FILLING THE INFO GAP

DALE BUSS

When it comes to the explosion in direct-to-consumer advertising by drug companies of prescription remedies on TV, in magazines and elsewhere, Stephanie Sparda, a pharmacist at a Hannaford Bros.' Shop N Save Supermarket, Scarborough, Maine, is ambivalent, as are other supermarket pharmacy colleagues.

Pharmaceutical manufacturers now are throwing at American consumers a whopping $1.5 billion a year in advertising. The industry's efforts appear to be paying off in high quarterly profits. Second-quarter, double-digit profits posted by Schering Plough, Eli Lilly & Co. and Bristol-Meyers Squibb are being attributed to DTC advertising. Schering Plough is supporting its Claritin allergy drug through television and magazine ads. Eli Lilly is running 30-minute cable-TV ads publicizing its antidepressant drug Prozac, and Bristol-Meyers Squibb advertises its diabetes drug Glucophage in popular magazines. While pharmaceutical companies are profiting, Sparda sees confusion within the marketplace caused by efforts to heighten consumer awareness of drug usage.

"It's good to get consumers aware of things they could be taking for various conditions that they might not know about," Sparda said. "But, on the other hand, it seems like they're confusing part of the public. We get a lot of unnecessary questions. And in some ways these ads misguide the public, because they don't go into interactions or indications."

The reason for this montage of flickering new impressions is the federal liberalization of pharmaceutical marketing that began two years ago. After several years of allowing drug manufacturers to advertise prescription remedies in a vague way or forcing them to load commercials with scary lists of side effects, the government began allowing TV advertisements to associate specific prescription drugs with identifiable ailments, briefer mentions of side effects and an invitation to viewers to ask their doctors about the drug. The higher awareness level among consumers about prescription drugs has coincided significantly with at least two other recent trends in health care: Americans' greater interest in self-directing their own medical care, instead of just taking instructions from a doctor; and the move of the pharmacy profession toward its own larger role as a counselor and adviser to consumers about the efficacy, administration and effects of both prescription and over-the-counter medications.

For supermarket-pharmacy operations, the confluence of these trends is producing both a markedly greater demand for information and advice from consumers and a significantly stronger commitment by pharmacists and their managers to advising their customers. Executives, pharmacists and others in the drug-dispensing industry, however, differ in their opinions about how well it is all working out.

Many of them embrace the changes, in part because, taken altogether, they underscore a growing role for pharmacists in patient care. John Fegan, vice president of pharmacy for the Quincy, Mass.-based supermarket chain, Stop & Shop Cos., said, "Much more is being expected of pharmacists in terms of being involved with their customers' care." He largely welcomes the increased curiosity that customers demonstrate because of the power of DTC drug advertising.

"It's letting people know what's going on, what's happening in terms of new products, and it's not bad that pharmacists are being asked to do more," said Fegan.

Also largely embracing the trend is John Beckner, director of pharmacy for Richmond, Va.-based Ukrop's Super Markets.

"We're getting more questions about products, particularly new products," he said. "Patients more often have a specific product in mind, so our pharmacists may be required to make a call to a doctor's office now, or refer a patient to his doctor's office for a prescription. There is increased awareness, and more subsequent questions."

Still others are expressing some concerns. Among them is Susan Winckler, director of policy and legislation for the American Pharmaceutical Association, a Washington-based trade group that represents pharmacists in all practice settings. "It's time to review the situation, such as what patients do remember from these DTC commercials and do they understand that even if they want to be like the person in the commercial, more has to go into deciding whether this prescription is for them," she said. "Not enough of that is being done. It's sort of, 'This is what the drug does, and here's what I can tell you in a 30-second ad,' but your lifestyle and other drugs you are taking have to factor into that decision."

Winckler cites calls from her members, from some consumer organizations and from some physicians' groups for the Food and Drug Administration to review DTC ads. "There needs to be a look at whether we're really talking about improved public health, or are we kind of stimulating an environment where, 'Hey, it's a medication, and I can take it and I'll be fine'?"

At the very least, advertising-inspired dialogue is adding to the time pressures felt by pharmacists who already, by some indications, are having trouble living up to the modern ideal of drug-dispenser-as-consultant.

Pharmacy executives also are dismayed when DTC ads don't invite viewers to "ask your pharmacist" as well as their doctors. "Manufacturers need to keep pharmacists in the loop," said Stop & Shop's Fegan. "Why wouldn't consumers want to know that they could get information from us as well as from their doctors? A pharmacist is definitely a partner with the prescriber."