Drug Company Spending on DTC Ads Tripled Between 1996 and 2000, Though Still Far Lower Than Spending on Marketing to Doctors, Study Says

Although pharmaceutical companies spent three times more on direct-to-consumer advertisements in 2000 than in 1996, the Washington Post reports that the amount still "paled in comparison to that spent wooing the doctors," according to a study published in the Feb. 14 New England Journal of Medicine (Connolly, Washington Post, 2/14). In the study, researchers from Harvard University and the Massachusetts Institute of Technology analyzed data on advertising and sales of prescription drugs between 1996 -- the year before the FDA lifted a ban on DTC advertising -- and 2000, collected by the pharmaceutical industry data firm IMS Health, the advertising tracking company Competitive Media Reporting and Scott-Levin, an independent consulting company. The study found that annual spending on DTC advertising for pharmaceuticals increased from $791 million in 1996 to about $2.5 billion in 2000 (Rosenthal et al., NEJM, 2/14). According to the study, spending on television ads, which increased from $220 million in 1996 to $1.6 billion in 2000, represented the "biggest jump" in DTC advertising (Johnson, AP/St. Louis Post-Dispatch, 2/14). In addition, the study found that a "handful of blockbuster drugs" represented the "most heavily advertised" (Washington Post, 2/14). The study found that ads for 20 prescription drugs, led by the arthritis treatment Vioxx, accounted for about 60% of pharmaceutical industry DTC spending in 2000. Drug companies spent $161 million on DTC ads for Vioxx in 2000, $108 million for the ulcer drug Prilosec and $100 million for the allergy treatment Claritin, the study found.

Small Percentage
However, the study found that drug industry spending on DTC ads only accounted for 15% of the total spent on advertising in 2000, up from 9% in 1996. "Although the use of DTC advertising has grown disproportionately to other forms of promotion, it continues to account for a small proportion of total promotional efforts," the researchers wrote (NEJM, 2/14). The study found that drug companies still spent 84% of drug marketing dollars in 2000 to target doctors -- including visits from sales representatives, free samples and medical journal ads -- though this figure represented a decrease from 91% in 1996 ( AP/New York Times, 2/14). According to the study, the finding "reinforces the conventional wisdom that physicians are unlikely to prescribe a drug unless they are familiar with it and comfortable prescribing it" (Washington Post, 2/14). The researchers predicted that DTC advertising would not "replace physician-oriented promotion of prescription drugs" but would "continue at current or higher levels" in the future. They added that DTC advertising may lead to "improved diagnosis, better matching of therapy to the needs and preferences of patients and possible enhanced compliance." However, they warned that the ads could prompt "inappropriate prescribing driven by the demands of misinformed patients and time wasted by physicians in explaining why a particular therapy or product is not appropriate." The researchers concluded that "physicians must assist patients in evaluating health-related information obtained through direct advertising (NEJM, 2/14). A copy of the study, which was funded by the Kaiser Family Foundation and is titled "Promotion of Prescription Drugs to Consumers" is available online with other resources. In addition, AdWatch has information on direct-to-consumer drug advertising online.

'Emotionally Charged' Debate
DTC advertising has become an "emotionally charged issue" in the past few years "as aging baby boomers grapple with rising medical bills and a plethora of new medications," the Post reports (Washington Post, 2/14). Although the pharmaceutical industry says that DTC ads "inform and empower consumers," some opponents warn that the ads "encourage use of expensive, sometimes unnecessary medicines" and "undermine the doctor-patient relationship." The American Medical Association has said that physicians "should not be biased" against pharmaceuticals advertised to patients but "neither should they cave to pressure" and prescribe treatments "just because a patient asks for the drug by name." According to the AMA, "Physicians should deny requests for inappropriate prescriptions and educate patients as to why certain advertised drugs may not be suitable treatment options" (AP/St. Louis Post-Dispatch, 2/14).