Most people in the United States, and perhaps the rest of the world, are exposed to direct-to-consumer advertising.
Direct-to-consumer advertising of medication often informs people about illness and treatment. Patients who see the television or print marketing may be more likely to discuss their symptoms and diseases with their doctors. On the other hand, advertising provides limited medical information. Commercials often encourage use of a medication for superficially described symptoms. Doctors are left to determine if the drug is appropriate for a patient’s true diagnosis. Physicians and other health care providers must often spend significant time reassuring concerned patients and explaining unnecessary treatments.
Direct-to-consumer advertising recently went in a new direction: On November 22, 2007, during a nationally televised American football game, a 60-second commercial promoted the use of a coronary stent made by Johnson & Johnson.
Stenting is a procedure done by highly trained cardiologists. It’s predominantly used to alleviate symptoms of coronary artery blockage and to prevent heart damage during a heart attack. The choice of which stent to use is complicated. Even cardiologists disagree about the ideal stent in some circumstances.
The pros and cons of a drug-eluting stent (the one advertised) vs. a bare metal stent vs. no stent at all include the need for life-long medications, which can make future minor surgical procedures life-threatening and aid in the risk of stent closure and clotting. The size and anatomy of the blocked coronary artery and which stent is the optimal choice, along with a doctor’s experience with each respective stent, are all considerations that should be made.
If the goal of direct-to-consumer advertising is to stimulate discussion between patient and doctor, regarding stents or any other treatment, then I wholly agree with its use. Unfortunately, advertisements, such as the one by Johnson & Johnson, suggest that stenting, and specifically their stent, is better than any other option.
Sixty seconds of a television commercial does not allow for a balanced pro and con discussion of stents and drug-eluting stents. It also does not present a “fair balance” of information, thereby not comply with American federal guidelines on medical advertising.
Sources:
Boden WE, Diamond GA. DTCA for PTCA — Crossing the Line in Consumer Health Education? N Engl J Med 358:2197, May 22, 2008.