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  Vol. 164 No. 4, February 23, 2004 TABLE OF CONTENTS
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Direct-to-Consumer Pharmaceutical Advertising

Physician and Public Opinion and Potential Effects on the Physician-Patient Relationship

Andrew R. Robinson, MD; Kirsten B. Hohmann, MD; Julie I. Rifkin, MD; Daniel Topp, MA; Christine M. Gilroy, MD; Jeffrey A. Pickard, MD; Robert J. Anderson, MD

Arch Intern Med. 2004;164:427-432.

Background  Previous studies have shown that direct-to-consumer (DTC) pharmaceutical advertising can influence consumer behavior and that many physicians have negative views of these advertisements. Physician and public opinions about these advertisements and how they may affect the physician-patient relationship are not well established.

Methods  Mail survey of 523 Colorado physicians and 261 national physicians and telephone survey of 500 Colorado households asking respondents to rate their agreement with statements about DTC advertising.

Results  Most physicians tended to view DTC advertisements negatively, indicating that such advertisements rarely provide enough information on cost (98.7%), alternative treatment options (94.9%), or adverse effects (54.8%). Most also believed that DTC advertisements affected interactions with patients by lengthening clinical encounters (55.9%), leading to patient requests for specific medications (80.7%), and changing patient expectations of physicians' prescribing practices (67.0%). Only 29.0% of public respondents agreed that DTC advertising is a positive trend in health care and 28.6% indicated that advertisements make them better informed about medical problems; fewer indicated that advertisements motivated them to seek care (10.5%) or led them to request specific medications from their physicians (13.3%).

Conclusions  Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.


From the Division of General Internal Medicine, University of Colorado Health Sciences Center and HealthONE Presbyterian/St Luke's Hospital, Denver. The authors have no relevant financial interest in this article.



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