A shift in power?

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Can the barrage of bad news about drug safety scare a public previously emboldened by DTC advertising-and the knowledge that came with it-and shift the balance of power in the doctor-patient relationship back to the physician?

"That could be one of the consequences of what's happened lately, yes," said Dr. Edward Langston, an Indiana-based physician and a member of the American Medical Association's board of trustees. "People are seeing Vioxx taken off the market, Bextra taken off the market, warning labels put on certain drugs, and they're looking for answers. And physicians will hopefully have the right answers for their patients."

One of the "side effects" of DTC advertising has been the breakdown in some doctor-patient relationships. In the most recent Food and Drug Administration study on patient and physician attitudes toward DTC promotions, released last November, 65% of physicians surveyed felt patients confuse the risks and benefits of DTC; 75% overestimate the efficacy; 38% believe DTC advertising causes patients to question their diagnoses; and 28% said DTC led to tension between doctors and patients.

According to Global Insights, professionals already receive the lion's share of a drug maker's budget. While pharmaceutical companies spent more than $4 billion in DTC advertising in 2004, they also spent more than $18 billion marketing to health-care providers, including free samples, and have traditionally spent four to five times more on professional marketing than consumer.

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