The Great DTC Shake-Up Patient perspectives on direct-to-consumer advertising

Although it has been several decades since the first direct-to-consumer (DTC) advertisement hit TV screens, the use of such promotional tools has recently come under a spotlight, with the American Medical Association (AMA) calling for an outright ban in 2015 and motions to curb DTC proposed in both houses of Congress in 2016.

Yet, investment in DTC promotion shows no signs of slowing; pharma has been steadily increasing expenditure since 2012, and data for the period October 2015 to September 2016 show a rise of 18% on the previous year. With the total for this period reaching $6bn, 2016 looks likely to have been a record year.
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In our ever-more patient-centric world, a key question arises – what do patients think about DTC? Health Perspectives Group, experts in patient engagement since 2002, partnered with eyeforpharma to answer this question in today’s changing environment. They contacted the Food and Drug Administration (FDA) and secured permission to reuse and update the patient portion of an FDA study conducted in 1999 and 2002, looking at patient and physician attitudes toward DTC. Health Stories Project – Insights (HSPi), a division of the Health Perspectives Group, then undertook a survey of patient attitudes, results from which are published for the first time in this white paper.

The DTC Attitudes, Behaviors and Preferences survey takes its protocol from the earlier study and uses the FDA survey as a baseline, tracking how patient perspectives have evolved across nearly two decades. Eyeforpharma then spoke to senior thought leaders in the pharmaceutical industry to gain feedback on these patient insights and to ask how companies are adapting to the evolution of engaged patients.. 

The survey’s findings show that investment in DTC may be increasing but its effectiveness is decreasing. 
Pharma’s approach to DTC is also decoupled from patient needs, causing patients to disengage from traditional tactics and, in some cases, become actively hostile to the medium. As a result, pharma is not just failing to maximize the value from this increasingly expensive investment, the current approach to DTC is undermining industry efforts to re-position itself as patient-centric. 

“Patients have become increasingly engaged in their healthcare, capable of researching and asking sophisticated questions about treatment options,” says Cheryl Lubbert, President and CEO of Health Perspectives Group and a 25-year veteran of the pharmaceutical industry. 
“Patients want convenient access to drug information without always having to engage their physician. They often prefer information that is delivered in a digital environment, and they’ve made it clear they appreciate information that comes through other patients.” 

Regulator constraints are cited by many as the reason why industry cannot meet these changing patient needs. However, the latest data on DTC spending confirms that the industry isn’t adapting,4 with DTC TV receiving the lion’s share of investment, despite a majority of patients expressing dislike for the medium.

What’s next for DTC ? 

Based on this analysis, Lubbert suggests this approach:

• -Reduce ad spend and focus on disease awareness with real patients instead of actors
• -Use the awareness to drive patients online, where companies provide richly curated and compliant patient-driven content
• -Connect patients with other patients to improve understanding of the disease and product 

Part of the resistance to change is driven by internal culture and ingrained practices of focusing on product-centric marketing. Pragmatically, this will take a long time to shift and there is no guarantee that all companies will recognize the need to change. 

What is clear, however, is that with patients spending more and more time engaging with digital channels, companies need to develop resonant stories in order to be successful in this space. In addition, as big data continues to power increasingly targeted digital campaigns at a fraction of the cost of DTC TV, even the most reluctant to change will surely respond to costeffective alternatives. 

While patient-centric digital alternatives are likely to win out over traditional DTC channels like TV in the long term, how long it will take is an open question. 

While the future of DTC will be more patient-centric, for the time being at least, the familiar TV ads are likely to continue. From the patient’s perspective, however, the good news is that change is coming.

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