Executive Summary

Direct-to-consumer advertising for Rx drugs will not be cost beneficial "because of the dynamic and dramatic changes occurring in health care," Michigan Pharmacists Assn. Director Louis Sesti maintained at a conference for pharmacy leaders, sponsored by Smith Kline & French. "I do not believe that direct-to-consumer advertising of specific drug products will be cost beneficial to the industry," Sesti said, because "the desired outcome" of patient influence on physician prescribing patterns will be "short circuited" and "have less and less of an opportunity even to exist." The increasing role of institutions and large health care groups will restrict individual physician prerogatives, he explained. "More and more of the prescribing decisions will become more and more a decisionmaking process rather than individual prescriber decisions. The process will include pharmacy and therapeutics cmtes., generic indexes, and formularies for patients in HMOs, PPOs, and third-party programs," Sesti said. Providing the industry perspective of the issue, SK&F Govt. Affairs Director Donald Fletcher contended that fear of a "media gunfight" will prevent mfrs. from promoting specific Rx products to consumers. "Industry has always feared . . . a public 'media gunfight' between directly competitive products," Fletcher said. SK&F "has no plans to market Rx pharmaceuticals directly to the public," he reported, and "my guess is that much of the pharmaceutical industry is close to this position today." However, another SmithKline rep acknowledged at a subsequent conference workshop that a soncumer campaign by a single, aggressive company could prompt responding promotions by competing companies. SmithKline Beckman Govt. & Industry Affairs Director James Russo noted that if Lederle were to promote Maxzide(END ITALICS) directly to consumers, "we would have to follow with our own ads for Dyazide." Two workshops independently recommended establishment of a council to review Rx ads intended for consumers prior to publication or broadcast. One panel recommended establishment of "an interdisciplinary consortium of major professional organizations," including FDA, and consumers "with the responsibility for reviewing and certifying both institutional and promotional Rx direct-to-consumer advertising, both electronic and written." Such a council might be funded along the lines of the Natl. Council on Patient Information & Education and be called the "Council of Ethics in Rx Direct-to-Consumer Advertising," the workshop suggested. American Assn. of Retired Persons Health Analyst Judith Brown suggested that industry resources are better spent on patient education programs than on consumer advertising. If Rx drug ads for consumers become commonplace, Brown said, "the money that should be spent informing patients about the drugs that their doctors have determiend they need would be diverted to informing potential patients an nonpatients alike about the benefits of products that the consumer is in no way able to judge."