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Nikhil, my initial impression of a 'QVC' for DTC medical sales is that it would provide little to no benefit and maybe even negative externalities. If I were a regulator, I would be extremely hesitant to allow this. There is robust research that pharmaceutical marketing to *healthcare professionals* altered their prescribing and those practices have now been substantially curtailed. On the other side, pharmaceutical advertising is restricted or banned in many countries because it leads to over-prescription.

Just as QVC causes people to purchase knick-knaks that they don't *really* need, I fear that a similar channel for DTC medical items will also lead to the over-purchase and over-use of items that don't lead to clinically meaningful outcomes.

Overall, I think the 'discovery' problem is more of an 'access' problem (at least in the United States). Individuals and families need more access and time with physicians.

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