Intended for healthcare professionals


Doctors feel pressurised by direct to consumer advertising

BMJ 1999; 319 doi: (Published 20 November 1999) Cite this as: BMJ 1999;319:1321
  1. David Spurgeon
  1. Quebec

    Most doctors whose patients asked them about drugs they had seen advertised in the media felt under pressure to prescribe them, according to a telephone poll reported at the annual meeting of the American Association of Pharmaceutical Scientists.

    In 30-36% of such cases the doctors gave in to the pressure, even when the drug in question was not their first choice.

    The poll was conducted among 199 primary care doctors practising in Ohio and Pennsylvania during January and February 1999, including those who were described as high prescribers of statins. Respondents were offered an honorarium of $75 (£47) for participating.

    Respondents to the poll, which was carried out by Benjamin Banahan, professor of pharmacy administration, and John Bentley, assistant professor of pharmacy administration, at the University of Mississippi, indicated that on average five patients a week asked them to prescribe a specific product, and 30% of the time they did so.

    The doctors said that television advertisements were the most frequent source of their patients' information (77print advertisements were next (51%), followed by television news stories (49%) and print news stories (48%). More than half (52%) of the doctors thought that the information in prescription advertisements was only partially accurate, and 42% thought it was mostly accurate.

    Altogether, 91% of the doctors who responded reported that they felt under pressure to prescribe products patients asked them about: 38% reported “very little” pressure, 47% “a little” pressure, and 6% “a lot” of pressure. The American Medical Association reversed its stand opposing direct to consumer advertising in 1992.

    Commenting on the poll, Professor Banahan said that doctors today were more likely to respond to pressure from patients to prescribe than they were in the past. Those who responded to pressure to prescribe a drug that was not their first choice said that they considered that the drug they ended up prescribing was acceptable.

    The project was supportedby a research grant from the R W Johnson Pharmaceutical Research Institute, a research arm of Johnson and Johnson.

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