Pros And Cons Of Direct-To-Consumer Advertising

Is Direct-to-Consumer Advertising of Pharmaceutical Drugs Ethical?

In 1985, the U.S. Food and Drug Administration (FDA) passed a ruling to allow direct marketing to consumers as long as the pharmaceutical companies included warnings about possible side effects and other dangers. This change allowed for print-based marketing such as magazines, but in 1997, the FDA lessened the requirement for detailed warnings. Furthermore, the FDA ruled that TV ads containing only the main dangers of the drug were permissible, and this resulted in an inundation of the direct-to-consumer advertising on television. “One study showed that for each dollar of direct-to-consumer advertising on TV by the pharmaceutical company during 1999-2000 resulted in a return of $4.20 for each dollar spent. By 2005, the pharmaceutical industry spent over one billion on TV ads” (DeGeorge 319). Based on these facts, the advertising is paying off for these large pharmaceutical companies.

There is a debate on whether direct-to-consumer advertising of pharmaceutical drugs is moral. These drug companies believe they are providing consumer awareness for patients potentially suffering illnesses, while critics argue that patients demand particular drugs from their doctor while there might be

other treatment options. Pharmaceutical companies promote their products directly to consumers by means of television, newspaper, magazine, radio, and digital promotion such as website and social media ads. Is the direct-to-consumer advertising of pharmaceutical drugs ethical? Does the advertising lead to self-diagnosis or take advantage of someone’s hope for a cure? Using a deontological approach, “one’s duty is to do what is morally right and to avoid what is morally wrong, regardless of the consequences of so doing. Actions are morally right or wrong independent of their consequences” (DeGeorge 62).

Applying Immanuel Kant’s categorical imperative, we cannot “subsume the action under a generally acknowledged substantive duty” (DeGeorge 70).

While pharmaceutical companies may use creative marketing to mislead consumers, in most cases the companies are not lying about their products to the general public. This deceptive marketing tactic falls in a gray area. Since there is some doubt, one should look at the three formulations of the Categorical Imperative to determine whether this action is moral. “The Kantian test of conformity to the moral law which an action must pass is a formal one. An action is morally right if it has a certain form; it is morally wrong if it does not have that form” (DeGeorge

63).

According to the first test, the action must be consistently universal which means everyone performs it without any contradiction. Only the United States and New Zealand allow pharmaceutical companies to advertise directly to consumers. Why are other countries not allowing the practice of direct advertising to the consumers? “Consumer drug advertising is banned in most of the world even while violating the limited guidelines for advertising in the United States” (Stange). It is illegal in the rest of the world because they believe it is unethical for patients to demand particular drugs from doctors. The average person does not have the medical knowledge and background to make informed decisions on medical diagnoses and prescription drugs. In order to be ethical the practice should be in accordance with the standards of the medical profession, and most of the world does not believe that it is. In addition, the marketing advertisements offer false promises with misleading ads about expensive drugs that drug companies want to sell to the public. If this practice were universal and allowed all over the world, nobody would trust the information provided by medical providers, information provided by the pharmaceutical companies, and most likely increase prices on these drugs. This practice cannot be applied universally without contradiction since many believe the practice is unethical therefore, it is illegal in most of the world. “If the maxim passes all three tests, it is moral; if it fails any one of the three, it is immoral” (DeGeorge 67).

According to Kant’s belief, to have good will one must perform the duty for the sake of the duty with no other reasons in mind. In this case, drug companies claim they are providing medical information and treatment knowledge to inform the public, but their main reason for advertising is to sell their product and increase profits. “It would be disingenuous to claim that TV ads achieved these returns without exerting any influence on prescribing patterns” (Lo). The second test considers whether the action respects people as ends and not as only means. The drug companies are deceiving the public with advertisements, therefore they use people to sell more medications and increase the company’s profits. Pharmaceutical companies treat people only as a means because their priority is selling the drug not a person’s well-being. “They are denying that as rational beings they deserve the truth, and we are attempting to achieve our own ends at their expense” (DeGeorge 66).

The third aspect considers whether all rational beings, thinking rationally, should accept it regardless of whether they are the agent or the receiver of the action” (DeGeorge 67). While considering a principle or action, we must also consider it from the point of view of the receiver. John Rawls, a deontological philosopher, created a way to apply this Categorical Imperative by using a veil of ignorance to consider whether a practice is fair to all affected parties. “A fair or just solution is one that all would agree to behind a veil of ignorance” (DeGeorge 78). As a stakeholder in a pharmaceutical company, one believes that direct-to-consumer drug advertising is fair and moral because they want to market their products to the public. They want to increase their profits, which occurs by selling the products they market. As for the people on the receiving end, one might discover he or she has an illness from an ad informing the public about the condition. One may even discover a medication to possibly address the medical condition, but many on the receiving end suffer from misdiagnosing their own condition, demanding a specific prescription from their doctor when cheaper or alternative options may be available, or suffer serious or life threatening effects from a particular drug. The public do not have the medical knowledge or training to select drugs for themselves. This practice is unjust because it is not in the best interest of the public despite what the large drug companies want you to believe. Health care providers inform their patients, give the information to patients so they can do their own research or get a second opinion, and make a decision in part with the healthcare provider.

“Proponents argue that it is a valuable source of information for patients, empowering them to discuss options with their physicians and reducing the need for expensive hospital stays” (Lo). Using Rawl’s first principle of justice, “each person is to have equal right to the most extensive basic liberty compatible with similar liberty for others” (DeGeorge 78). Therefore, drug companies might argue that that it is their right of free speech to deliver this information directly to the consumers so they can make informed opinions. Looking at this further with Rawl’s second principle, “social and economic inequalities are to be arranged so that they are both reasonably expected to be to everyone’s advantage and attached to positions open to all” (DeGeorge 78). However, considering the inequalities of the low-income people, they would not have the money to afford these expensive drugs. Since most of the advertised drugs are the more expensive versions, they would not have equal opportunity to afford it. Therefore, this inequality benefits the rich and not the least advantaged group of people, which is a result of the direct-to-consumer advertising. This makes the practice unethical based on Rawl’s second theory of justice because it provides large profits to the drug companies but it does not benefit the lives of the poor.

I feel that the United States and New Zealand allow this practice because the drug companies spent money to lobby for this practice. In the U.S. President Reagan’s terms, he deregulated many policies at the request of the party lines.

In conclusion, profit is the number one concern for these drug companies. They will also spend money to market their expensive drugs that they want consumers to purchase. If direct-to-consumer advertising was illegal, the money saved on advertising costs might down the costs and lower the price on drugs. This current practice uses patients as a means to reach the company’s end, which is profit. Therefore, this practice is unethical. Drug companies omit some of the side effects, provide samples to doctors to encourage the use of the product as well as overstating promises on the marketing campaigns. While patients need a prescription from their doctor, the public should not self-diagnose medical problems because it may create an issue as the doctor missing the symptoms for another illness. Medical professions received many years of schooling, and they should be the one to diagnose and present solutions that may include generic drugs or alternative non-drug solutions. “The American Medical Association as recently as November 17, 2015 called for a ban on advertising prescription drugs and medical devices directly to consumers, saying the ads drive patients to demand expensive treatments over less costly ones that are also effective” (Kelly). In closing, direct-to-consumer advertising of pharmaceutical drugs is unethical. The practice leads to self-diagnosing, but it does not take away a person’s hope for a cure. The information should be delivered by your physician, and not provided by an Internet ad on Yahoo’s website or a commercial during your favorite TV show.