Consumers Still Waiting for Promised DTC "Education"

Pharmaceutical companies began to seek approval for direct to consumer advertising in the early 1980s. They argued that DTC ads would give consumers information they would not otherwise receive, making them more educated, responsible decision-makers in their use of medications.

"Where's the Beef?"
After 20 years, however, the educational benefit of DTC advertising is still more potential than reality, according to a study published in the March/April issue of Health Affairs. The researchers concluded that the effectiveness of DTC promotions in educating the public about medical conditions and their treatments hinges on the quality of drug information available through advertising, but that the educational quality of DTC ads is highly variable.

The study found that DTC ads do a poor job in a number of areas:

• steering consumers to other sources of valuable information
• identifying causes or risk factors
• providing "how to use" information
• offering treatment details
• clarifying condition-related myths or misconceptions
• presenting information in language people can understand

Quality Is the Issue
Lacking balanced, practical and understandable information, consumers will continue to experience confusion and make inaccurate treatment decisions and unwise demands on their physicians.

On the other hand, high-quality information in DTC ads can assist consumers in becoming better informed about the need to seek treatment for their medical conditions and more aware that new treatments are available. They also may learn that physicians need to decide if a medication is "right for them." Consumers should be told in plain language that no medicine is ever "100 percent safe and effective" and that physicians must make a decision to prescribe a medicine based on the patient's overall medical history.

Room for Improvement
The researchers suggest specific areas pharmaceutical companies can address to improve the value of DTC ads:

• provide straightforward, detailed explanations of the benefits and risks
• write Patient Package Inserts at a level readers can understand
• devote as much attention to side effects as to treatment effects
• avoid technical charts and graphs as well as complex medical terminology
• create ads that focus less on the product and more on the medical condition.

With so much DTC experience under their belt, it is unfortunate that advertisers need to be reminded of those fundamentals of effective patient education. The problem is that too much DTC advertising is created by people untrained in developing credible, understandable messages.

Patient Education 101
There are three ways to provide a discussion of side effects to a consumer. First, the ad can minimize the side effects. The company then runs the risk that a consumer will experience an unexpected side effect and lose faith in the medication and the company. It could also lead to regulatory consequences.

Second, side effects can be drawn straight from the product monograph and presented in stark medical detail. That may pass regulatory muster, but will likely frighten and confuse consumers so much that some will want nothing to do with the product.

Third, side effects can be skillfully presented in a manner the consumer can understand. Ideally, the information will suggest practical ways to identify and manage side effects so consumers don't stop taking the medicine.

It's All in the Translation
The authors also believe that the industry should "enter into more proprietary partnerships with health communication researchers to develop a better understanding of how people process DTC advertising information and to devise strategies to communicate more effectively with consumers."

Once those partnerships are established, consumers will be better served. The credibility of the company and its products will be enhanced. Not to mention that companies are less likely to face new regulations governing DTC advertisements.

In short, pharmaceutical DTC advertising must meet an entirely different set of consumer needs than ads for cars or blue jeans. After all, at stake are peoples' health and quality of life.

Dr. Dorothy L. Smith is a consumer education expert and president of Consumer Health Information Corporation. The full-service company specializes in patient labeling, program development, and strategic planning for DTC campaigns.

Do you have a DTC question? E-mail it to dlsmith@consumer-health.com or call (703)734-0650.

Published in Pharmaceutical Executive, May 2000. Copyrighted material; All rights reserved.