Bypassing the Gatekeepers: Selling Prescription Drugs Directly to Consumers

Abstract

Prior to 1989 there were virtually no prescription drug advertisements aimed at consumers, and their absence was largely a result of the medical profession's opposition to this marketing. However, only seven years later the use of the ads had mushroomed, and the drug manufacturers were spending more than $790 millions on this marketing vehicle, despite continued physician opposition to the ads. Why did doctors lose their power over the use of these ads? Addressing this key question will be the main focus of this paper, and towards that end I reconstructed the history leading up to this marketing revolution, relying on various types of documents, including Congressional records, secondary literature, as well as interviews with key informants in the medical profession and advertising industry. My finding was that the physicians' loss of power was due to two factors, with one being the circumscription of their prescribing power, which arose as a result of the Managed Care revolution. In addition, by studying the physicians' opposition to the ads, drug manufacturers were able to use the ads in ways that minimized the risk of arousing physicians, thereby effectively managing the physicians' opposition.