Since a 1997 regulatory shift on the part of the US Food and Drug Administration (FDA), there has been an explosion of televised direct-to-consumer (DTC) pharmaceutical advertising in the United States. The introduction and growth of this form of advertising, as well as other recent evolutions in the health care arena, have altered relationships among key countervailing powers in the health care system, suggesting the need to recast countervailing powers theory so as to account for these changes. Coming from the perspective that the news media play an important role in reflecting the balance of power among the various countervailing powers, the paper advances this theoretical framework through an empirical assessment of the relative prominence of those entities in print news media coverage of the DTC advertising phenomenon. The study finds that `corporate sellers' (pharmaceutical industry) are accorded more prominence in news coverage than are providers, consumers, corporate purchasers, or state players and that DTC critics, in particular, have minimal representation. In addition, the findings point toward two modifications for countervailing powers theory: (1) an incorporation of the role of academic/research organizations, and (2) a consideration of the universe of possibilities with respect to each of the countervailing powers.
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