The Worst Case
I am a big advocate of scenario planning. That is, all drug companies should actively develop possible future scenarios that could affect their marketing. These include variants of restrictions on marketing all the way to a ban on DTC. What would you do if your ability to communicate with doctors and consumers changed? Are you ready to implement new approaches? Have they been developed and tested?
Most companies do not do this. Strategic and scenario planning is really more of a sales projection exercise based on clinical expectations of approved drugs. Risks to success are usually limited to one chart of a massive deck of charts.
What if a “change” election occurs as seems entirely likely? With a likely expansion in Americans covered by health insurance and the resulting costs to do so, what changes might occur to limit cost increases? Hmm, let me think! Drug costs will be a key component. Drug marketing affects cost by emphasizing newer and more expensive drugs. So a scenario that greatly limits drug company marketing is entirely possible.
Free speech issues are going to limit how draconian regulation could be. That does not mean government will not be able to restrict marketing. Courts will allow reasonable regulation to protect public health. A tweak here or there could make it much harder for drug companies to use mass media. Congress could also go after how drugs are detailed.
So what would you do if President Obama ( or McCain) convinced Congress to end mass media for DTC? Have you the ability to quickly shift to other media that have the capacity to explain the pages of required risk and clinical disclosure in a new world of regulation? What if detailers were restricted from calling on doctors and could not give them a nickel in freebees? Great marketing companies will be ready for both expected and unexpected change. Mediocre companies will give lip service to planning for future bad scenarios expecting that their lobbyists will prevent them.
Do I really think mass media is going to end? I would say it is 70% likely it will stay pretty much as is for the next few years. If Obama wins, he may succeed in his goal of greatly expanding medical coverage by the end of his first term. If that happens then I would place the odds of greater restrictive change at 50% or higher. After all, we have only had easy to do mass DTC for 11 years, so going back to pre-1997 is not a stretch in scenario planning. I would hate to see an end to mass media DTC, but thinking that first amendment protection guarantees it long term is a mistake.