Please help me answer the questions to this case study below:

What do Tamiflu and Natazia have in common? They are both gold medal winners for their direct-to-consumer advertising (DTCA). Although their brand name recognition does not rival that of Coca-Cola, their names are familiar to consumers across the nation. As flag bearers of the DTCA efforts of the pharmaceutical industry, they are at the forefront of the DTCA debate. At this writing, the United States and New Zealand are the only developed countries that permit DTCA. However, the pharmaceutical lobby has been pressuring European regulators to open the European Union to DTCA and so the debate is certain to continue.

Why debate DTCA? In his testimony before the Senate Commerce Subcommittee on Consumer Affairs, Dr. Sidney Wolfe, director of the Public Citizens Health Research Group, expressed the following concern: There is little doubt that false and misleading advertising to patients and physicians can result in prescriptions being written for drugs that are more dangerous and/or less effective than perceived by either the doctor or the patient. Beyond safety concerns, there are also concerns over the additional costs that consumers bear with DTCA, as well as the emotional impact and tone of images used in the advertising. In November 2015, the American Medical Association called for a ban on DTCA practices for prescription drugs and medical devices with concerns that the growing proliferation of ads is driving demand for expensive treatments, despite the effectiveness of less costly alternatives.

The findings of a CMI/Compas survey of 104 physicians across multiple specialties underscore these concerns: 89 percent of the physicians indicated that a patient requested a prescription because of seeing a DTCA and 43 percent of the physicians reported changing their prescribing as a result. Only 20 percent agree (5 percent strongly and 15 percent somewhat) that DTCA improves the relationship between a clinician and the patient. The FDA is currently in the process of surveying physician, nurse practitioners, and physician assistants again about their experience with DTC ads, including questions about the impact of social media advertising.

On the positive side, DTCA can also help patients. In the CMI/Compas Survey, 48 percent of the same physicians agreed (5 percent strongly and 43 percent somewhat) that DTCA educates patients and 52 percent agreed (9 percent strongly and 43 percent somewhat) that DTCA lessened the stigma of some diseases. Dr. Richard Dolinar, an endocrinologist, says that the ads empower consumers, Direct-to-consumer advertising is getting patients with diabetes into my office sooner so they can be treated. Professor Dhaval Dave of Bentley University conducted a study for the National Bureau of Economic Research (NBER) and found that advertising directed at consumers can expand the total market for drug treatment by educating consumers with regard to treatment options for their symptoms, by facilitating contact between the patient and the physicians, and by reminding patients who already have prescribed medications to adhere to their drug therapy.

With strong arguments for and against DTCA, many people find their opinions evolving. John LaMattina, the former president of Pfizer Global Research and Development, is an expert on the pharmaceutical industry. In a Forbes article entitled, Maybe Its Time for Drug Companies to Drop TV Ads, he questions whether the negatives of DTCA are starting to outweigh the benefits. He was an early supporter of DTCA based on its education value for the consumer and he still believes that some benefits remain; however, he now feels that the ads are having too many negative effects due to industry missteps. For example, some of the commercials are not age appropriate for children and so are subject to tighter industry standards. Denis Arnold and James Oakley found that, over a four-year period, five major pharmaceutical companies violated industry standards in their marketing of erectile dysfunction drugs, leading to children being exposed to sexually themed advertising over one billion times. Another issue Mattina raises is that the endless listing of negative side effects creates problems. He quotes Elizabeth Rosenthals New York Times article:

When the Food and Drug Administration in the 1990s first mandated that drug makers list medicines side effects in order to advertise prescription drugs, there was a firestorm of protest from the industry. Now the litany of side effects that follows every promotion is so mind-numbingdrowsiness, insomnia, loss of appetite, weight gainas to make the message meaningless.

QUESTIONS:

1. What are the ethical issues in this case?

2. Should DTCA be judged by the same criteria as other advertising?

3. If not, how should it be judged differently?

4. Should DTCA be banned in the United States?