US MDs divided over direct-to-consumer advertising: survey
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* Laura Aiken

Physicians are split in their attitudes toward direct-to-consumer advertising (DTCA), a survey by the US Food and Drug Administration (FDA) indicates.

When asked about DTCA's overall impact on their patients and practices, 32% of physicians said it has had a negative effect, while 40% said the impact has been positive; 28% said it had no effect.

In the survey of 500 physicians — half FPs and half specialists — 62% said DTCA had caused some tension between them and their patients, while 25% said it had caused patients to second-guess or question their diagnoses.

The most common reason for supporting the advertisements was that they promoted discussion. The major reason for dissent was the amount of time doctors had to spend correcting misconceptions created by the ads, which are now ubiquitous in the US.

Eighty-six percent of respondents said patients have asked them for drugs by brand name; in 88% of cases, patients did have the condition the drug was used to treat, but most had little or no understanding of side effects or limitations.

Jacques Lefebvre, spokesperson for Rx&D, the lobby group representing brand-name drug manufacturers in Canada, said the organization would not comment on the FDA survey because it had no bearing on Canada.

Health Canada regulations permit pharmaceutical companies to advertise prescription drugs as long as their purpose isn't mentioned (*CMAJ* 2002; 167 [10]:1153). This explains why a Canadian TV commercial shows a man dancing happily through sunny streets. The only clue about the ad's sponsor is the word Viagra, which appears at the end. But given the drug's popularity, most viewers will understand why the man is so happy.

The FDA relaxed its rules governing the broadcast of DTC drug ads in 1997, and the amount of money being spent has skyrocketed, as have drug company profits. Survey results are available at [www.fda.gov/cder/ddmac/globalsummit2003/sld001.htm](http://www.fda.gov/cder/ddmac/globalsummit2003/sld001.htm). — *Laura Aiken*, CMAJ