- Email: [email protected]
Information is a good thing
Clinical Therapeutics/Volume 28, Number 12, 2006
Editorial Comment Information Is a Good Thing As an economist, I was trained to believe that information is a good thing--although some might use the term indoctrinated rather than trained. I also acknowledge that misleading information may be worse than no information. Concerning the value of information in the health care sector, one topic that has gained considerable attention and generated considerable controversy since the early 1990s is direct-to-consumer (DTC) advertising. I understand that any information can be misinterpreted and that some information is simply incorrect, but I cannot help but fall back on the principle that information generally is good--which is not to say that the information itself is good, but that the presence of information is good. The cynic in me observes that it is harder to understand the directions for using the remote control of a VCR (or is that a DVD player?) than to understand the message in DTC advertisements. The realist in me responds that the failure to understand how to use my video equipment means I may not be able to watch a movie, whereas the failure to understand my medicines could result in suboptimal health or even harm. The optimist in me, who still wants to believe that information is good, wonders why we harbor the suspicion that DTC advertising is misleading. Yes, DTC advertising is produced by pharmaceutical companies that have a financial stake in convincing patients to use their drugs, but when did taking medicines become a bad thing? In this issue of Clinical Therapeutics, Bradford et al report that "higher levels of DTC television advertising of statin treatment were significantly associated with improvements in the likelihood of attaining cholesterolmanagement goals for at least some patients." This article can be viewed as an anecdote representing a single case study of the potential value of DTC advertising in improving patient surrogate markers. Even as an anecdote, the article supports the hypothesis that information is good. In fairness to physicians with busy practices, I acknowledge that the information presented through DTC advertising may make their jobs more difficult because they now have to answer more questions from patients. However, as an economist, I would argue that an increase in patients' desire for medical education is a good thing. The problem in this instance lies in the reimbursement structure, which does not provide physicians with appropriate incentives to educate their patients. I also recognize that the matter is not as simple as saying that patients need more education, and health care providers should assist in this process. Information about diseases and medicine is complex, and health care providers have spent many years becoming educated. Therefore, they cannot reasonably be expected to educate their patients in a single office visit. Still, I would argue that information is good, and our health care system could do a better job of bringing education to patients, whether through direct provider-patient contact, medication therapy monitoring and counseling, or patient navigators. Is DTC the answer to providing patient education? Probably not the ideal answer, as true education takes more than 30 seconds. However, if DTC advertising were seen as reinforcing information from providers about the importance of complying with the prescribed therapeutic regimens, then those advertisements could be good for patient health. C. Daniel Mullins, PhD Section Editor
doi:l 0.1016/j.clinthera.2006.12.004 2104
Volume 28 Number 12
Editorial Comment Information Is a Good Thing As an economist, I was trained to believe that information is a good thing--although some might use the term indoctrinated rather than trained. I also acknowledge that misleading information may be worse than no information. Concerning the value of information in the health care sector, one topic that has gained considerable attention and generated considerable controversy since the early 1990s is direct-to-consumer (DTC) advertising. I understand that any information can be misinterpreted and that some information is simply incorrect, but I cannot help but fall back on the principle that information generally is good--which is not to say that the information itself is good, but that the presence of information is good. The cynic in me observes that it is harder to understand the directions for using the remote control of a VCR (or is that a DVD player?) than to understand the message in DTC advertisements. The realist in me responds that the failure to understand how to use my video equipment means I may not be able to watch a movie, whereas the failure to understand my medicines could result in suboptimal health or even harm. The optimist in me, who still wants to believe that information is good, wonders why we harbor the suspicion that DTC advertising is misleading. Yes, DTC advertising is produced by pharmaceutical companies that have a financial stake in convincing patients to use their drugs, but when did taking medicines become a bad thing? In this issue of Clinical Therapeutics, Bradford et al report that "higher levels of DTC television advertising of statin treatment were significantly associated with improvements in the likelihood of attaining cholesterolmanagement goals for at least some patients." This article can be viewed as an anecdote representing a single case study of the potential value of DTC advertising in improving patient surrogate markers. Even as an anecdote, the article supports the hypothesis that information is good. In fairness to physicians with busy practices, I acknowledge that the information presented through DTC advertising may make their jobs more difficult because they now have to answer more questions from patients. However, as an economist, I would argue that an increase in patients' desire for medical education is a good thing. The problem in this instance lies in the reimbursement structure, which does not provide physicians with appropriate incentives to educate their patients. I also recognize that the matter is not as simple as saying that patients need more education, and health care providers should assist in this process. Information about diseases and medicine is complex, and health care providers have spent many years becoming educated. Therefore, they cannot reasonably be expected to educate their patients in a single office visit. Still, I would argue that information is good, and our health care system could do a better job of bringing education to patients, whether through direct provider-patient contact, medication therapy monitoring and counseling, or patient navigators. Is DTC the answer to providing patient education? Probably not the ideal answer, as true education takes more than 30 seconds. However, if DTC advertising were seen as reinforcing information from providers about the importance of complying with the prescribed therapeutic regimens, then those advertisements could be good for patient health. C. Daniel Mullins, PhD Section Editor
doi:l 0.1016/j.clinthera.2006.12.004 2104
Volume 28 Number 12