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The influence of direct-to-consumer marketing of prescription drugs on consumer perceptions is examined.

As patients continue to take a more active role in their health care, an understanding of patient requests of health care providers, including what happens when requests are not fulfilled, is becoming more important. Although its merits have been debated, direct-to-consumer advertising of prescription drugs generates patient requests. The objective of this study was to assess the influence of physician communication style, respondents' expectations of receiving a requested prescription, and perceived symptom severity on respondents' evaluations of care following a physician denial of a prescription drug request stimulated by direct-to-consumer advertising. A 2 x 2 x 2, between-subjects experimental design was used. The respondents were made up of employees of the University of Mississippi. Physician communication style, respondents' expectations, and respondents' perceived symptom severity were manipulated using vignettes. Respondents' post-visit evaluations of care were assessed by measuring trust in the physician, visit-based satisfaction with the physician, and commitment toward the physician. Factorial analysis of variance procedures for a three-way design were used to test the hypotheses and assess the research questions. Manipulation checks suggested that the independent variables were appropriately manipulated. No significant first-order or second-order interactions were noted in any of the analyses. Post-visit evaluations of care were significantly associated with physician communication style (a partnership response led to better evaluations of care). There were no significant effects of either prior expectation of request fulfillment or perceived symptom severity. However, non-significant trends in mean scores suggested a potential role of these variables in the evaluation process following request denial. The manner in which a physician communicates with an individual is an important determinant of the evaluation of care following the denial of a request. The results suggest that health care providers attempting to minimize the effect of request denials on patient evaluations should make an effort to involve the patient in the decision-making process. Keywords: Physician communication style; Patient requests; Patient physician relationship; Direct-to-consumer advertising; Prescription; Vignette design

The role of drugs promotion in general and direct-to-consumer advertising of prescription drugs is discussed. Patients and physicians have mixed reactions to both types of content, as there is perceived imbalance between the information about risks and the information about benefits that most advertisements convey.

The sale of prescription drugs over the Internet is under-regulated with insufficient consumer safeguards. Congress should create a body of experts which could centralize regulation of online pharmacies and provide greater consumer protection.

Pharmaceutical companies that promote their products inappropriately may gain huge profits at the expense of patients' and physicians' best interests. In addition, they may be censured by the Food and Drug Administration (FDA). 'Seeding' trials, unsubstantiated claims of superiority over competing products, and 'switch' campaigns are the three tactics drug companies use to promote 'me too' drugs. These drugs are similar to other drugs in a therapeutic class, with some classes quite crowded and entry competitive. Seeding trials attempt to get doctors to prescribe the new drug; they have little research value. Switch campaigns are efforts to get patients to change from the medicine they are taking to the new one. These may be targeted at patients, doctors or pharmacists. The FDA's efforts to discourage and regulate the promotion of drugs using false tactics include letters of warning, injunctions and criminal prosecutions.

One of the few US industries that has maintained its global lead is the ethical pharmaceutical industry. This advantage is based on innovation in terms of aggressive product introduction. However, intensifying competition, increasing R and D costs and higher health care spending have forced these firms to raise efficiency. A model that explains new product success iin terms of the speed to market measure is proposed. A comparative analysis of new chemical entities, which refer to drugs that are approved internationally within four years from introduction, is used to support the model.