Thursday, June 28, 2007

Medical Advertising

Am back in the US and am generally apalled at the rash of pharmaceutical advertising that seems to be everywhere. It is well known to marketing professionals that pharmaceutical sales are essentially a "promotion response", i.e. there is a very strong correlation between promotional expenditure by a pharmaceutical company and the sales of the pill being promoted. The corollary is that non-promoted drugs will have very limited uptake. In addition to bribing doctors and skewing a drugs efficacy profile [most drugs provide some immediate symptomatic relief and these beneficial effects are promoted while the nasty longer term side-effects generally receive passing mention and are brushed aside] pharma companies now have medical advertising to be even more manipulative. It is clear that pharma is no different from big tobacco in its strategic approach.

Unfortunately, what's most worrying is that US consumer trends tend to get replicated all over. Well, it's the same ol' gang.

The following article provides food for thought:

Most forms of advertising, to some degree, rely on "information asymmetry," the idea that the party doing the marketing knows more about the product and how to sell it than the consumer. Information asymmetries result in higher profits for advertisers. It is, thus, in their interest to increase the divide: for them to know more, and the consumer, less. When the product is chewing gum, the imbalance is usually no big deal. But when you’re talking about something as crucial as health care–where the opportunities for information asymmetries happen to be much greater–all sorts of problems crop up.

Pharmaceutical companies argue that direct-to-consumer drug advertising "empowers" the patient to learn more about medical options. This is pretty much a joke, for these drug ads are as uninformative and image-oriented as Calvin Klein ads (although much less sexy). They’re also not geared toward educating people about medical options, which would include drug-free or otherwise unprofitable practices.

What’s more, drug companies know that high information asymmetry in health care has been well-documented since the 1960s. Drug companies also know that patients–although ignorant of professional medical standards–routinely overestimate their ability to make medical judgments. The line about advertising "empowering" thus becomes a cruel irony, encouraging patients to rely even more on their own misjudgments.

The field of optometry, which was deregulated in the 1980s, serves as a prime example. Optometry research has shown a great divide between what patients know versus what they think they know about the medical quality of eye exams. Studies have shown that many consumers (patients) believe they’ve had a medically thorough exam after simply looking at eye charts. Putting patients in rooms with "high-tech"-looking equipment also contributed to patients’ belief that they’re being properly examined.

Irrespective of the technology used, the minimum standard accepted by optometry professors and practitioners dictates that no examination can last less than twenty minutes and be medically adequate. (Short exam-based prescriptions will often improve sight in the short term but decrease visual acuity in the long run.) Yet beyond a certain amount of time, patients may erroneously infer that the service provider is incompetent. One chain firm manager explained during FTC hearings that an optometrist "could only spend ten minutes on each patient because otherwise they might think he wasn’t very good."

Similarly misguided ideas about what constitutes quality care have been found among patients with a variety of health problems. If direct-to-consumer advertising empowers anyone, it’s drug companies. Even the argument that ads encourage people to talk to their doctors is a wash. How many doctors really take the time to talk? And once patients get fixated on trying a certain medicine, chances are they’ll either pressure the doctor for a prescription or find another doctor. Medical advertising encourages such actions by hitting people when they’re ill and most vulnerable to the lure of a quick fix.

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