Two things that I have noticed about direct-to-consumer (DTC) television advertisements lately is that 1) they seem to be fewer in number, and 2) they aren’t very useful. Fair balance, which is neither fair (to the industry) nor balanced, has essentially ruined the DTC prescription drug commercial, with the litany of dangerous side effects enough to scare off almost any prospective patient. However, the pharmaceutical industry should think very carefully before pulling the plug on DTC. With the future of healthcare moving toward accountable care organizations (which are likely to be pharma restrictive) and data from the Sunshine Act soon publicly available, access to physicians will shortly become more difficult than ever. Though some physicians may not agree with me, I actually like DTC because it initiates a conversation that, in some cases, may not have ever happened. However, a much better approach will be needed in today’s DTC. As a physician, here are three things that I would like to see from DTC campaigns in the near future.

1. Go unbranded. I have been told that the industry generally does not like unbranded DTC, especially television ads, because they feel they get little ROI. However, unbranded ads are the only way to eliminate distracting fair balance and the only way to truly make patients aware of an unmet need. Diabetes is an excellent example. Far too many type 2 diabetics are on sulfonylureas, not recognizing that hypoglycemia is a serious risk, and that newer diabetes medications may eliminate their need to check their finger stick glucoses (which are heavily advertised on TV). I am sure that Eli Lilly, Merck and AZ-BMS, who all make competing diabetes pills, would worry that an unbranded DTC campaign would likely sell their competitor’s product and therefore not be worth the expense. However, just as a rising tide lifts all boats, expanding the market helps everyone.

2. Go back to the FDA. This all started when the first Claritin commercials didn’t even state an indication. The FDA’s dilemma was how to include fair balance in a 30-second ad. However, we are now at a point where current fair balance policies have made almost all drug ads useless for patients. It should be the physician’s job to warn a patient about side effects and drug interactions, not a TV commercial. The industry, with the help of consumer groups, should work with the FDA for a more “balanced” fair balance approach to TV commercials.

3. Go online. In addition to the growth of social media, it is becoming more common to watch television online. The pharmaceutical industry appears to be unwilling to go beyond banner ads that link to their product’s website. One advantage of online advertisement is its ability to link to other material. Just as an entire PI can be placed on the back of a magazine advertisement; an online ad, video or tweet can link to fair balance content. In addition, an online unbranded campaign can more easily link to branded material than the unbranded TV commercial that the industry seems so reluctant to make.

  • Matthew Mintz, M.D.

    Matthew Mintz, MD, FACP, is Associate Professor of Medicine and Director, Premier Access and Executive Services at The George Washington University School of Medicine in Washington, DC. Visit his blog at


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