Direct to Consumer Advertising (DTCA) — Should it be made legal in India?

Direct to Consumer Advertising (DTCA) is a marketing tool used by pharmaceutical companies to market their prescription products directly to consumers. This is done mainly via media like newspapers, magazines, television, radio, internet, hospital display boards, etc. Currently, DTCA is legal only in the U.S. and New Zealand. There are strict government regulations for DTCA but due to the internet and social media, it has become very arduous for the governments to properly implement the laws that govern DTCA. Before 1983, the pharma companies could market their products only through a registered medical practitioner (RMP) and so, DTCA had no existence. But later in 1997, the US FDA made gave relaxations in its rules for the direct- to- consumer which enabled the pharmaceutical companies to be able to advertise their prescription drugs directly to the consumers or the potential patients. This enabled the pharma companies to move their products directly to the patient’s home which ultimately increased revenues and hence, sales. Each of the 3 types of DTCA differs in the information and the amount of information that the ad delivers about the product:

• Product claim advertisements- It specifies the brand name along with the drug indications, briefly mentioning the major risks and benefits in a balanced amount.
• Reminder advertisements- These ads specify the name of the drug, its dosage form, and sometimes its costs. No product claims are made. But these advertisements are not allowed by the FDA for drugs with serious risks.
• Help-seeking advertisements- The major objective of these ads is to make the general public aware of the various kinds of diseases and health conditions and encourage them to consult a physician when needed.

No doubt it has and will definitely result in converting sales for the company but is it the only goal? Unlike most of the other industries where converting sales is the main goal, the pharmaceutical industry deals with the health of the people and hence, cannot just focus on increasing their profits.
DTCA informs, educates, and empowers the patients by encouraging them to consult the physicians and take charge of their health when required. There are times when people feel some discomfort but ignore it because they feel it's minor. DTCA will encourage them to contact their physician earlier which will also protect them from possible risks due to delayed treatment. Not only this, but it will also help in bridging the communication gap between the patients and the healthcare providers. Patients will be able to ask more thoughtful questions. They will be comfortable seeking help for diseases that have a social stigma connected to them like STD’s. This as a result will reduce the underdiagnosis and undertreatment of conditions. A major concern for people from middle- and lower-income groups is the affordability of healthcare services and medicines. DTCA encourages product competition and thus lowers the prices.

While DTCA educates people, it also misinforms them at times. Taking its advantage, some companies make false claims that only medication can improve their condition and not lifestyle changes. Some people who have a tendency to be hypochondriac may start pestering the doctors and the healthcare providers to prescribe them the particular medicine even when it is not required. This strains the patient-clinician relationship and also wastes time. Many times the consumers might misinterpret an ad and start self-medication which could have harmful effects. Even if the ad wants to inform and empower the people, we should not forget that getting profits is also one of their objectives. The companies tend to overshadow the risks by overemphasizing the potential benefits.

In India, DTCA is allowed only for over-the-counter or OTC drugs. There is no actual list of OTC drugs through all those which are not included in the list of ‘prescribed drugs’ are considered OTC drugs. Those falling under schedule- H, schedule- G, and schedule- X of Drugs and Cosmetics Rules 1945 are not allowed for DTCA. There are certain ailments and conditions whose advertisement is strictly prohibited. Pharma companies are still involved in some kind of direct-to-consumer strategies as they realize the importance of the internet and social media and how this can benefit them as well as consumers. The turnover for India’s domestic pharmaceutical market was $20.03 bn USD in 2019. It is expected to reach US $55 bn USD by 2020 which doesn’t seem possible, COVID-19 adding to the list of reasons. Pharma companies are trying to put more of their drugs in the OTC category so that they can advertise them and can reach the areas and consumers which were earlier inaccessible.

After looking at what DTCA is, how it works, its advantages and disadvantages, I think it should be implemented in India but under strict legal restrictions. Even now when DTCA is banned, companies are somehow engaged in it. So, these activities should be monitored. DTCA can transform the Indian healthcare system if implemented properly. As people get educated about various health issues and medications, delayed treatment can be avoided, decreasing the cost burden. People tend to search for their symptoms online first and then consult a physician instead of directly going to the physician. DTCA will make more people start making doctor appointments to talk about symptoms that were not previously discussed. They will become more conscious and give attention to their health conditions which ignored earlier. Providing the right and authentic amount of information through DTCA is essential. So, every ad needs to be sterling before getting released into the market. By making it mandatory to get the ad approved by the FDA, this problem can be solved. Advertisement of the new drugs can be delayed till all the information about its side effects and potential risks are known. Action should be taken if the rules are broken. If all the laws and regulations are made and followed properly then DTCA can prove to be really valuable for the Indian healthcare and pharmaceutical industry.

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Author: Samadrita Pal
2nd Runner-up, Article Writing Competition, Buzz 2020
Class of 2022, SIBM Bengaluru