M e d i c i n e A v e n u e dollar level, it is estimated, in 1999. FDA's new regulation on DTC issued in 1997, which relaxed the brief summary requirement for TY will likely encourage increased spending on DTC. Sizable percentages of DTC funds are gravitating to consumer agencies and their direct-marketing units. The growing market for DTC advertising is an impetus for consumer agencies to acquire medical agencies in order to gain access and expertise in pharmaceutical marketing and advertising. Likewise, medical agency ownership has seen the need for consumer agency association in order to compete for DTC business. Consumer advertising has become a basic element in pharmaceutical promotion in the second half of this decade. All major Rx companies have conducted or are now conducting DTC campaigns. So it is that the pharmaceutical industry and its specialized advertising agencies, which once defined themselves by a marketing style that shunned advertising to the public, have come full circle, and ended in the surprising location of embracing the promotion of branded products to consumers. This does not mean that medical advertising will abandon its professional tone and scientific approach. It does indicate, however, that medical agencies will continue to expand their scope, going beyond healthcare professionals to lay audiences. If anything, the American medical agency in the late 1990's occupies a pivotal position in pharmaceutical marketing which, with the advent of more complex biotech products, requires even more of what Dr. Fishbein was looking for in a medical agency in 1926: "... advertising writers [consulting! vast amounts of controversial medical literature ... sales of commodities on the basis of scientific evidence ... logic that is logical... that will yield the best results for the public good." 76
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