Direct-to-consumer

The introduction of oral medications and direct-to-consumer advertising has made patients feel more comfortable approaching practitioners for treatment advice. 

It is possible to sell directly to the consumer (via farm shops, farmers markets, mail order and internet), or to restaurants and institutional buyers, or to brokers, distributors, wholesalers, processors, food manufacturers, millers, abattoirs, butchers, farm shops, co-operatives, local retail stores, speciality stores and large supermarket chains. If one outlet does not work, it is possible to switch to another. Some farmers use multiple outlets, selling directly to consumers as well as commercially to middlemen. In this way, the farmer is not reliant on just one outlet. Some farmers also take the decision to have their own processing facility, such as milk processing or cheese-making. 

Third, pharmaceutical advertisements increasingly are targeted directly to consumers. The major impetus for an increase in this technique was publication of a draft guidance by the FDA in 1997 and a final guidance in 1999 that permitted advertisements to include the purpose of the product (FDA, 1999). From 1997 to 2000, direct-to-consumer advertising in the U.S. increased from 860 million to 2.5 billion (Lancet, 2002). It must be assumed... 

Food and Drug Administration (FDA) (1999) Final Guidance on Direct-to-Consumer Advertising. Federal Register 64 43,197-198, available at www.fda.gov/cder/guidance/1804fnl.htm (accessed May 26, 2002). 

The Lancet, "Europe on the Brink of Direct-to-Consumer Drug Advertising," Lancet, 359, 1709 (2002). 

Annex I contains the list of permitted colours for food. Only colours included on this list may be sold directly to consumers, except that E 123, E 127, E 128, E154, E 160b, E 161g, E 173 and E 180 may not be sold directly to consumers. The complete hst of authorised colours is stated in Table 2.4. 

Basara, L.R., The impact of a direct-to-consumer prescription medication advertising campaign on new prescription volume. Drug Inf. J., 30, 715-729,1996. 

Except in the United States of America and New Zealand, where direct to consumer (DTC) advertising of prescription medicines is allowed, companies are not allowed to communicate directly with patients. The Association of the Pharmaceutical Industry (ABPl) Code of Practice has been relaxed a little in this area in recent years and companies can now communicate in a very limited fashion with the general public. Clause 20.2 of the Code allows the provision of non-promotional information either in response to a direct enquiry from an individual or via press conferences, press announcements, lectures and media reports, public relations activities and the like. 

A recent innovation has been direct-to-consumer (DTC) prescription drug promotion in the broadcast media. Because FDA regulations require a summary of the entire approved package insert to appear with any prescription drug advertisement, it was extremely difficult to use radio or television advertising for this purpose. Most consumer advertising for prescription drugs was therefore limited to the print... 

The Therapeutic Goods Advertising Code currently forms the basis for determining the acceptability of advertisements directed to consumers. All advertisements for therapeutic goods directed to consumers, published or broadcast in mainstream (designated) media, must be approved before publication or broadcast. The Minister for Health has delegated this responsibility to the Australian Self-Medication Industry and the Complementary Healthcare Coimcil. 

A voucher is a grant for consumption of a specific good or service provided directly to consumers who have certain attributes (Bradford and Shaviro 2000). Voucher programs coupled with private provision of the goods or services are typically viewed as alternatives to its public provision. Vouchers with private provision are often viewed as superior to public provision because of efficiency gains relative to provision by a public monopolist. Lack... 

The United States Experience with Direct-to-Consumer Advertising of Prescription Drugs... 

Currently only two countries, the United States and New Zealand, permit pharmaceutical manufacturers to market directly to consumers, where consumers are defined as potential ordinary patients and not as health care providers. The United States also now permits direct-to-consumer advertising (DTCA) for prescribed medical devices. Whether DTCA should be permitted at all, permitted but only with much more stringent regulation, or replaced with public health announcements, are issues on which much has been written and continue to be controversial in the United States and in New Zealand. There is also a considerable literature surveying consumers and physicians perceptions of DTCA. ... 

Figure 9.1. Trend in direct-to-consumer advertising spending, 1994-2004. Source IMS Health and Competitive Media Reports.

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