Direct-to-Consumer Drug Advertising Expands Despite Criticism

Drug company spending on direct-to-consumer advertising continues to skyrocket, even as criticisms against it have soared. Calling to get a moratorium, rather than just restrictions, on this kind of advertising might be to be able, say the authors of a study in the Aug. 16 problem of the brand new England Journal of Medication.”Direct-to-consumer marketing spending is increasing with regards to its talk about of total marketing budget, but it’s still a smaller share relative to promotion aimed at influencing prescribers,” stated study writer Julie M. Donohue, an assistant professor of health policy and management at the University of Pittsburgh Graduate College of Public Health. The U. S. Meals and Medication Administration started allowing direct-to-consumer marketing of prescription drugs on television 10 years ago. After that, dots of Dorothy Hamill and Sally Field peddling Vioxx and Boniva, respectively, cartoon character types illustrating the consequences of the antidepressant Zoloft, and a wide variety of similar promotions have become commonplace on American Television screens and in other mass media. But so, too, has criticism of the practice. Skeptics say that direct-to-consumer advertising encourages overuse of medications and drives up drug spending. The controversy reached critical proportions when the arthritis drug Vioxx, probably the most heavily promoted medications ever, was withdrawn from the market in 2004 because of serious cardiovascular risks.”It has been a decade because the FDA clarified its policy regarding broadcast marketing and unleashed direct-to-consumer marketing on television, that was new,” Donohue said. “We wished to find, in the wake of the Vioxx withdrawal and an elevated focus on the protection of medicines and a focus on drug costs in light of the implementation of the new Medicare drug benefit, what market and the FDA were doing regarding advertising.”Because of this evaluation, Donohue and her co-workers viewed pharmaceutical company shelling out for direct-to-consumer advertising and advertising to physicians in the last decade. Total pharmaceutical industry spending on promotion soared from $11.4 billion in 1996 to almost $30 billion in 2005. During that time, spending on direct-to-consumer marketing increased by 330 percent, yet this kind of advertising only made up 14 percent of total marketing expenditures. These mass-media advertising blitzes generally start before a drug’s safety background has been established in the marketplace, the researchers said.”In most of heavily advertised medications, direct-to-consumer marketing starts within in regards to a yr of FDA approval and typically prior to the security profile provides been established,” Donohue said. The many heavily marketed drug in 2005 was that “little purple pill,” Nexium, a proton pump inhibitor heartburn drug, which AstraZeneca spent $224 million. Next arrived the sleeping tablet Lunesta ($214 million), followed by the cholesterol-lowering statins Vytorin ($155 million) and Crestor ($144 million), then Advair, a corticosteroid ($137 million). Viagra was 17th on the list, with $80 million spent in 2005.Eight of the very best 10 drug classes when it comes to sales had in least one item that was promoted through DTC marketing. Producers of proton pump inhibitors, statins and erythropoietin medicines (drugs such as Procrit, which increase reddish blood cell counts) spent 34 percent, 34 percent and 31 percent of their total marketing budget on direct-to-consumer advertising in 2005, respectively.”In the majority of top-selling classes, at least one medication is advertised to customers and in more than half of the classes multiple medications are advertising to consumers, so it really does perform a major function,” Donohue said. “DTC marketing is used for a little subset of medicines, whereas other types of advertising like ‘detailing’ [person-to-person meetings] and free samples are used by manufacturers for practically all branded items.”The antidepressants referred to as selective serotonin reuptake inhibitors (SSRIs), which include 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), then proton pump inhibitors ($884 million).At the same time, Donohue stated, “The FDA’s monitoring of drug advertising has not kept pace with the quantity of advertising of prescription medications. The amount of warning letters going out to drug companies has decreased markedly [from 142 in 1997 to 21 in 2006], and the number of FDA staff responsible for advertisements was relatively flat in recent years, regardless of spending raises.”It could be that the rules themselves are sufficient, but that enforcement powers aren’t.”My look at is that the advertising rules that are on the book at this point are adequate. Prescription drug ads are among the most heavily regulated advertisements if you look at all the consumer items,” Donohue said. “However the enforcement of the regulations needs to be there aswell, and resources essential for reviewing advertisements need to be sufficient.””And drug manufacturers don’t need to have FDA approval of advertisements before airing them, so an advertisement campaign can operate its course prior to the FDA can review the advertisements,” she added. In response to the analysis, 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 sufferers, improving patient understanding of disease and available treatments, and fostering solid relationships between individuals and their health-care providers. Unfortunately, the analysis published today in the New England Journal of Medicine all but overlooks these important contributions to patient wellness.””Surveys show that DTC marketing brings patients into their doctors’ offices and helps start important doctor-patient conversations about conditions that may otherwise move undiagnosed or untreated. In fact, a national study by Prevention Magazine discovered that 29 million sufferers talked to their doctor for the first time about a health condition after viewing a DTC advertisement. The survey also discovered that of the patients, most discuss behavioral and lifestyle changes and over fifty percent get a recommendation for nonprescription or generic alternatives,” the declaration said. Dr. A. Tag Fendrick, a professor of wellness management policy at the University of Michigan College of Public Health in Ann Arbor, said: “As the health-care consumerism movement encourages more data on cost and quality, it is increasingly vital that you consider the foundation of information.””This research confirms that direct-to-consumer advertising of drugs is here now to stay and can contribute to the information overload confronted by the typical consumer. Patients, clinicians and payers should interact to implement procedures to increase the positive facet of DTC advertising —
increased usage of drugs in these most likely to benefit — while minimizing the safety worries and unnecessary expense of inappropriate use,” this individual said.

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