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Orthopedic and Dental Industry News Complete Archive »

Impact of Direct-to-Consumer Advertising BY MATTHEW JAFFE, APRIL 6, 2006

Kevin Bozic, MD of UCSF presented the impact of Direct to Consumer Advertising (DTCA) in Orthopedics during the Health Policy Symposium at AAOS. Since the FDA issued a draft guidance for consumer directed advertisements in the late 90's, first pharmaceutical firms, and now orthopedic implant makers and hospitals have been using DTCA to their advantage. Dr. Bozic explained this partially happens because implant manufactures receive the bulk of their sales come from low-volume surgeons and hospitals. Additionally, the manufactures see that this pull strategy works very well.

Although DTCA may educate and compel patients to seek medical care for previously untreated disorders, many advertisements simultaneously stress emotional and physical benefits, while glossing over potential risks of the procedures. Even with the safest and most effective treatments advertised, patients may still become confused, seek inappropriate treatment and inflate demand for an inappropriate device. He stressed the potential strain on the doctor patient relationship.

The lecture became really interesting when Dr. Bozic reviewed a study he did on internet DTCA. He searched for "minimally invasive hip replacement" on three popular search engines, excluded duplicate matches and examined the top 50 results. A hospital/university or private medical group wrote the content for about 70% of the sites, and of the original 150 sites, 45% allowed the reader to make an appointment. When looking at risks and benefits, 91% claimed a shorter recovery time, where as only 13% even described risks. Only 9% of the sites referenced some peer-reviewed literature.

He continued by describing his new research into DTCA for medical devices. Since most research focuses on pharmaceuticals, and significant differences exists between drugs and implants, he wants to see how it relates specifically to orthopedics. In his preliminary findings, almost 75% of physicians polled found that it had a negative impact on patient interaction. About 50% said they found pressure to use a "particular surgical technique approach or specific type of implant" by patient request. Patients said they initiated a conversation about a surgery or implant based on an ad they had seen 40% of the time, and had an opinion about what should be done before speaking with the doctor 60% of the time. He concluded that in the future, we should work on improving the quality and accuracy of information targeted at patients.

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