American Exceptionalism and Direct-to-Consumer Advertising: Structural and Philosophical Impediments to Reform in Europe

Abstract

Despite a recent EC Proposal to relax its prohibition on direct-to-consumer (DTC) advertising of prescription drugs in certain, limited contexts, the prospects for broader reform in Europe on this issue are extremely grim. This essay argues that fundamental structural and philosophical differences in health care administration between the United States and Europe bode ill for the further relaxation of the prohibition in Europe. After exploring the causes and consequences of the emergence of DTC advertising in the United States, the essay examines the likelihood that a similar constellation of factors might align in Europe to produce similar results, concluding that the particular differences between the US and European systems render harmonization on this issue highly unlikely. Nevertheless, drawing on criticisms of the practice of DTC advertising in the United States, the essay notes that Europeans’ emphasis on deference to the expertise of the physician would vitiate some of the problems associated with DTC advertising in the United States.