the true messages of drug advertisements. Direct-To-Consumer drug advertisements have made health a non-market good by coercing consumers into fearing their own body or mortality, simply to sell drugs.

A drug is a drug. It is illegal to phone a dealer, yet legal to phone a doctor. People have to be able to trust their dealers or they could face going to jail. People have never had reason not to trust the doctor, so what does that mean society will face now? Which kind of drug trafficking should people really be more concerned about?

The telephone is resting comfortably in its cradle, and it will stay there. This is one consumer that is not about to be “dared” into trying a drug, especially just because the television commercial suggests it.

Additional Points of Interest

Kaiser Family Foundation Survey Report

Direct-To-Consumer Advertising article by Pharmaceutical Research and Manufacturers of America

Dartmouth Medical School article on Direct-To-Consumer advertising

The “Joe Camel” ads of AIDS by Daryl Lindsey

The Christian Science Monitor article on Direct-To-Consumer advertising by Alexandra Marks

Beauchamp, Tom & Bowie, Norman. Ethical Theory and Business 6th Edition. Prentice-Hall, Inc. 2001.