When it comes to the lack of trust in healthcare, direct-to-consumer (DTC) advertising receives an unhealthy dose of suspicion.
Critics finger these flashy ads for magnifying benefits and downplaying risks. They claim that the ads create widespread demand for a product that may be appropriate only for specific groups.
And they also point to the role these advertisements play in inflating drug costs in the US, comparing the rate of increase to places like the UK, where DTC is prohibited.
In short, product advertising is very much the domain of corporate reputation officers.
Now a study in the Journal of the American Medical Association (JAMA) confirms what everyone has suspected for years: Patients who ask for drugs are more likely to get them. And people who ask for drugs by name get brand name drugs.
Both positive and negative messages emerged from these findings.
There was good news for people with illnesses that are traditionally under-treated; they were more likely to get treatment than their mum counterparts. But the message that received greater hype was that people could talk their way into a prescription that wouldn't help them.
But an accompanying editorial suggests that there is worse news for the industry.
Its author calls DTC "a haphazard approach to health promotion." He also notes that more than 80% of physicians distrust DTC ads.
Therefore, the underlying message suggests that the greatest fall-off in communication is between doctors and drug companies.
Doctors are supposed to be the gatekeepers to prescription products. But these days, doctors are squeezing more patients into their schedules, with less time to devote to each case. In 2001, the Centers for Disease Control and Prevention found that the average patient visit was only 19 minutes, barely enough time to debate the pros and cons of a particular therapy.
Yet doctors are bombarded with requests for prescriptions. Requests, the JAMA editorial notes, that are based on vague, overly emotional, and unsubstantiated information.
Doctors want greater control, and right now they are potential advocates for the drug companies' critics.
Already the California State Assembly is considering a bill that would drug companies to reimburse the state for marketing costs that raise the price of medications.
The medical community is highly influential, enjoying the highest level of trust in surveys. Doctors are the voices of authority in any campaign. And in these legislative battles, these are the advocates that drug companies want on their side.
To be fair, there is growing consensus that the drug industry needs to self-police its ads.
Drug company executives have pledged to be more candid in communicating the risk-benefit profile of their products. And they've also committed to undertaking more educational, unbranded, disease awareness campaigns.
But none of those efforts matter without the support of doctors. Drug companies must now court physicians who support the positive aspects of DTC marketing and who will speak out in favor of them.
If there are DTC supporters in the medical community - and surely there are - those voices are lost. The critics are far, far louder.