Direct-to-Consumer Advertising of Drugs is Expanding Despite Criticism

Drug company spending on direct-to-consumer advertising continues to skyrocket, even as criticisms against this have soared. Calling for a moratorium, instead of just restrictions, on such marketing might be to be able, say the authors of a report in the Aug. 16 issue of the New England Journal of Medication.”Direct-to-consumer marketing spending is increasing with regards to its reveal of total marketing spending budget, but it’s still a smaller share relative to promotion aimed at influencing prescribers,” stated study author Julie M. Donohue, an assistant professor of wellness policy and administration at the University of Pittsburgh Graduate School of Public Health. The U. S. Meals and Medication Administration started allowing direct-to-consumer marketing of prescription drugs on television a decade ago. Since that time, spots of Dorothy Hamill and Sally Field peddling Vioxx and Boniva, respectively, cartoon heroes illustrating the effects of the antidepressant Zoloft, and a wide variety of similar promotions have grown to be commonplace on American Television displays and in other media. But so, as well, has criticism of the practice. Skeptics state that direct-to-consumer advertising encourages overuse of medications and drives up drug spending. The controversy reached critical proportions when the arthritis drug Vioxx, one of the most heavily promoted medications ever, was withdrawn from the market in 2004 because of serious cardiovascular risks.”It has been 10 years because the FDA clarified its plan with respect to broadcast advertising and unleashed direct-to-consumer marketing on television, that was new,” Donohue said. “We wished to observe, in the wake of the Vioxx withdrawal and an elevated focus on the security of drugs and a focus on medication costs in light of the implementation of the brand new Medicare drug advantage, what industry and the FDA had been doing regarding advertising.”For this analysis, Donohue and her co-workers looked at pharmaceutical company spending on direct-to-consumer advertising and advertising to physicians in the last decade. Total pharmaceutical industry shelling out for promotion soared from $11.4 billion in 1996 to almost $30 billion in 2005. Throughout that time, shelling out for direct-to-consumer marketing improved by 330 percent, yet this type of advertising just produced up 14 percent of total promotional expenditures. These mass-media advertising blitzes generally start before a drug’s safety background has been established available on the market, the researchers said.”In most of heavily advertised medicines, direct-to-consumer advertising starts within about a calendar year of FDA authorization and typically prior to the basic safety profile offers been established,” Donohue stated. The many heavily marketed drug in 2005 was that “little purple pill,” Nexium, a proton pump inhibitor heartburn medication, which AstraZeneca spent $224 million. Next arrived the sleeping pill Lunesta ($214 million), followed by the cholesterol-lowering statins Vytorin ($155 million) and Crestor ($144 million), after that Advair, a corticosteroid ($137 million). Viagra was 17th on the list, with $80 million spent in 2005.Eight of the top 10 drug classes when it comes to sales had at least one item that was promoted through DTC advertising. Producers of proton pump inhibitors, statins and erythropoietin medicines (drugs such as for example Procrit, which increase red blood cell counts) spent 34 percent, 34 percent and 31 percent of their total marketing budget on direct-to-consumer marketing in 2005, respectively.”In the majority of top-selling classes, at least one drug is advertised to customers and in more than half of the classes multiple medicines are advertising to customers, so it really does play a major part,” Donohue said. “DTC advertising is used for a small subset of medicines, whereas other kinds of advertising like ‘detailing’ [person-to-person meetings] and totally free samples are utilized by manufacturers for practically all branded items.”The antidepressants referred to as selective serotonin reuptake inhibitors (SSRIs), such as Celexa, Paxil, Prozac and Zoloft, led the field in promotional spending with an increase of than $1 billion spent in 2005. Next were statins ($859 million), after that proton pump inhibitors ($884 million).At the same time, Donohue stated, “The FDA’s monitoring of drug advertising has not kept speed with the quantity of advertising of prescription drugs. The amount of warning letters venturing out to drug companies has decreased markedly [from 142 in 1997 to 21 in 2006], and the amount of FDA staff accountable for ads was relatively flat recently, in spite of spending boosts.”It may be that the rules themselves are sufficient, but that enforcement powers aren’t.”My watch is that the marketing regulations that are on the book at this point are adequate. Prescription drug ads are being among the most heavily regulated advertisements if you look at all other consumer items,” Donohue said. “But the enforcement of the rules must be there as well, and resources necessary for reviewing advertisements have to be adequate.””And drug manufacturers don’t need to have FDA approval of advertisements before airing them, so an advertisement campaign can run its course before the FDA is able to review the advertisements,” she added. In response to the study, Ken Johnson, senior vice president of the Pharmaceutical Study and Manufacturers of America (PhRMA), said in a statement: “DTC advertising has been shown to play an integral role in educating and empowering patients, improving patient knowledge of disease and obtainable treatments, and fostering solid relationships between patients and their health-care providers. Unfortunately, the analysis released today in the brand new England Journal of Medication all but overlooks these important contributions to patient wellness.””Surveys show that DTC advertising brings patients into their doctors’ offices and assists start essential doctor-patient conversations about conditions that may otherwise proceed undiagnosed or untreated. Actually, a national survey by Prevention Magazine found that 29 million individuals talked with their doctor for the first time about a health condition after seeing a DTC ad. The survey also discovered that of these patients, most discuss behavioral and lifestyle changes and over fifty percent receive a recommendation for non-prescription or generic alternatives,” the declaration said. Dr. A. Mark Fendrick, a professor of wellness management policy at the University of Michigan School of Public Health in Ann Arbor, stated: “As the health-treatment consumerism movement encourages more data on cost and quality, it is increasingly important to consider the foundation of information.””This study confirms that direct-to-consumer advertising of drugs is here to stay and can contribute to the information overload confronted by the normal consumer. Patients, clinicians and payers should interact to implement procedures to increase the positive aspect of DTC advertising —
increased use of drugs in those most likely to benefit — while minimizing the safety problems and unnecessary expenditure of inappropriate use,” this individual said.