Most of us born and raised in America would not bat an eye at the sight of a commercial for an allergy pill or an antidepressant. It is even a running joke among households about the list of side effects being longer than what it cures. However, if you mentioned this in a place like Canada, Australia, France, or Peru, you will find quickly that they aren’t familiar with it. That is because the United States is only one of two countries that allow direct to customer sales for prescription drugs. It is outright illegal, partially legal, or has never come up in other countries around the world. How can that be? Is there an ethical or moral reason behind these decisions, or is it an unnecessary roadblock for medical marketing? Is it somewhere in between? Let’s find out.
Where is Direct to Consumer Medical Advertising Fully Legal?
Legality behind direct to customer (d2c) sales in the pharmaceutical market varies from country to country. The United States and New Zealand are the two countries that make it legal. It was United States policy since 1983 which allowed over-the-counter sales of various drugs. Until then, things like Tylenol needed a prescription from a doctor. In New Zealand, it is still policy, but most support the removal of this system.
At first, it sounds completely and utterly irresponsible for medical marketers to just sell whatever they want to any prospective customer. However, that isn’t an accurate picture of what is going on. This is all under the initial assumption that drug companies do not go under any form of oversight.
Just because something is legal, doesn’t mean that there aren’t stipulations or circumstances attached to that legality. For example, in the United States, you have the right to bear arms, but that doesn’t mean that they allow you to just carry your gun everywhere and point it at anyone for no reason either. You have the right to free speech, but you don’t lie in the middle of a criminal trial. There are still consequences for improper actions. Consequences apply when drug companies are not keeping the best interests of their customers in mind. So there are licensing regulations, limitations, and guidelines for medical marketing. However, are the FDA and Pharmaceutical Research and Manufacturers of America (PhRMA) enough?
Current Effects of D2C Medical Marketing
What Critics Say
There are several points of criticism towards d2c medical marketing from both the medical community, the public, and some marketers. Some of these groups believe that the d2c medical marketing has impacted the market, patients, and their doctors negatively. So, what are some results of decades d2c marketing tactics for medication and pharmaceuticals?
For starters, there has been concern that the advertising would impact the doctor-patient relationship. The television and online video advertisements often asked patients to talk about certain medications that doctors aren’t aware of. Doctors rely on replicated results and multiple studies before they add a medication onto their list. Advertisements often jump the gun to drum up sales. This causes a disconnect between doctors who are trying to do their job and patients asking for things they don’t need because advertising works.
Another critique is these drug companies spend so much money on advertising when it should be on research and development.
There are also safety issues. As of the early 2000s, “Advertisements generally begin within a year of drugs entering the market, before post-marketing surveillance is available to see if adverse effects emerge, which increases the risk of harm”.

What Supporters Say
However, in America, there is just as much support for D2C medical marketing as there is opposition. While physicians on surveys thought patients were not getting the right information from the ads about a drug, they still thought it made their patients put more effort into their own healthcare. Some of them even stated that it fostered helpful discussions between doctors and patients and that most of them understood that they should talk about it before going through with using it as a treatment for a condition.
There is also the argument that D2C marketing helped drum up sales for the medication. This would make a profit and a part of that profit would go into research and development. It has also brought innovative and useful treatments to the public when financial interest or unfair bias impedes making a product available to the public. And that happens, ask the inventor of Invisalign. Medical institutions are made of people who are never flawless, last I checked. So, it is possible that there is a place for D2C Medical Marketing.
Conclusion
This brings me to my conclusion. Medical marketing and D2C advertising is a more complicated and nuanced issue that most people can’t solve right away. Like any other system, it is flawed, meaning that it has good and bad involved. If you throw it all out, you could be potentially “throwing out the baby with the bathwater”. So, there should be regulatory changes, but if I had to decide I wouldn’t scrap all D2C medical marketing aside. Like everything else in life, it is about striking a balance, and if most of the institutions in charge of that have the best interest of the public in mind then it can be found.