History of Direct to Consumer Advertising in the United States

Dr. Barbara Mintzes Researcher, Assistant Professor, Dept. of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver,B C, Canada

Types of DTCA

Health-seeking ads

Mentions condition, do not mention drug name
(No risk disclosure required)

Reminder ads

Promote drug by name but do not mention the condition treated
(No risk disclosure required)

Product-specific ads

Mention drug name and condition treated
(Risk disclosure required)

from UCSF Marketing Medicine 2007

Canada is like most countries in the world in that it does not allow direct to consumer advertising. That’s true for all the countries of the European Union, Australia, Japan, and really all the industrialized countries. (You have to look at industrialized countries a little differently from developing countries because in developing countries they don’t really honor prescription only status. A person can go in to a pharmacist or sometimes even onto a market and buy whatever drug.) Among industrialized countries there are two countries that allow the practice, the U.S. and New Zealand. In both the U.S. and New Zealand, there wasn’t any specific prohibition in law on advertising prescription-only medicines to the public.

In the U.S., the first direct to consumer ads were in the early 80s and those were all print ads/ magazine ads. Then between 1983 and 1985, the FDA actually called a moratorium on direct to consumer advertising. It was just a few months after an arthritis drug that had been advertised to the public ended up being pulled because of liver toxicity. They called the moratorium for two years and then, at the end of the two years, went back to the practice as it had existed before. Direct to consumer advertising was simply covered under the same laws that the US had for advertising to physicians or other health professionals.

In the late 90s, there was a major shift in the U.S.; FDA guidance came out in late 1997, in which they limited the risk information that had to be provided in broadcast ads (basically, TV ads) to major risks and the most common risks, as long as people had sources of information for the other risks. Before that, the advertisers would have had to actually put the full risk information similar to what you have on the back of an ad in a medical journal. This format was something that was really not suited for television advertising. In essence, that FDA guidance opened up television advertising. There was a very large increase in the spending on direct to consumer advertising on TV and now it’s the majority of DTCA spending.