Medtronic: Could Direct-to-Consumer Advertising Backfire?

For the past week, there have been reports about Medtronic's direct-to-consumer (DTC) advertising campaign to promote automatic implantable defibrillators, devices costing about $20,000-$30,000 that detect and treat rapid, abnormal heart rhythms that can be potentially fatal in people with abnormal heart function.

The company announced plans to spend $75 million to $100 million to improve sales of implantable defibrillators, which have been hurt by doctors concerned about recalls and by worries about proposed sharp cuts in Medicare reimbursement for the devices.

The campaign will include Medtronic's first large-scale advertising aimed directly at patients. Such ads are common for prescription drugs but have been a rarity in the medical device business.

But could such a DTC campaign backfire? Physicians have typically been the individuals to recommend such expensive, life-saving technology to their patients based on recent studies demonstrating a survival benefit to many patients with significantly compromised heart muscle function. Will doctors become frustrated by every patient with normal heart function or no heart diease at all (and hence are not appropriate candidates) calling their clinic to see if they might be candidates for expensive ICD's or who demand immediate appointments because they might fear "sudden unexpected death?" Are doctors' offices prepared for the emotionally-charged ads of people whose lives have been saved by these devices that then ask: "Are you protected?" (or something like this?). Will doctors feel coerced to act, especially when the implication of not acting might be perceived by their patients as not doing enough to protect them, at all costs? Doctors are not oblivious to these marketing tactics, especially in lieu of the "ask your doctor" pharmaceutical campaigns that have preceeded the medical device industry's proposed campaign.

The indications for appropriate referral for ICD's are complicated. Not all patients need them. But some do. The real question is separating the wheat from the chaff - and no advertising campaign can do this. Such a campaign might raise unnecessary fears in our patient population and subsequently cross an important line that shouldn't be crossed: recommending health care for financial incentive rather than by actual need. Oh sure, it might pay off on the short run (some doctors might enjoy the increased volume of patient visits) and their actions with this ad campaign couched in the "feel good" guise of "saving lives." But it might also alientate the very physicians in whom Medtronic relies to recommend their devices, tacitly implying they are incapable of appropriately recommending such therapy to their patients.

But Medtronic is savvy. No doubt this upcoming campaign has been thoroughly vetted by consumer focus groups. But were doctors part of those focus groups? I doubt it.

--Wes