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1/17/2003

FDA Survey Gauges Physicians' Opinions on DTC Ads

Kate Traynor

Preliminary results from a Food and Drug Administration (FDA) survey indicate that physicians see both benefits and problems arising from patients' exposure to direct-to-consumer (DTC) advertisements.

In all, 92 percent of the 500 physicians surveyed said that a patient had initiated a discussion about a prescription drug after exposure to DTC advertising. Fifty-nine percent of these physicians said they believed that the patient's exposure to the ad had benefited the physician–patient relationship in some way.

More than half of the physicians agreed at least somewhat that exposure to the DTC ad had caused the patient to ask better questions during the health care visit. About the same proportion of physicians were at least somewhat convinced that exposure to a DTC ad had promoted a better discussion about the patient's heath.

Fifty-eight percent of the physicians said that a DTC ad was at least somewhat responsible for making the patient more involved in health care, and 54 percent said that the ad had increased the patient's concern about health overall. Nearly three fourths of the physicians agreed at least somewhat that the DTC ad made the patient more aware of possible treatments.

The most common problem that physicians noted about DTC advertisements is their tendency to make patients think the products are more effective than they really are. Forty-three percent of physicians said that the ads exaggerate a drug's benefits at least somewhat, and 32 percent agreed strongly that the ads overstate the benefits of the therapy. Sixty-five percent of physicians agreed at least somewhat that DTC ads confuse patients about the relative risks and benefits of the advertised products.

Half of the survey respondents said that DTC ads do not increase patients' awareness of adverse events associated with the advertised products.

Fifty-seven percent of physicians considered DTC ads at least somewhat responsible for causing patients to seek unnecessary prescriptions. The same proportion of physicians expressed this level of concern that DTC ads cause patients to expect a prescription for every condition from which they suffer.

This survey is the third in a series conducted by FDA to determine the effects of DTC on public health. Survey participants were randomly selected from the American Medical Association's master file of physicians and received a letter asking if they would like to participate in the survey. The survey was conducted by telephone. Half of the participating physicians were general practitioners, and half specialized in dermatology, allergy, pulmonology, endocrinology, or psychiatry.

In general, the survey results indicated that patients often ask their physician questions about prescription drugs, including questions about how much the drugs cost. Most physicians reported that drug-related questions from patients have increased over the past five years.

According to FDA's report, 86 percent of physicians said that a patient had initiated questions about a particular drug product. Of these patients, 88 percent had the condition for which the drug was indicated.

Fifty-nine percent of the survey respondents whose patient had seen and responded to a DTC ad said that the patient had asked to be prescribed a particular brand-name drug product. In 57 percent of these cases, the physician complied with the patient's request. More than half of the time, physicians who did not prescribe the product said that a different one was more appropriate for the patient, the requested drug was not right for the patient, or the drug could cause adverse events not considered by the patient.

Overall, 47 percent of physicians who were asked by a patient to prescribe a drug, whether by brand name or not, reported feeling at least a little pressure to comply with the request. Of those physicians who wrote the prescription, about 9 percent reported feeling very pressured to do so.

According to FDA, the survey findings support the agency's current understanding that DTC advertising can make patients more aware of the availability of effective treatments. The agency noted that its policies must be geared toward ensuring that DTC ads do not cause misperceptions by the public about the benefits and risk of advertised products.