The Ethical Aspects of Direct-to-Consumer Advertising of Prescription Drugs in the United Kingdom: Physician versus Consumer Views

Jon Reast
Hull University Business School, UK

Dayananda Palihawadana and Haseeb Shabbir
Leeds University Business School, UK


Direct-to-consumer advertising (DTCA) of prescription drugs, first established in the large U.S prescription drugs market in the early 1980s (Hoek and Gendall, 2002), has yet to be embraced around the world, where the “promotion” of prescription drugs tends to be outlawed. The advent of DTCA in the United States has engendered much ethical debate (Hensley and Vranica, 2004; Joseph and Spake, 2006; Lee, Salmon, and Paek, 2007), and the rise of vast advertising budgets applied to “power brands,” with pharmaceutical brand owners accounting for an expenditure of $9.4 billion between 1996 and 2001 (IMS Health, 2002). However, DTCA, worth some $4.1 billion in annual advertising revenue within the beleaguered U.S. media market (Thomaselli, 2006), has recently run into problems within this core market, facing calls for severe regulatory restrictions following the recent withdrawals (Edwards, 2005), due to safety concerns, of high profile and well-supported DTCA “star brands” Vioxx (Merck) and Bextra (Pfizer). Amid concerns about aggressive DTCA strategies and loss of corporate reputation (Wielondek, 2005), some manufacturers have vowed to reduce above-the-line expenditures (Arnold, 2005). Bristol Myers Squibb has unilaterally decided to introduce a temporary moratorium on the advertising of new prescription drugs, Johnson & Johnson has announced intentions of including more risk information within its advertisements (Thomaselli, 2005), and new FDA powers to pre-vet DTCA copy prior to airing (Teinowitz, 2007) are being debated. Despite the regulatory environment getting tighter and the practice coming under sustained attack in the United States, consumer support for DTCA appears to remain strong (Dolliver, 2005; Kucharsky, 2005), with 7 out of 10 U.S. citizens upholding the right of manufacturers to advertise directly to consumers.