Direct to Consumer Advertising (DTC Advertising)

Direct to consumer advertising (DTC advertising) is marketing that is aimed toward consumers when access to a product may require an intermediary. Direct to consumer (or D2C) advertising may utilize print, social media, TV, radio, and other forms of media with the goal of informing a customer about a product or reminding them of a need for such a product. The most common example of DTC advertising involves prescription pharmaceuticals, but may also include medical and diagnostic devices or services, as well as financial products and services. Since consumers may not be able to obtain products featured in DTC advertising on their own, such as with prescription drugs, the objective is to create a dialog between patients and their doctors with the ultimate goal of increasing sales.

The first direct to consumer print ad in the United States appeared in Reader's Digest in 1981. The Food and Drug Administration (FDA), which is responsible for DTC advertising regulation in America, placed a moratorium on such ads in 1983 so it could devise some basic rules. It lifted the moratorium in 1985, as few drugmakers showed interest in running such ads, though television network CBS issued its own guidelines that same year. DTC advertising was approved in New Zealand in 1981, Hong Kong in 1953, and Brazil in 2008. With the prevalence of socialized medicine, Europe has thus far avoided DTC advertising. For more, see this DTC advertising timeline.

There are several types of direct to consumer advertising:

• Product claim ad: Will name a drug and summarize efficacy and risks. The most common type of DTC advertising.
• Reminder ad: Generally include a product name, provide information about price or dose but avoids making claims.
• Help-seeking ad: Includes information about a medical condition and encourages individuals to see a doctor but generally does not name a product.

DTC advertising is also used to promote financial services products, following on the success of the pharmaceutical industry. Such advertising strategies may be an effective way to reach middle market consumers that tend to be underserved by traditional distribution channels. Such advertising, when coupled with the advice of a fiduciary, may be advantageous to savings rates, retirement preparation and other financial planning.

Direct to consumer advertising use accelerated in the U.S. after 1997 when the FDA suggested to drug manufacturers how they could comply with the regulations that were in place while also providing an exemption for certain types of ads from fully providing a list of side effects as long as such information is available elsewhere. Over the next two decades DTC advertising saw significant growth and additional clarification of legal guidelines and best practices. In 2005, the Pharmaceutical Research and Manufacturers of America issued its Guiding Principles on Direct to Consumer Advertisements About Prescription Medicines. The document was intended to act as a means of self-regulation. Direct to consumer advertising is the most prominent type of health communication to consumers.

Proponents of DTC advertising claim that it raises awareness of ailments and treatments, which leads to more doctor visits, better engagement, and better and earlier diagnoses of diseases. It may also lead to better adherence to courses of treatment and therefore better outcomes. Such advertising may also enlarge the market for pharmaceuticals, which leads to greater competition, more drug development and lower prices.

However, there are considerable concerns regarding DTC advertising, such as unethical practices and increased consumer demand for prescriptions that may not be needed. Patients are more likely to request or switch to heavily advertised drugs regardless of need, suitability, cost effectiveness or safety. DTC advertising also may lead to a new drug being prescribed far more often before a full knowledge has been developed regarding long-term side effects and rare reactions (most drugs see relatively limited testing in clinical trials).