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direct-to-consumer advertising

The paper discusses direct-to-consumer advertsing programmes which have been introduced by several governments in the recent past. A close scrutiny of the pharmaceutical industry has been done to identify the amendments which have been placed about the direct-to-consumer advertsing. The pros and cons of direct-to-consumer advertsing have been explained.

The pharmaceutical industry has encountered a major change in the last one decade. The companies in the industry develop, produce and market the drugs which have been licensed to the general public. Both generic and brand drug products are provided by the companies to ensure the consumers and patients acquire the best treatment possible. The marketing strategies of pharmaceutical products have encountered a major change after the companies sought permission to promote and advertise their products directly in the market. In the previous years drug companies could not directly advertise their products to the people. Various amendments have been created to reduce the regulations in the industry. Prescription-only medicines are products which are used for the treatment of more serious diseases. These drugs have a higher level of toxins when compared to over-the-counter medicines. Many patients do not understand the risks and benefits of these drugs and proper guidance is required when they are being used. Many governments have but in place laws to restrict the marketing and advertising of these drugs to protect the health of the consumers. Even though there are many restrictions about the advertising of prescription drugs, there are certain allowances for use of these advertisements for patients who are seriously ill (Mintzes, 2001).
Many countries especially those located in the European Union, have forbidden the direct advertisements for drugs to the general public. However, in some countries such as United States and the New Zealand the advertisement of drugs is acceptable. The importance of placing the restrictions for advertising the drugs is to ensure the government protects the general public. In such a case the public can access information about drugs by prescription only but not through advertisements. However, the creation of restrictions by the New Zealand government has not solved the problem fully since pharmaceutical companies continue to advertise about their drugs in their efforts to provide medical knowledge to the stakeholders. Drug companies promote their drugs by the use of indirect means in the countries where restrictions are placed on advertising them. This has forced some governments to deregulate the laws and allow direct promotion of the drugs. Amendments to the US laws prohibiting the advertising of drugs has been encouraged to allow direct advertising of drugs relating to AIDS, diabetes and asthma (Mintzes, 2001). In the European Union the use of direct-to-consumer advertising has been prohibited to protect the interest of the citizens. According to Mintzes (2001, para. 7) “Article 88 (1) prohibits advertising of prescription-only medicines to the public. Article 88 (2) prohibits all advertisements mentioning a specified list of serious diseases.”
The pharmaceutical industry
The industry is made up of companies which are involved in researching, developing, manufacture, marketing and the sale of drugs. Byrne and Weeks (2009) found out that $615.1 billions were generated by the industry in year 2008. In United States the amount of revenues generated were $273.9 billion; which represents 44 percent of the international market. A positive growth continues to be experienced in the industry over the years.
Global Pharmaceuticals Market Value: $ Billion 2004-2008
Source: Datamonitor, 2008.
The top ten companies in the industry have dominated the industry and they contribute a large amount of income. The top ten companies in the global pharmaceutical industry include Pfizer (U.S.), Johnson & Johnson (U.S.), GlaxoSmithKline (United Kingdom), Bayer (Germany), Hoffmann-La Roche (Switzerland), Sanofi-Aventis (France), Novartis (Switzerland), AstraZeneca (UK/Sweden), Abbott Laboratories (U.S.), and Merck & Co. There has been an increase in the promotional as well as advertising expenditure in the pharmaceutical industry. The amount spent in research and development in United States has doubled in the last one decade. Expenditure in promotion in the industry has been categorized into three distinct areas: direct-to-consumer advertising (DTC), professional promotion, and free samples.
Source: Donohue, Cevasco and Rosenthal (16 Aug. 2007).
From the above graph direct-to-consumer advertising has become the most dominant promotional strategy in the market. A growth rate of 330 percent was registered from 1996 to 2005, that is, a sales value of $985 million in 1996 was increased to $4,237 million in 2005.
DTC advertising in the pharmaceutical industry is achieved through two means: the use of television and the internet. The use of television has over ruled in the industry and most of the promotional strategies involve the television more than the internet. The industry has experienced a great increase in the promotional expenditures especially after the FDA reduced the regulations concerning promotion of drugs under direct-to-consumer advertising programme in 2007. Before the reduction of the regulations the laws required pharmaceutical companies to provide the brand name, the benefits and the related risks of a particular drug. This regulation made advertisement of drugs ineffective and few companies used DTC advertisement as a major strategy to increase the sales of their drugs (Byrne & Weeks, 2009). After the elimination of the regulations many companies used the strategy to increase the sales of their products. The advertisements provide the consumers with information about the website locations of the companies, contact addresses as well as the phone numbers where more information about drugs traded by particular companies can be obtained. The brand image of the products has been promoted to improve the perception of the customers of certain drugs and companies producing them. The reduction in regulations exempt the pharmaceutical companies from disclosing the risks associated with the drugs being advertised. The companies can reach a large number of customers for the introduction of their products. Minimum regulations have been placed on the promotional strategies in the industry (Spake & Mathew, 2007).
The use of direct-to-consumer advertising programmes has been encouraged as well as criticized by many people. There are several benefits of deregulation the laws concerning direct-to-consumer advertsing. However, many critics have been opposed to the deregulation of the system. Some of the suggested reasons are provided by Spake and Mathew (2007, pg. 26) whereby “several studies have shown that direct-to-consumer advertising commonly contains misleading, inaccurate or unbalanced information.”
Pros of direct-to-consumer advertising concerning pharmaceutical companies advertising to the general public
The use of DTC advertising has been related to reduction in health costs in the long run. The consumers and patients can detect the diseases before they build up to lethal levels. The DTC advertising provides the general public with information about detecting diseases and the application of the available drugs in the market. Consumers can detect the diseases early enough and prevent them. When diseases build up to unmanageable level, it becomes very expensive to control or treat them. The DTC has created this advantage since all people are aware of the signs and symptoms of any disease advertised in the media as well as knowing the best prescription for each disease (Desselle, 2004).
There is increase in awareness about the health issues by the public after the regulations concerning the DTC advertising were established. Many consumers have the knowledge about the treatment methods of the various diseases and ailments that they may be suffering from. The patients have the power to make decisions about which drugs to use to treat specific diseases. Physicians no longer have exclusive control over the type of drugs to be administered to the patients. Knowledge about the appropriate drugs has increased and patients can determine the drugs to use. Dialogue between patients and physicians has been enhanced and freedom of the patients has increased. Few patients feel embarrassed about their conditions since they are aware of the symptoms and the appropriate medications to take. The growth of internet has made global expansion of the pharmaceutical industry since many people can obtain information about the drugs in the market. This has accelerated the growth of the industry in the global markets. Patients and consumers can now make informed decisions since there is adequate information in the market from the television and website advertisements (Spake & Mathew, 2007).
In the United States there has been an exponential growth in the expenditure for DTC advertising for the last few years. Estimates provided by Mintzes (2001) indicate that in 1991 the expenditure on advertising was $55 million while in the year 2000 the expenditure was valued at $2.5 billion. The increasing expenditure has promoted growth in the industry as well as in the entire economy. Many drug manufacturing companies have resorted to using DTC advertisements as a means to achieve better sales in the market. The marketing industry has expanded after the introduction of new range of products to advertise in the market (Mintzes, 2001).
Advertising provides information to the people about the drugs they are using. The current laws prohibit advertising but do not limit access to information about drugs. Many institutions are involved in the provision of drug information to the general public. Reducing the restrictions upon the use of direct-to-consumer advertising will enable the consumers and patients have enough information about the drugs they are using. There is inefficient access to information relating to drugs and allowing advertising of the prescription drugs will provide consumers with more information (Mintzes, 2001).
Patients have become good partners in their medical care issues. They can now seek medical attention about some diseases they were not aware of before. More education has been provided to consumers and patients about their health care issues and they can make better informed decisions. People can seek medical attention to before they build to irreversible or lethal status. This has encouraged many patients to become responsible about their health conditions. Physicians can discuss with their patients about the best options to take about health conditions affecting patients. All these strategies have been achieved by the increased awareness and education about the DTC advertising (Weissman, et al 2004).
            The demand for information by the consumers in the market has enhanced the growth of the DTC advertising programmes. Many people have the desire to make decisions about their health individually and the rise of the DTC advertising has enabled the consumers obtain enough information about the drugs in the market. Knowledge about the existing drugs enables the consumers purchase the appropriate drugs. People can no longer rely entirely on the physicians for information about their health. The patients can acquire knowledge about diseases that they considered not treatable. In the past many people were not aware about the existence of some medical care services and they could suffer from unknown diseases and sometimes death was a common occurrence. The deregulation of the DTC advertising has encouraged the general public to take appropriate measures about the diseases affecting them. Some diseases were considered untreatable and after the spread of information through DTC advertising people have realized the truth about the diseases. New researches are advertised through the media and people can access this information more easily. Many lives have been saved from killer diseases after the introduction of the DTC advertising (Spake & Mathew, 2007).
The DTC advertising encourages consumers and patients comply with the prescriptions required for certain drugs. Since the patients are aware about the required dosage for specific drugs they can use the drugs appropriately. Before the deregulation of the DTC advertising consumers and patients relied entirely on their physicians for advice. In some cases the physicians may not be having adequate information about specific drugs. Patients and physicians can combine their knowledge about the drugs in the market to ensure the proper use of drugs is adhered to. Patients can comply with the directions provided by their physicians since they have reference points to any questions they have about the drugs they are using. There is need to visit the physicians always whenever there is need to seek medical advice (Weissman, et al 2004).
DTC advertising enables patients seek medical attention to some ailments which are under-treated or under-diagnosed. The ads provide information about new diseases and their appropriate treatment. People can seek medical attention to some diseases which were previously unknown to them. The ads about DTC enables the people acquire knowledge about diagnosing diseases before they can build up to alarming levels. Symptoms about the diseases are provided to consumers and they can use the best drugs when need arises (Weissman, et al 2004).
The Pharmaceutical Research and Manufacturers of America (PhRMA) has provided that DTC communication is very essential in the modern society and that the government should support the programme so that the stakeholders can provide accurate information to the patients and consumers. PhRMA is an association that links all pharmaceutical and biotechnology companies and ensures that these companies do not provide misleading information to the public. The members of PhRMA have encouraged patients and consumers to collaborate with their physicians about the provision of genuine information by the DTC advertising companies. DTC advertising has been identified by PhRMA as very important tool in promoting understanding about the drugs in the market (PhRMA Guiding Principles 2005).
DTC ads encourage the patients and consumers to seek professional advice from their physicians when they encounter problems about the use of the drugs being advertised. Many patients who have no idea about the best application of drugs being advertised can consult with their physicians. The pharmaceutical companies have created education centers where the physicians from many regions can learn about the drugs being released into the market. The drug companies have collaborated with many education and research institutions to ensure all professionals are aware about the use of the drugs in the market. Consumers and patients can consult these physicians for any information they feel is important. This collaboration has encouraged many drug companies to provide accessibility to information by the consumers of their products. Campaigns about the promotion of drugs are done at all levels to ensure all stakeholders have the correct information about the drugs in the market (PhRMA Guiding Principles 2005).
Members of PhRMA have established some guiding principles to ensure all DTC communications are valuable and do not provide misleading information to the consumers. The DTC advertising should be designed in a manner that benefits the general public through increased awareness about the diseases that affect patients and consumers, providing educative adverts about the best options of treating specific diseases, motivate the consumers and patients to consult their physicians about their health before using drugs and encouraging dialogue between the patients and their physicians concerning health concerns. The principles were created to ensure that patients receive care about the conditions which were previously under diagnosed, and to encourage them comply with the prescriptions provided for the drugs being advertised (PhRMA Guiding Principles 2005).
PhRMA uses the principles provided by FDA to ensure all members comply with the guidelines concerning DTC ads. FDA provides that all drug companies should provide information which is not misleading and should provide substantial evidence about their claims. These companies should consider the risks and benefits of each drug being advertised and should label the drugs according to the guidelines provided by FDA (PhRMA Guiding Principles 2005).
Another guideline by PhRMA provides that the design for the television and print ads should be done with the objective of educating the consumers about the drugs being advertised. Information about the conditions for which the drugs may be applied should be made available to ensure consumers do not make blind judgments. DTC TV and print adverts about prescription drugs should differentiate such adverts from those for non-prescription products. PhRMA members created this guideline to ensure all consumers get the required information about the drugs in the market and to distinguish drugs which require prescription by a qualified physician and those which do not require such prescription. DTC TV and print adverts should encourage open communication between patients and physicians about the use of drugs. This guideline was established to ensure patients appreciate the benefits of good health while minimizing risks associated with certain drugs that are advertised by the DTC ads (PhRMA Guiding Principles 2005).
The guidelines require that all pharmaceutical companies should educate the health care professionals concerning the new drugs being released into the market before they start the initial DTC advertising campaigns. In addition, the companies ought to inform both the health care professionals and the patients about therapeutic conditions associated with the new medicines before the first DTC advert is released. Appropriate time should be spent in educating the parties about the new drugs in the market. Information about the availability of the new medicines should also be provided. The companies should inform the patients and physicians about the risks and benefits associated with the medicines (PhRMA Guiding Principles 2005).
The DTC advertisements should be discontinued or altered immediately when changes in the existing drugs are made. When risks associated with the drugs are identified the DTC advertising campaigns should be altered to inform the public about the findings. It is a requirement for all drug companies to submit new DTC ads to the FDA before they are released for broadcasting. Other options about the conditions being advertised should be provided. The DTC advertising should include any information such the required diet and lifestyle about the new drugs being advertised. The health conditions for which the medicine is approved should be provided (PhRMA Guiding Principles 2005).
A balanced presentation of both risks and benefits of the DTC ads should be designed. The language used in presenting the risks associated with the medicine should be presented in a clear and understandable manner. The content of the presentation should be straightforward and lead the consumers to the appropriate use of the medicines. The information provided by the ads should ensure a responsible dialogue is created between the patients and their physicians. The DTC ads should consider the seriousness required for each health condition. The adverts should place adequate precautions for each drug being advertised. The age factor should be considered when placing the DTC adverts in the televisions and print media. The different age groups require different information about the drugs they are required to use and the DTC adverts should consider this aspect. The health and disease awareness about the drugs in the market should be created through the DTC ads. All uninsured and underinsured individuals should be provided with adequate information through the DTC ads to ensure they take appropriate decisions (PhRMA Guiding Principles 2005).
To ensure accountability for the guiding principles PhRMA has established internal processes to ensure all companies comply. Publication of the intentions of each company will be made to ensure all people are aware about the level of compliance by each company in the industry. An office of accountability will be established by PhRMA to receive comments from the general public as well as physicians concerning the DTC advertising. All companies that comply with the guidelines will be considered signatory companies and will be appreciated by the PhRMA as well as improving their image in the public. The PhRMA office of accountability has the mandate to provide the signatory companies with comments about compliance with the guidelines. The PhRMA will then release reports about the comments to the public as well as the signatory companies. The FDA will also be provided with a copy of the report by the PhRMA (PhRMA Guiding Principles 2005).
According to Desselle (2004, pg. 5) the DTC advertising must contain
a statement that health professionals can provide additional information about the drug and disease condition, a toll-free number for obtaining the product labeling information by mail, fax, or telephone, a reference to one or more print advertisements or brochures and a Web site address.
The requirements have been put in place to ensure that the patients can access the origin of the information provided to them about the drugs in the market. The spread in the use of internet services has encouraged spread of knowledge about DTC advertising. Even though most of the ads are done through the television and print media, the internet is an up-coming tool in the advertising of drugs and other pharmaceutical products. Some companies create web links where potential consumers can access information about the drugs. Many pharmaceutical companies have been involved in research and development about the best approaches to use to promote their products. Most researches are done to identify the best strategies to market the drugs and reach as many consumers as possible. Research on new drug products has also been on the increase to create more opportunities for the companies in the industry (PhRMA Guiding Principles 2005).
Cons of direct-to-consumer advertising concerning pharmaceutical companies advertising to the general public
The American college of Physicians has suggested that the deregulation in the DTC advertising will upset the relationship between the doctors and patients (Spake & Mathew, 2007). The consumers and patients may demand drugs that might not be appropriate since they have control over the drugs to be administered to them (Huh & Langteau, 2007). The physicians have the pressure to prescribe drugs which accommodate the requests made by their patients. This reduces the freedom of the physicians to practice professionalism in their career. Revealing the truth about the safety of drugs may become challenging since most of the consumers trust the media more than the physicians and will follow the information provided by media even though misleading. To approve the clinical effects of drugs requires the experiments on for detecting diseases which are rare but have significant adverse effects on human beings. This creates a great threat especially where the people have no information about the adverse effects of the drugs. An example of such an incidence is seen in the case of Vioxx (rofecoxib). The drug was promoted heavily in the market but was later found to carry the risks of heart attacks (Spake & Mathew, 2007).
There are higher risks involved with advertising drugs for vulnerable health conditions. Prescription drugs are used in the treatment of serious diseases and when the laws permit the advertising of these drugs there is a high degree of vulnerability to the patients. Patients suffering from terminal diseases are more vulnerable to be exposed to poor medication. Advertising products does not provide equal levels of vulnerability to all customers. Mintzes (2001, para. 9) provides that “someone in pain, who has been diagnosed with debilitating illness, or who is caring for an ill family member is vulnerable in a different way from someone who is going shopping for a new car or a loaf of bread.”
Direct-to-consumer (DTC) advertising does not provide adequate information to the consumers. Making health care decisions by the consumers and the patients requires a lot of information to choose the best option. Manufacturers using DTC advertising aim at making profits and will use any method to capture as many customers as possible. In their efforts to promote their sales they fail to provide the required information about the drugs but instead aim at improving the image of their products in the market (Mintzes, 2001).
Pubic safety is compromised when the direct-to-consumer advertising of drugs is allowed by the government. Consumers are exposed to dangerous drugs when this practice is allowed. Consumers incur a lot of risks when they are allowed to make their own decisions about the drugs to use without the appropriate prescription, for example, “troglitazone (Rezulin) for diabetes and cisapride (Propulsid) for nighttime heartburn in the U.S” (Mintzes, 2001, para. 6). In most cases the new drugs being advertised are more costly than the existing ones even though very new drugs provide advantages compared to the existing drugs (Mintzes, 2001).
The DTC advertising has adverse monetary effects upon the health care system in the United States. The money spent on DTC advertising yields additional costs on the sales of these drugs. Prescription drug sales have caused an increased with the introduction of DTC advertising. The prices for new drugs are very high compared to the prices of generic drugs, for example, Avandia and Actos- used in the treatment of Type 2 Diabetes have higher prices than the indigenous drugs in the market. These drugs were found not to be safer or more effective than the existing drugs despite the high prices provided for them. When some new drugs such as Zyprexa, Seroquel and Risperdal were properly analyzed; they were found less effective compared to older drugs and they were more expensive (Vedantam, 2006). DTC advertising increases the costs of prescribing drugs and the public medical services find it difficult and expensive to provide their services. This creates threat to national health care services since private individuals take better advantage. Universal access to health care becomes unsustainable under the DTC programme. Since access to health care is a fundamental human right, many people are restricted from accessing medical prescription, especially the low income class of citizens. The national health care service providers have received a great blow to their services since they are being overtaken by the DTC advertising companies. The general public has suffered a lot since they are not aware of the best products to use. Access to health care services has become very expensive due to increase in costs of prescription (Mintzes, 2001).
A research conducted by Findlay S. Prescription Drugs and Mass Media Advertising (2001) established that more than 95 percent of direct-to-consumer advertising expenditure was registered for 50 drugs in 2000. The total retail sales value of the 50 drugs was estimated at $41.3 billion. Findlay (2001, pg 20) explained that sales value was almost “one third of total US retail prescription drug spending in 2000; These 50 drugs were responsible for $9.94 billion of the $20.8 billion increase in US retail prescription drug spending from 1999 to 2000, or 47.8% of this increase.”
The activities of DTC advertising have been criticized for promoting medical attention to non-existing problems. The drugs which are heavily advertised relate to long-term impacts on the health of the patients and those under use by a large number of people. These drugs have been criticized for providing solutions to mild medical problems which may not require the use of these drugs. Others are used to change the lifestyle of the people. This creates a major threat to the health of the consumers since they indulge in the use of drugs for conditions which may require normal body processes to cure (Mintzes, 2001).
The European Commission’s Proposals for Legislative Change requires the laws concerning the advertising of drugs amended. The new laws will provide permission to advertise drugs relating to AIDS, diabetes and asthma. The amendments will require all drug manufacturing companies to create self regulatory procedures. The advertisements will then be submitted to the European medicines Evaluation Agency to be screened. The agency has the mandate to maintain a database of the adverts made by the drug manufacturing companies (Mintzes, 2001).
DTC Advertisements about are in most cases inaccurate and misleading. In US the government has enacted laws through US Food and Drug administration to issue regulations about promotion about drugs. Most of the adverts made in the TV violate the regulations set by the federal laws. These companies exaggerate the benefits of the drugs as well as promising the customers to reduce the risks associated with such drugs. There is inadequate evidence to support the claims about the benefits of the drugs advertised in the media (Mintzes, 2001).
Food and Drug Administration (FDA) takes slow to respond to complaints by the consumers in the market about the drugs being sold to them by the manufacturing companies. Regulations by FDA are delayed and this has been a course of the increase in malpractices in the industry. Several complaints have been received by FDA, for example, exaggerated drug effectiveness, claims of risk minimization, and others. These complaints have been solved at a very slow pace and the reliability of the FDA is being questioned. Spake and Mathew (2007, pg. 289) examined that the Government Accountability Office in the United States, in 2006, “criticized the FDA on behalf of U.S. Senators after the time it took to issue a regulatory letter rose from an average of two weeks from 1997 to 2001 to an average of four months from 2002 to 2005.” A reduction in the regulatory letters issued by FDA also decreased from 142 in 1997 to 21 in 2006 (Spake & Mathew, 2007). This is an indication of the declining effectiveness of FDA and many pharmaceutical companies may continue to exploit consumers as well as exposing the patients to more risks. The number of workers employed by FDA to supervise adverts by pharmaceutical companies has been on the decline while, on the other hand, DTC advertising are increasing tremendously. The drug companies must present their adverts to FDA before they distribute the drugs. The understaffing of FDA has created inefficiencies and many companies are corrupting their way out. Many companies continue to issue misleading ads despite the operations of the FDA leading to a great risk to the consumers (Spake & Mathew, 2007).
An analysis done by Donohue, Cevasco and Meredith (2007) indicates that there has been an inverse trend in the number of letters concerning the advertisements for pharmaceutical drugs and the letters related to warnings about the risks associated with such drugs. This has been a major weakness and the drug companies have been criticized for the reduction in efforts to inform the general public about the risks associated with the drugs provided in the market. Drug companies have been identified to promote the sale of their products more than educating the public about the risks associated with such drugs (Donohue, Cevasco and Meredith, 2007).
Direct-to-Consumer Advertising and Promotion to Health Professionals, 1996-2005
Source: Donohue, Cevasco and Meredith, (2007).
The graph indicates that there has been an increase in the direct-to-consumer advertising since 1997; when the DTC advertising was deregulated in the US economy. Many people have received letters related to DTC advertising and the trend has been on the increase after the introduction of the new laws. Contrary to this, the letters related to warnings about the risks of the drugs advertised have reduced since 1997. The trend provided by the graph indicates that at the beginning many companies issued warning letters about the risks and threats of the drugs advertised in the media. As time goes by, the number of letters issued has declined.
The US federal government deregulated the laws concerning the DTC advertising in 1997 and since then an increasing trend has been witnessed in the pharmaceutical industry. New Zealand government among other governments have maintained strict rules about deregulation of the DTC advertising to ensure the companies in the industry do not misuse the laws, thus endangering the general public. The DTC advertising programmes allows companies manufacturing drugs to promote their products to increase their sales. This strategy has been criticized by many stakeholders since it does not provide enough information about drugs to the consumers and the patients. The use of DTC advertising has been associated with the increase in the prices of drugs and the increase in costs of prescription drugs. The drugs have been criticized that they are not effective and that they are not as important as they appear in the adverts. Several countries have placed restrictions to avoid the misuse of the industry by unscrupulous business people who are ready to exploit the consumers and desperate patients. FDA has been criticized for its delay to regulate the advertisements made by the drug companies. The organization has been understaffed and this has created delays in dealing with misleading ads. The consumers continue to be exposed to great danger of making poor decisions about the drugs they use. The reduction in deregulations about the DTC advertising has exposed many people to unnecessary risks. People seek medications for simple ailments which can be left to heal through the natural process. The reduction in regulations about the pharmaceutical drugs has increased knowledge to the patients and consumers and people can make informed decisions about the drugs to use. The patients have more power to decide the kind of drugs to use for specific ailments. PhRMA members have created guidelines to ensure the DTC ads provide accurate information about the drugs being introduced in the market. The organization ensures all consumers and [patients are protected against misleading advertisements about drugs in the market and to create a better system of regulating the companies manufacturing drugs to ensure they provide appropriate information about the drugs. PhRMA has created a set of guidelines that all companies in the pharmaceutical industry must comply with. Companies that comply with the guidelines will be considered signatory companies. The guidelines were created to ensure accountability by all drug companies in the market. Government leaders should realize that a new era has been realized and regulating the pharmaceutical industry will do no good. The companies should be allowed to provide the general public with enough information about the drugs in the market. However, adequate structures should be put in place to ensure the activities of these companies are properly monitored to avoid exploitation of the people and exposure to harmful and risky drugs. The international laws concerning the pharmaceutical companies should be amended to allow the DTC advertising in the global markets.

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