Like you, I've worked in healthcare and pharma for a long time. I've watched over the years as the regulations have gotten tighter, the environment has gotten tougher, and the press has gotten nastier. And, like you, I'm quick to object when our industry is mischaracterized as malevolently profit-driven, with no acknowledgement of the millions of lives saved and improved through the work we do.

And that's why it makes my blood boil when I see someone like Wally Snyder, President-CEO of the American Advertising Federation, obliviously fanning the flames by defending DTC advertising with statements like this (from a recent Advertising Age article):

"If the product has been approved after an elaborate scientific presentation, it makes no sense not to run ads… If the FDA has decided that a drug is effective, why shouldn't consumers have that information?"

Why, as Mr. Snyder implies, should we resist driving consumers to their doctors with requests for medications they may or may not need, for conditions they may or may not have, when it's not illegal and DTC has been proven to work?

The answer: Because while DTC ads do indeed "work" economically in our favor, they carry with them a cost; a side effect, if you will. That side effect is negative goodwill — a very real phenomenon which, in casting our industry as the villain until proven otherwise, detracts from both our progress and our profitability.

Ironically, the very DTC ads which drive sales, also — through their fine print, implied promises, incomprehensible fair balance language and inadequate risk information — drive suspicion. We've become an easy and obvious target for the media, legislators, physicians and consumers, and much of it is our own doing.

Some examples of how negative goodwill plays out:

• We get more blame than we deserve: According to an Arxcel survey, "Consumer drug advertising remains corporate benefit managers' favorite culprit in rising prescription drug costs." 45% cited DTC as the top cause of rising costs, ahead of 24% for R&D and 17% for an aging population.
• We get more suspicion than we deserve: Schering Plough's stock value plummeted nearly 30% in the two weeks following the results of a single study suggesting that Vytorin may be no more effective than the generic Zocor.
• We get more antipathy than we deserve: In both local and national media, when it comes to the question of trustworthiness, our industry is consistently grouped with the alcohol, tobacco and oil industries.

Taken together — and, I would argue, thanks in large part to the goodwill we've squandered with excessive DTC — we're forced to operate in a world with little room for error; a world in which the risks we take are amplified considerably.

Let me be clear… I'm not suggesting an end to DTC. There's little doubt that it creates demand for drug sales, and in an environment where annual NME approvals are at their lowest in a decade, I understand that DTC in some form is a viable and necessary strategy.

But let's not lose sight of the potential side effects either. As negative goodwill spreads, we may find ourselves faced with many of the things we wish to avoid, including price controls, increased regulations, worsened credibility with physicians and patients, and perhaps, even an outright ban on DTC (as is the case in the European market).

A recent post at World of DTCMarketing.com offered six suggestions for regaining credibility, all of which I applaud and agree with. I'd add my own seventh, which is the need for us to reach out to physicians — proactively and ongoing — with information and advance notification regarding the DTC programs we implement. They are our link to the patient, and in that person's eyes, the number one trusted source. The investment we make in the physician relationship will serve us well.

In summary, we need to realistically assess the longer term cost of our current behavior; in my opinion, we are already over the line. If we continue to ignore the DTC backlash, and blindly press forward as Mr. Snyder seems to advocate, at some point the credibility gap we're creating will outweigh the benefits. When that day comes, even increased DTC spending won't solve our problems.

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As a physician, I've experienced life both before and since DTC advertising took hold.

In the "old days," a patient would arrive at the doctor's office with an ailment or set of symptoms. The physician would discuss, advise and — after taking into account the patient's physical, psychological and emotional state — might recommend medication. For the most part, patients were oblivious to and unconcerned with drug brands; they arrived with few preconceptions.

In today's environment, on the other hand, we've put the doctor in the position of having to react to an imposed message. More than ever before, he is subservient to DTC. The patient sees the ad, becomes enthused and — sometimes without even possessing the "correct" symptoms — requests a particular drug by name. A surprisingly high number of these requests are in fact honored by the doctor.

Why is this bad? Simply because the DTC ad has inserted itself into the patient-doctor relationship. Most doctors consider this relationship paramount, and we create both resentment and a jaundiced view of pharma in the medical community when we force doctors to undo the effects of consumer marketing.

A better approach, I believe, is to support and improve the patient experience after a specific drug has been prescribed by a physician. In this case, the patient is on the drug that is best for his or her specific set of circumstances, and resources spent here (through patient experience programs and the like) improve both patient benefits and drug sales. In the long term, we will see superior results for all concerned by working alongside the physician community.

InfoMedics is a leader in the creation and management of patient experience programs. As the chart below demonstrates, patient feedback has a significant effect throughout the product lifecycle.

These results come from an independent analysis conducted by IMS Health