In addition, studies have shown that DTCA increases the frequency of physicians prescribing drugs that have been advertised (J Gen Intern Med. 2021;36:1390–1394; CMAJ. 2003;169:405–412). “DTCA is created to persuade,” Dr. Applequist said. “Patients sometimes prioritize their own suggestions for care on 60 to 90 seconds of advertising creativity over many years of professional medical training. Physicians may feel pressured to prescribe a certain drug, especially when patients create a dynamic in which they undermine a provider’s role in making healthcare decisions.”
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December 2022Another downside, Dr. Rathi added, is that patients may lose confidence in physicians when they suggest therapeutic alternatives to drugs seen on TV. “Patients may lose confidence in these alternatives, even when there is strong evidence supporting their safety and effectiveness and even if they are more cost-effective,” he said. “This could result in physicians feeling pressured to prescribe drugs that they don’t consider appropriate or are less comfortable managing.”
Problems can also occur when a physician doesn’t fully understand a new drug’s nuances. “In general, physicians prescribe drugs that they have a long history with and know how to manage,” said Marc G. Dubin, MD, president and CEO of The Centers for Advanced ENT Care, LLC, in Baltimore. “Many of the newer drugs don’t have as long of a follow-up because the post-marketing analysis hasn’t been completed.”
Handling Expectations
When a patient is interested in an advertised medication, Dr. Luong recommended asking them what they know or understand about it. “This helps patients to feel that they are being heard, while also helping me to determine how to respond,” she said.
Dr. Rathi noted that it’s important to understand what goals patients have for their health. “Marketing may help patients formulate or shape these goals, but it’s the physician’s responsibility to help them fill in any knowledge gaps about how advertised drugs may or may not help them achieve those goals,” he said. “Patients often appreciate learning about potential benefits with greater nuance or being alerted to important potential risks.”
DTCA can result in patients wanting the “latest and greatest treatment,” said Dr. Dubin. Physicians can use this opportunity to begin a beneficial dialogue. “Providers should educate patients on why they did or didn’t prescribe a drug initially or why it may or may not be the right treatment for them,” he said. “When a physician takes the time to do this and educates patients about the benefits of an alternative medication, it builds trust between them.