Which US doctor is most likely to be receptive to patient requests for brand-specific medications advertised on television:
a 58-year-old pulmonary disease specialist in a group practice in the West, or a 36-year-old ob/gyn in the South who participates
in e-detailing? What variables accompany-and predict-physician perceptions of direct-to-consumer (DTC) advertising? How do
doctors' attitudes on the subject affect their prescribing behavior?
To answer those questions-and thereby help pharma companies get the most from their $2.6 billion annual investment in DTC
advertising-IMS Health conducted a nationwide, online study of 2,300 physicians across 16 specialties regarding their attitudes
toward DTC and the patient and physician behaviors it prompts. The study had two additional benefits: It gave doctors an opportunity
to advise pharma companies about the importance of giving them advance notice of upcoming campaigns so they can better prepare
for patient requests, and it examined the extent to which physicians have incorporated e-communications in their practices.
Pro, Con, or On the Fence The doctors surveyed fell into three groups: those with positive views of DTC advertising (15 percent), those who were neutral
on the subject (33 percent), and those who disapprove of the practice (52 percent).
The positive group consisted of doctors who "agreed strongly" or "agreed somewhat" with the statement, "DTC advertising contributes
to a stronger doctor/patient relationship, due to promoting higher levels of patient interest in their well-being." The category
also included doctors who wanted DTC to increase or remain the same. The group that opposed DTC advertising "disagreed strongly"
or "disagreed somewhat" with the same statement and wanted to see the practice decrease or discontinue.
STUDY METHODOLOGY
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To learn which variables indicate doctors' attitudes toward DTC ads, the researchers compared the profiles of physicians within
the two extreme groups and analyzed them using a logistic regression model. (See "Study Methodology," page 124.) The analysis
covered more than 70 variables, including physicians' age, specialty, and region, as well as their response to each of the
18 survey questions.
In both the positive and negative groups, respectively, the following characteristics were essentially the same:
- the mean age (49.4 and 50.3 years)
- distribution by gender (84 percent were male)
- office-based (85 percent) and solo practice (70 percent).
Therefore, none of those factors could be used to predict doctors' opinions of DTC advertising.
Positive DTC attitude by us region
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When geographic region, medical specialty, and internet use were taken into account, however, significant differences emerged.
More doctors in the South-and fewer in the West-held favorable views of DTC advertising than those in other regions of the
United States. (See "Positive DTC Attitude by US Region" and "Positive DTC Attitude by Specialty.")
Furthermore, doctors in certain specialties surfaced as more supportive of the concept than others. Ob/gyns (36.1 percent),
psychiatrists (34.8 percent), and urologists (34.7 percent) were the most likely to be positive, while pediatricians (13 percent)
and pulmonary disease specialists (11.1 percent) were inclined to be negative.
POSITIVE DTC ATTITUDE BY SPECIALTY
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Third, doctors who were more accepting of DTC advertising also used the internet more than others and were more apt to recommend
a healthcare website to their patients and to communicate with them via e-mail within six months of completing the survey.
Physicians' stance on whether direct-to-consumer advertising improved the doctor/patient relationship corresponded strongly
with their views on several other aspects of promoting products to consumers. The study examined their answers to the following
questions:
- Does DTC advertising lead to better patient behavior?
- Do companies have the right to promote directly to consumers?
- Can the public understand DTC ads?
- Should marketers provide advance notice of DTC campaigns to physicians and managed care organizations?
- Do DTC campaigns create a conflict for doctors between satisfying patients and following formularies?
CRITICAL QUESTIONS
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The only area of congruence between the positive and negative groups was a strong belief that pharma companies should provide
advance notice of DTC campaigns to physicians and managed care organizations. On every other question, the two groups were
opposed. (See "Critical Questions.")
Within Advertisers' Control Although it is obviously impossible to control, or even influence, many of the variables associated with physician opinions
about DTC advertising, two factors on which pharma companies can have a direct impact emerged:
Doctors attitudes When sales reps mention DTC
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First, doctors who said sales reps usually, frequently, or occasionally mention DTC ads during a sales call were more likely
to view DTC advertising positively than those whose reps "seldom" or "never" briefed them on consumer marketing plans. Of
the negative group, 4 percent reported that reps usually or frequently mentioned DTC campaigns, compared with 12 percent in
the positive group-suggesting that pharma companies may be able to affect doctors' opinions through the way they coordinate
detailing with DTC campaigns. (See "Doctors Attitudes When Sales Reps Mention DTC,")
Second, on average, more than 70 percent of respondents (84 percent of the positive and 64 percent of the negative) said they
were "more likely to prescribe a brand-name medication based on a patient request when they had a sample available to give
to the patient." That suggests pharma companies can achieve effective product pull-through by sampling, even with doctors
who don't necessarily support DTC advertising.
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