DTC in Perspective: The Stuart Elliott Flip on DTC
Who is Stuart Elliott and why should we care what he thinks? Let me back up a bit. Stuart Elliott was the advertising reporter for the New York Times for over 20 years. He left in 2014 to write for Media Village.com. In a column written on 12/9 Mr. Elliott said he no longer supports DTC. The piece is titled “ Madison Avenue Has Overdosed on Prescription Drug Ads.”
Mr. Elliott says he was a long time supporter of DTC ads. He now thinks they should be reconsidered. He cites the American Medical Association( AMA) call for a ban as a major reason. He also uses the criticism on high drug prices as a reason to end advertising. He thinks ending DTC may help the image of drug companies.
Whenever a long time DTC supporter changes positions it is significant and concerning. As a veteran advertising reporter Mr. Elliott certainly has the experience to weigh in credibly on DTC. I must, however, take issue with his column. Clearly I have my biases toward DTC, as the CEO of a company doing DTC conferences. That bias being revealed I think the facts support the drug industry in not reconsidering use of DTC.
All advertising for profit making companies is designed to increase sales. The fact that DTC does increase sales is apparently the reason critics want it banned. AMA does not like that patients ask for branded drugs potentially increasing use of higher cost drugs over cheaper alternatives. While DTC may lead to patient initiated discussion, I am not apologetic to doctors that patients want to be involved in drug selection. DTC advertising creates inquiries and discussion but doctors have the ultimate power what is prescribed.
Second, there is no basis to think ending DTC will improve the drug industry image. That position seems to based on the faulty assumption that advertising raises prices and takes money away from R&D. The reported $5 billion in DTC spending is really about 3.5 billion in actual spending because drug companies pay less than the reported estimates. That 3.5 billion is just a bit over 1% of drug revenue, not much of a price decrease if it was all used to provide price support . To think cutting all DTC would reduce consumer prices is just not true. If that DTC spending was banned sales would drop by about 10 billion, if we assume a 2 to 1 ROI on current DTC spending. Why would drug companies cut prices if they are losing revenue?
Consumer advocates and politicians complained about drug company pricing prior to DTC. They complained about patent life being too long before DTC. They complained about inadequate clinical studies before DTC. They complained about drug sales forces before DTC. Drug companies have been characterized negatively for decades, long before DTC. Unless drug companies charge generic prices for their branded drugs and never cause a drug related death, there will be critics.
Mr. Elliott says an outright ban might be phased in and maybe we should consider a two year moratorium on DTC ads for new products. Most companies already wait at least a year before they run ads. I am sure considering an extra year is a subject for reasonable discussion between industry and regulators.
What is interesting in this flip flop position is the failure to mention free speech. Mr. Elliott does not discuss why he feels a lawful product should be denied commercial free speech. His rationale that DTC creates image problems and that the AMA is against it, does not address free speech protection. I ask him where he draws the line? Does he think other industries with image problems should stop advertising? There are many advertised products such as cigarettes, alcohol, video games, birth control, and fast food that have numerous critics.
So, Mr. Elliott, while I understand the AMA reasons for being against DTC, I would hope you would investigate whether ending it would actually lower prices or raise the drug industry image. I think the facts are against either of Mr. Elliott’s anti-DTC argument.