To the Editor: Mr Holmer1 makes a case in support of direct-to-consumer (DTC) advertising that puts critics on the defensive. After all, who can be against free speech and educating and empowering patients?
Holmer plays down the inflationary effect of DTC advertising, with which the costliest drugs are pitched with all the skill that the advertising budgets of pharmaceutical companies can buy. There is no corresponding lobby for less expensive drugs with lower profit potential. Instead, spin doctors take over from medical doctors and profitability supersedes the presentation of balanced information.
Holmer neglects the role of managed care. Because benefit managers are able to negotiate for lower drug prices, pharmaceutical manufacturers seek to offset managed care "losses." What could be simpler than doing an end run around the cost-containment efforts of health managers and physicians by going directly to patients to create demand that will be difficult to refuse?
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