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To the Editor: While we concur with Dr Berwick's recommendations for disseminating innovations in health care,¹ we note that they focus exclusively on dissemination through health care workers. As demonstrated by pharmaceutical advertising during the past decade, however, the consumer is also an influential, complementary driving force for disseminating innovations in health care. Direct-to-consumer (DTC) pharmaceutical advertising expenditures are estimated at $2.5 billion per year, a number that tripled between 1996 and 2000.² Recent surveys attest to the remarkable results: 92% of the population have seen these advertisements, 21% have asked their physician for a prescription drug as a result, and among these, 58% have been given a prescription for a medication they asked about.³

Notwithstanding the ongoing debate about the health benefit of DTC pharmaceutical advertisements, there are many lessons to be learned from their example about how innovations can be disseminated in health care. Is it possible that . . . [Full Text of this Article]

JoAnne E. Epping-Jordan, PhD
Health Care for Chronic Conditions
World Health Organization
Geneva, Switzerland

Evette J. Ludman, PhD
Center for Health Studies
Group Health Cooperative
Seattle, Wash

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