Direct-To-Consumer Pharmaceutical Services In Dermatology: Ethical Implications

Direct-to-consumer (DTC) teledermatology companies are expanding, offering treatments such as finasteride for conditions like androgenetic alopecia. However, these services present ethical issues, including problems with confirming patient identity, ascertaining medical history, prescribing non-evidence-based therapies, and providing inadequate counseling on medication side effects. There's also a potential for drug-drug interactions and exacerbation of pre-existing conditions due to lack of knowledge of comorbidities. These companies profit from the medications they sell, creating a potential conflict of interest. Despite these issues, DTC services can increase access for underserved populations and provide care with a sense of anonymity. The authors suggest that dermatologists using DTC services should have an existing physician-patient relationship, take an adequate history and examination, and prioritize patient care over profit.