直接面向消费者的处方药广告一项消费者态度和行为意图的研究【外文翻译】.doc

1、标题DIRECTTOCONSUMERPRESCRIPTIONDRUGADVERTISINGASTUDYOFCONSUMERATTITUDESANDBEHAVIORALINTENTIONS原文INTRODUCTIONINORDERTOINCREASEBRANDAWARENESSFORPRESCRIPTIONMEDICATION,DRUGMANUFACTURERSSPENT157BILLIONONPROMOTIONSIN2001,OFWHICH25BILLIONWENTTOMASSMEDIAADVERTISINGPRESCRIPTIONDRUGADVERTISING,OFTENREFERREDTO

2、ASDIRECTTOCONSUMERDTCADVERTISING,HASINCREASEDATANANNUALRATEOF1320PERCENTSINCE1997THUSFAR,THEREHAVEBEENMIXEDFINDINGSREGARDINGTHEOVERALLFINANCIALIMPACTOFDTCADVERTISINGONTHEPHARMACEUTICALINDUSTRYWHILETHEREISSOMEEVIDENCETHATSUGGESTSADIRECTANDPOSITIVECORRELATIONBETWEENMASSMEDIAADVERTISINGANDDRUGMANUFACTU

3、RERSEARNINGSFINDLAY,2002ANDERSON,2003,THERELATIONSHIPBETWEENADVERTINGEXPENDITURESANDTHESUCCESSOFSPECIFICBRANDSISNOTCLEARCLEARLY,DRUGMANUFACTURERSPLACEAGREATDEALOFFAITHINDTCADSANDTHEIMPACTTHATTHEYCANHAVEONCONSUMERSDECISIONTOADOPTADVERTISEDBRANDS,BUTTHEEXACTNATUREOFTHATIMPACTREMAINSCONTROVERSIALWHILEA

4、RECENTSTUDYREPORTSTHATFOREVERY10PERCENTINCREASEINDTCADVERTISING,THEREISA1PERCENTINCREASEINDRUGSALESKAISERFAMILYFOUNDATION,2003,THEREISALSOEVIDENCETHATDTCADVERTISINGOFTENSERVESTOINCREASETHESIZEOFAMARKETFORASPECIFICCLASSOFDRUGS,BUTNOTNECESSARILYTHEMARKETSHAREFORAPARTICULARBRANDKRISANITS,2003RESEARCHER

5、SHAVEEXAMINEDDTCADVERTISINGFROMVARIOUSVIEWPOINTSSOMEHAVEFOCUSEDONTHEGOVERNMENTALRULINGSTHATHAVEPAVEDTHEWAYFORDTCADVERTISINGDUKESETAL,2001ANDTHECASELAWTHATDEALSWITHDRUGMANUFACTURERSRESPONSIBILITYTOWARNCONSUMERSABOUTTHESIDEEFFECTSOFPRESCRIPTIONMEDICATIONOTHERRESEARCHERSHAVERECENTLYADDRESSEDTHEEFFICACY

6、OFDTCADVERTISINGASANEDUCATIONALTOOLWHILESOMECLAIMTHATTHEREIS“LITTLERATIONALEFORDIRECTTOCONSUMERADVERTISINGOFPRESCRIPTIONDRUGS”LEXCHINANDMINTZES,2002,P194,OTHERSSUGGESTTHATDTCADVERTISINGBENEFITSNOTONLYHEALTHCAREORGANIZATIONS,BUTALSOPHYSICIANSASWELLASPATIENTSCALFEE,2002RESEARCHERSWILKESETAL,2000HAVEAL

7、SOEXAMINEDCONSUMERSATTITUDESTOWARDSDTCADVERTISINGANDTHEACTIONSTHATCONSUMERSHAVETAKENINRESPONSETODTCADSHOWEVER,RESEARCHHASNOTINVESTIGATEDHOWCONSUMERSSELFPERCEPTIONSORPERCEPTIONSOFTHEIRRELATIONSHIPWITHTHEIRPRIMARYPHYSICIANMIGHTIMPACTTHEIRDECISIONMAKINGFORDTCADVERTISEDDRUGSFURTHER,WHILEALLOFTHESESTUDIE

8、SHAVEESTABLISHEDTHATDTCADVERTISINGISATOPICWORTHYOFFURTHERINVESTIGATION,THEREHASNOTBEENANYRESEARCHDONEONTHEINDIVIDUALANDRELATIONALVARIABLESTHATMIGHTINFLUENCETHEBEHAVIORALINTENTIONSOFCONSUMERSDURINGTHEIRMEDICALDECISIONMAKINGPROCESSESFURTHERMORE,RESEARCHERSHAVENOTINVESTIGATEDWHETHERTHESEBEHAVIORALINTEN

9、TIONSMIGHTBEDETRIMENTALTOTHEDOCTORPATIENTRELATIONSHIPTHEDEBATEBETWEENINDUSTRYADVOCATESANDPUBLICPOLICYADVOCATESISOFTENRANCOROUSINSOFARASDTCADVERTISINGISCONCERNEDINDUSTRYADVOCATESOBVIOUSLYARGUETHATTHEREARENUMEROUSMERITSTODTCADVERTISINGTHEYCONTENDTHATITISPRIMARILYANEDUCATIONALTOOLFORTHECONSUMERCONVERSE

10、LY,PUBLICPOLICYADVOCATESPOINTTOTHEINHERENTDANGERSOFSUCHADVERTISINGANDSUGGESTTHATTHEEFFECTSOFTOOLITTLEKNOWLEDGEMAYINFACTBEHARMFULTOTHECONSUMERTHISSTUDYWASDESIGNEDTOPROVIDESOMEINSIGHTSINTOCONSUMERSTHINKINGANDDECISIONMAKINGPROCESSESASTHEYRESPONDTODTCADVERTISINGINTHECURRENTMARKETPLACEINPARTICULAR,THESTU

11、DYATTEMPTEDTOANSWERTHEFOLLOWINGQUESTIONSHOWDOCONSUMERSVIEWDTCADVERTISINGINGENERALDOESDTCADVERTISINGCAUSECONSUMERSTOENGAGEINSPECIFICBEHAVIORSORBEHAVIORALINTENTIONSEG,ASKINGAPRIMARYCAREPROVIDERFORMOREINFORMATIONABOUTADRUGTHATTHEYHAVEBEENEXPOSEDTOORASKINGAPHYSICIANTOPRESCRIBEAPARTICULARADVERTISEDDRUGDO

12、ESDTCADVERTISINGEMPOWERCONSUMERSANDIFSO,WHATARETHEOUTCOMESOFTHISPERCEIVEDEMPOWERMENTBACKGROUNDHISTORYOFDIRECTTOCONSUMERADVERTISINGDESPITEITSORIGINSINTHESIXTEENTHCENTURY,DIRECTMARKETINGOFPHARMACEUTICALPRODUCTSTOCONSUMERSISARELATIVELYRECENTPHENOMENONDUKESETAL,2001PRIORTOTHE1980S,PRESCRIPTIONDRUGMANUFA

13、CTURERSPRIMARILYMARKETEDBRANDEDDRUGSTOPHYSICIANSINANEFFORTTOAVOIDDISRUPTINGTHEINTRICATE,ANDOFTENDELICATE,RELATIONSHIPTHATEXISTEDBETWEENDOCTORSANDPATIENTSDUKESETAL,2001AUSNESS,2002BETWEEN1983AND1985THEFDAREQUESTEDAVOLUNTARYMORATORIUMONDTCADVERTISINGNOTINGTHATTHEREWASALACKOFPREVIOUSCOURTRULINGSONTHEIS

14、SUEAROUND1985THEBANWASLIFTEDANDTHECOURTSREACHEDACOMPROMISEBYDECLARINGTHATDTCADSWERETOBESUBJECTEDTOTHESAMEREGULATIONSTHATHADPREVIOUSLYGUIDEDPHARMACEUTICALDRUGADVERTISINGTOPHYSICIANSCONSUMERSWERETOBEPROTECTEDTHROUGH“FULLDISCLOSURE”ANDDRUGMANUFACTURERSWOULDBEREQUIREDTOPROVIDEA“BRIEFSUMMARY”OFTHEPRODUCT

15、INTHEFORMOFPACKAGEINSERTASARESULTOFINDUSTRYPRESSURE,ANDAFTERCONSIDERABLEDEBATEANDDELIBERATION,THEFDARELAXEDITSRULESIN1997ANDFORTHEFIRSTTIME,MANUFACTURERSWEREALLOWEDTOPROVIDETHENAMEOFTHEDRUGANDTHECONDITIONSTHATWEREASSOCIATEDWITHITSUSEATTHESAMETIME,THEFDARELAXEDTHEGUIDELINESCONCERNINGTHEINFORMATIONREG

16、ARDINGTHEINCLUSIONOFPRODUCTRISKINFORMATIONWITHTHERELAXEDGUIDELINES,DRUGMANUFACTURERSWOULDONLYBEREQUIREDTOMENTIONTHEMOSTCRITICALINFORMATIONBASICALLYTHOSERISKSTHATWOULDBECOMMONFORTHEGENERALPOPULATIONINADDITION,DRUGMANUFACTURERSWEREALSOREQUIREDTOOPENUPTHELINESOFCOMMUNICATIONWITHTHEIRCONSUMERSCONSEQUENT

17、LY,DRUGMANUFACTURERSSTARTEDPROVIDINGCONSUMERSWITHINFORMATIONONREQUESTVIATOLLFREENUMBERS,THEINTERNET,PRINTADVERTISINGANDSIMILARMEANSWILKESETAL,2000BY1999,THEFINALGUIDANCEONDTCADVERTISINGWASISSUEDANDDTCADSHADGONEMAINSTREAMWITHDRUGMANUFACTURERSUSINGABROADSPECTRUMOFPROMOTIONALDEVICESFORPRESCRIPTIONDRUGS

18、INCLUDINGTHEBACKOFATMRECEIPTS,BANKSTATEMENTS,ANDAIRLINELUGGAGELABELSREASTETAL,2004THEDEBATEOVERDTCADVERTISINGWHILETHEPHARMACEUTICALINDUSTRYWASONCEENVELOPEDINASHROUDOFMYSTERY,CONSUMERSNOWHAVEMOREINFORMATIONATTHEIRDISPOSALTHANEVERBEFOREONTHESURFACEITAPPEARSTHATCONSUMERSMIGHTAPPRECIATETHEOPPORTUNITYTOB

19、ECOMEMOREINVOLVEDINTHEIRMEDICALCAREANDITALSOSEEMSAPPARENTTHATDRUGMANUFACTURERSSHOULDBENEFITFROMTHEPROVISIONOFINFORMATIONINTHEFORMOFDTCADSHOWEVER,THEREHAVEBEENGROWINGCONCERNSABOUTTHENECESSITYOFDTCADSANDTHEIRTRUEBENEFITS“PROPONENTSANDOPPONENTSOFDIRECTTOCONSUMERADVERTISINGHAVEESTABLISHEDTHEIRRHETORICAN

20、DHAVESTAKEDOUTTHEIRPOSITIONS”DUKESETAL,2001,P2WHILEMANYARGUMENTSHAVEBEENADVANCEDREGARDINGTHELEGITIMACYOFDTCADVERTISING,THECENTRALQUESTIONREVOLVESAROUNDWHETHERORNOTDTCADVERTISINGISTRULYBENEFICIALTOCONSUMERSANDIFSO,HOWDRUGINDUSTRYADVOCATESPOINTTOTHE“EDUCATIONAL”VALUEOFADVERTISINGDIRECTLYTOCONSUMERSAND

21、ASSERTTHATCONSUMERSARENOWABLETOMANAGETHEIRHEALTHISSUESMOREEFFECTIVELYBECAUSEOFTHEINFORMATIONTHEYGARNERFROMDTCADSSUPPORTERSALSOPOINTTOTHECRITICALITYOFTIME,NOTINGTHATTHEREHASTRADITIONALLYBEENATIMELAGINTHECOMMUNICATIONBETWEENPHARMACEUTICALCOMPANIESANDDOCTORS/PATIENTSTHATDOCTORSWOULDOFTENHEARABOUTMEDICA

22、LADVANCESANDNEWMEDICINESWELLAFTERTHEINFORMATIONWASNEEDEDSUPPORTERSASSERTTHATDTCADVERTISINGBRIDGESTHISINFORMATIONGAPBYINFORMINGCONSUMERSANDPHYSICIANSABOUTNEWANDPROMISINGADVANCESINTHEMEDICALFIELDTOTREATPARTICULARCONDITIONSCALFEE,2002OPPONENTSOFDTCADVERTISINGDISAGREEWITHTHESEASSERTIONSANDCHARGETHATFDAS

23、DECISIONTOALLOWDTCADVERTISINGOFPRESCRIPTIONDRUGSHASCREATEDORWILLCREATENUMEROUSPROBLEMSELLIOTT,2002SOMELAMENTTHECHANGINGDOCTORPATIENTRELATIONSHIP,WHILEOTHERSDECRYTHEVIEWINGOFPATIENTSASCONSUMERSREASTETAL,2004THESEDETRACTORSARGUETHATDTCADSMIGHTCREATEAFALSESENSEOFEMPOWERMENTFORTHEAVERAGECONSUMERWHODOESN

24、OTHAVETHEABILITYORBACKGROUNDTOEFFECTIVELYEVALUATETHECLAIMSASSOCIATEDWITHTHEADVERTISEDDRUGWILKESETAL,2000FORTHESECONSUMERS,THECOMPLEXITYOFINFORMATIONPRESENTEDINDTCADVERTISEMENTSMAYPROVETOBETOODIFFICULTTOUNDERSTANDANDINTERPRETOPPONENTSALSOCONTENDTHATDTCADVERTISINGMIGHTRESULTINSELFDIAGNOSISOF“ASSUMED”M

25、EDICALCONDITIONSBYTHECONSUMERS,LEADINGTOUNNECESSARYANDPERHAPSEVENDANGEROUSUSESOFPRESCRIPTIONDRUGSCHANDRAANDHOLT,1999OPPONENTSAREALSOSKEPTICALABOUTTHEINCREMENTALVALUEOFINFORMATIONPROVIDEDABOUTNEWDRUGSCITINGDATAFROMNUMEROUSSTUDIES,LEXCHINANDMINTZES2002,P194NOTETHATAVERYSMALLPERCENTAGEOFNEWMEDICATIONSA

26、RETRULYBREAKTHROUGHADVANCESTHATPROVIDE“SUBSTANTIALIMPROVEMENTSOVEREXISTINGTHERAPIES”INFACT,THEYCLAIMTHATDRUGCOMPANIESAREMOTIVATEDMOREBYPROFITSTHANTHEYAREBYINFORMINGCONSUMERSABOUTBETTERORSAFERDRUGSTHATOFFERSIGNIFICANTADVANCESOVEREXISTINGTREATMENTSITHASALSOBEENSUGGESTEDTHATTHEDRIVETOINCREASEPROFITSCOU

27、LDEVENTUALLYBECOMEADETRIMENTTODRUGMANUFACTURERSOPPONENTSBELIEVETHATDTCADVERTISINGHASLITTLEEDUCATIONALMERITANDTHATMOSTPRESCRIPTIONDRUGADVERTISINGONLYSERVESTOMEETTHEFINANCIALMOTIVESOFDRUGMANUFACTURERSSOMEFEELTHATDTCADVERTISINGMIGHTEVENTUALLYINCREASETHECOSTSOFPRESCRIPTIONMEDICATIONASCONSUMERS“DEMAND”BR

28、ANDEDDRUGSTOTREATTHEIRMEDICALCONDITIONSANDABANDONTHELESSEXPENSIVE,GENERICVERSIONSOFTHEDRUGSTHATMIGHTBEEQUALLYEFFECTIVEOVERALL,DTCADVERTISINGOFFERSSEVERALFRUITFULAVENUESFORCONTINUINGRESEARCHFROMACONSUMERCONTEXT,ITISIMPORTANTTHATRESEARCHERSEMPIRICALLYASSESSTHEIMPACTOFDTCADVERTISINGONCONSUMERDECISIONMA

29、KINGREGARDINGMEDICALTREATMENTTHISEXPLORATIONSHOULDFOCUSONCONSUMERSACQUISITIONOFPRODUCTKNOWLEDGE,THEFORMATIONOFCONSUMERATTITUDESTOWARDSINDIVIDUALBRANDSAND/ORCLASSESOFPRESCRIPTIONMEDICATIONANDTHEBEHAVIORALOUTCOMEAFTEREXPOSURETODTCADSFOREXAMPLE,ITWOULDBEINSTRUCTIVETOEVALUATEWHETHERDTCADVERTISINGHASCHAN

30、GEDTHEMANNERINWHICHCONSUMERSACQUIRE,VIEWANDUTILIZEMEDICALINFORMATIONIFCONSUMERSHAVEBECOMEMOREATTENTIVETOTHEIROWNMEDICALNEEDSANDHAVETAKENSTEPSTODISCUSSTHEIRMEDICALQUESTIONSWITHAMEDICALPRACTITIONER,THENDTCADSWOULDFOSTERPOSITIVEBEHAVIORCHANGEHOWEVER,IFCONSUMERSRESORTTO“SELFDIAGNOSIS”AFTEREXPOSURETODTCA

31、DS,HAVEPRESSUREDTHEIRPHYSICIANSTOPROVIDEUNNECESSARYPRESCRIPTIONS,ORHAVERESISTEDCOMPETENTMEDICALADVICE,THENDTCADSWOULDBECONTRIBUTINGTONEGATIVEANDPOTENTIALLYDANGEROUSBEHAVIORCHANGESTHEORETICALFOUNDATIONSATTITUDEBEHAVIORRESEARCHGENERALLY,ADVERTISERSHAVEASSUMEDTHATCONSUMERSATTITUDESTOWARDSABRANDDIRECTLY

32、AFFECTTHECHOICEOFTHATPARTICULARBRANDWHILEITISNOTPOSSIBLETOREVIEWTHEVASTDOMAINOFATTITUDERESEARCHINTHISPAPER,THEEARLIERFOUNDATIONALTHEORIESINATTITUDERESEARCHWOULDLEADONETOASSUMETHATCONSUMERSBEHAVIORALINTENTIONSCOULDBEREFLECTIVEOFTHEIRATTITUDESTOWARDSADVERTISING,ASWELLASATTITUDESTOWARDSACERTAINBRANDEDP

33、RODUCTINOTHERWORDS,ITCOULDBEARGUEDTHATIFCONSUMERSHAVEPOSITIVEATTITUDESTOWARDSDTCADVERTISING,THEYAREMORELIKELYTOADOPTTHESPECIFICADVERTISEDBRANDANDVICEVERSAAJZENANDFISHBEIN,1977MORERECENTRESEARCHHASSHOWNTHATATTITUDETOWARDSANADORABRANDMAYNOTALWAYSBEINDICATIVEOFACONSUMERSFINALCHOICEINDECISIONMAKINGINFAC

34、T,INSOMECASESCONSUMERSINTENTIONSANDFINALBRANDCHOICEMAYNOTNECESSARILYBERELATEDATALLBIEHALETAL,1992RESEARCHALSOSUGGESTSTHATTHERELATIONSHIPBETWEENCONSUMERATTITUDESANDBEHAVIORALINTENTIONSMIGHTBEMORECOMPLEXTHANORIGINALLYBELIEVEDBIEHALETAL,1992BURTONANDLICHTENSTEIN,1988ASSUCH,CONSUMERSMAYDEVELOPAPREFERENC

35、EFORAPARTICULARBRANDORPRODUCTEVENWHENTHEYDONOTHAVEVERYFAVORABLEATTITUDESTOWARDSTHEADVERTISEMENTSFORTHESEPRODUCTSPARTICULARLYINSITUATIONSWHERECONSUMERSPERCEIVEGREATERRISKLEVELSBIEHALETAL,1992VARIOUSSTUDIESPOINTTOCONSUMERSLACKOFFAITHINDRUGMANUFACTURERSANDTHEIRPERCEPTIONSREGARDINGPRESCRIPTIONDRUGSASBEL

36、ONGINGTOARISKLADENPRODUCTCATEGORYARECENTSURVEYINDICATED57PERCENTOFAMERICANSDONOTTRUSTCORPORATEEXECUTIVESTOGIVETHEMHONESTINFORMATION,WITHANOVERWHELMINGNUMBEROFRESPONDENTSEXPRESSINGNEGATIVEVIEWSABOUTDRUGMANUFACTURERSINPARTICULARSCHROFF,2003ADDITIONALLY,AHARRISPOLLREPORTEDTHATTHENUMBEROFRESPONDENTSWHOF

37、ELTTHATDRUGMANUFACTURERSDOAGOODJOBOFSERVINGCONSUMERSDROPPEDBY20PERCENTBETWEEN1997TO2002THESESTATISTICSSUGGESTTHATCONSUMERSMAYNOTBEASRECEPTIVETODTCADVERTISINGASDRUGMANUFACTURERSWOULDLIKEANDASCONSUMERADVOCATESFEARTHEREFORE,ITSEEMSTHATWHILECONSUMERSMAYHAVENEGATIVEPERCEPTIONSOFDTCADVERTISINGAND/ORDRUGMA

38、NUFACTURERS,THEYARESTILLWILLINGTOINQUIREABOUTANDREQUESTSPECIFICBRANDEDDRUGSTHATTHEYHAVECOMETOKNOWABOUTASARESULTOFDTCADVERTISING出处TANUJASINGHANDDONNAVIEVESMITHDIRECTTOCONSUMERPRESCRIPTIONDRUGADVERTISINGJJOURNALOFCONSUMERMARKETING,VOLUME22,NOVEMBER7,2005,PP369378标题直接面向消费者的处方药广告一项消费者态度和行为意图的研究译文介绍为了提高处

39、方药物治疗知名度，2001年药品生产企业耗资157亿在促销上，其中25亿美元到大众传媒广告。处方药广告,通常被称为直接面向消费者的DTC广告,自1997年以来以百分之十三至二十的年利率增长着。迄今为止，还混合发现对于整体财务影响的DTC广告的制药企业。有一些证据显示在大众媒体广告和药品生产企业收益之间直接呈正相关关系FINDLAY,2002ANDERSON,2003，广告支出和特效品牌的成功之间的关系还不清楚。显然,药品生产企业在DTC广告上有很大信心，他们用影响消费者决定的效果来采用广告品牌,但确切性质的影响仍存有争议。然而,近期一项研究报告显示DTC广告每增长10，药品销量就会增加1KAI

40、SERFAMILYFOUNDATION,2003，也有证据表明DTC广告经常为扩大一个特定类药物的市场大小而服务，但不一定是为了某个品牌的市场份额KRISANITS,2003。研究人员有从不同角度来观察DTC广告。有一些主要集中在已经为DTC广告做好准备的政府裁决上DUKESETAL,2001和判例法处理药物制造商的责任来警告消费者关于处方药的副作用。其他研究人员最近把DTC广告的功效作为一个教育工具。虽然有些人声称现在有“微小的理由对于直通消费者广告处方药来说”LEXCHINANDMINTZES,2002,P194，另一些人建议DTC广告效益不仅与医疗组织有关,也与医师和患者有关CALFEE

41、,2002。研究者WILKESETAL,2000也调查了消费者对于DTC广告的态度和消费者已经回应DTC广告的行动。然而,研究还没有探讨消费者的自我认知或者对他们和他们的主要医师可能影响他们决定对DTC广告药品做的之间关系的认知。进一步的,而所有这些研究已证实,DTC广告是一个热门的质的进一步调查的话题，现在还没有任何在个人和关系变量之间有可能在医疗决策过程中影响消费者行为意向的研究。此外,研究人员还没有确定这些行为意向是否可能会伤害到医患关系。到目前为止,行业提倡者和国家政策拥护者之间的辩论通常是怀有敌意的，就DTC广告而言。工业倡导者显然认为DTC广告有许多优点。他们认为它主要是一个教育工

42、具对消费者而言。相反地,国家政策拥护者指向此类广告的内在危险，而且建议这样的广告知识太少的影响,事实上可能会给消费者。本研究的目的在提供一些消费者思维的见解和决策的过程，当他们在当前市场回应DTC广告时。值得一提的是,该研究试图回答下列问题消费者通常怎么看待DTC广告DTC广告有导致消费者参与特殊行为或行为意向吗例如，问初级护理医师更多的关于他们已经接触过的的药品的信息或者要求医师开一个特定广告药品DTC广告授权消费者，要是如果这样的话，这种感知授权是什么结果背景直接面向消费者广告的历史尽管它的起源在十六世纪,直接销售医药产品给消费者是较为近期的现象DUKESETAL,2001。在20世纪80

43、年代以前，处方药品生产企业主要把品牌药品销售给医生来避免干扰复杂而且通常微妙的存在在医生和患者之间的关系DUKESETAL,2001AUSNESS,2002。从1983年到1985年,FDA要求那些缺乏先前法院裁决有关问题的DTC广告注释的自愿中止。这项禁令是在1985年提起来的而且法院达成了一项协议，就是DTC广告药受到相同的曾指导医师的医药药品广告的规则。消费者通过“充分披露”受到保护而且药品制造商将会被要求提供一个“小结”形式的产品包装说明书。由于行业压力,在相当大争论和审议后，FDA放松了1997年的法规而且第一次制造商被允许提供药品的品名和与它使用有关的状况。与此同时,FDA缓和了关

44、于担心产品的风险信息的指导方针。通过轻松的指导方针，药品生产企业只会被要求提到最关键的信息基本来说,那对于一般人群将会是普遍的风险。另外,药品生产企业也需要打开和他们的消费者通讯的路线。因此,药品生产企业应要开始为消费者提供信息通过免费电话,互联网,印刷品广告和类似的方式WILKESETAL,2000。到1999年,DTC广告的最终指导方针发行了，而且DTC广告已经成为药品制造商的主流通过使用处方药促销设备的广谱，包括ATM收据的背面，银行对帐单和航空公司的行李标签REASTETAL,2004。DTC广告的争论制药行业曾经被裹上一层神秘色彩,消费者现在在处理上有比以往任何时候都多的信息。表面上

45、看来,消费者会很希望有机会更加积极的参与到他们的医疗保健，而且似乎也明显,药品生产企业应该受益于DTC广告形式的条款。但是,已有越来越担心DTC广告的必要性和他们真正的好处。“直接面向消费者广告的支持者和反对者已经建立了他们的说辞而且表明了他们的立场”DUKESETAL,2001,P2。虽然许多关于DTC广告合法性的争论被升级了，但是要解决的主要问题是围绕DTC广告真正有利于消费者，如果真是这样的话那该怎么做医药行业倡导指出广告的“教育”价值是直接面向消费者的饿，而且声称消费者现在能够更有效地管理自己的健康问题由于他们从DTC广告中所获得的信息。支持者们还指出临界的时候,要注意在制药公司和医生

46、或患者之间的交流方面通常有时间滞差；医生往往在信息需要后经常会听到关于药医学的进步和新的药品。支持者声称DTC广告通过有知识的消费者和医师弥补了关于新的有前途的在医药学领域的进展信息差，来对待特殊条件CALFEE,2002。DTC广告的反的反对者不同意这些言论而且声称FDA关于允许处方药DTC广告的决定已经造成或将会造成巨大的问题ELLIOTT,2002。一些人悲叹医患关系的变化,而另一些人谴责患者的观点比如消费者REASTETAL,2004。这些批评者辩称,DTC广告对一般消费者可能会造成一种错误的许可意识，他们没有能力或北京来有效评估与这些广告药品有关的主张WILKESETAL,2000。

47、为这些消费者,复杂的在DTC广告方面的信息发布可能会被证明为太难去理解和翻译出来。反对者也提出,DTC广告可能会导致消费者自我诊断的“假设”的药品情况，导致不必要的甚至危险的处方药的使用CHANDRAANDHOLT,1999。反对者也怀疑新药品信息提供的价值增值。从众多的研究引用数据,LEXCHIN和MINTZES2002,P194注意到一个非常小的新药物的比例是真正突破性的进展，它提供了“实质性的发展在现有的治疗方法上”。事实上,他们声称制药公司在关于更好或更安全的在现有治疗方法上可提供重大进展的药物上有所动机，而这种动机比起被有见识的消费者更加会被利润所激励。还有人暗示增加利润的驱动力对于

48、药品生产企业最终可能成为一种伤害。反对者认为,DTC广告很少有教育的价值而且大多数处方药广告仅仅是满足药品生产企业得财务动机。有些人认为DTC广告最终可能会增加处方药的费用通过消费者“需求”品牌药物来改善他们的医疗条件和便宜,通用版本的但同样有效的药物。总的来说,DTC广告为持续研究提供了几个卓有成效的方法。通过消费者环境，研究人员有经验的评估DTC广告在消费者关于医疗决策上的影响是很重要的。此探究应该集中在消费者的产品知识获得上，消费者对个人品牌和/或处方药类别上的态度的形成上和在DTC广告曝光后的行为结果上。举例来说,评估DTC广告是否已经改变了消费者认知，观点和利用药品信息的习惯将会是有

49、益的。如果消费者已经变得更专注于自己的医疗需求和已经采取措施和医师来讨论他们的医疗问题，然后DTC广告建立积极的行为改变。然而,如果消费者在接触DTC广告后诉诸于“自我诊断”，他们已经给他们的医师施加了压力在不必要的处方上，或者已经反抗足够的医学建议，然胡DTC广告将会有助于消极和潜在性危险行为的改变。理论基础态度行为研究一般来说,广告商会假设消费者对于品牌的态度直接回营销到某个特定品牌的选择。在纸上回顾态度研究的广阔领域是不可能的，在态度研究上的早期基础理论将会让人认为消费者行为意向可能会反射他们在广告上的态度，以及某一产品品牌的态度。换句话说,可能有人会指出如果消费者对DTC广告有积极的态度，他们更有可能采用特定的广告品牌,反之亦然AJZENANDFISHBEIN,1977。更多的近期研究显示，对广告或品牌的态度未必总是表明一个消费者在决策上的最终选择；事实上，在某些情况下,消费者的意图和最终品牌的选择可能并不一定是相关的BIEHALETAL,1992。研究也表明消费者态度和行为意向之间的关系可能比原来相信的更加复杂BIEHALETAL,1992BURTONANDLICHTENSTEIN,1988。就本身而言，消费者可能会显露出一种对特定品牌或产品的偏爱甚至于在他们对那些产品的广告没有非常满意的态度下，尤其是在消费者感到更大风险水平的情况BIE