Direct-to-Consumer Drug Sales Continues to Increase Despite Criticisms


Drug company spending on direct-to-consumer marketing continues to skyrocket, even while criticisms against it have soared. Calling meant for a moratorium, instead of just restrictions, on this kind of advertising might be to be able, state the authors of a study in the Aug. 16 issue of the brand new England Journal of Medicine.”Direct-to-consumer advertising spending is increasing when it comes to its share of total marketing budget, but it’s still a smaller share in accordance with promotion aimed at influencing prescribers,” said study author Julie M. Donohue, an assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Wellness. The U. S. Meals and Drug Administration started allowing direct-to-consumer advertising of prescription drugs on television 10 years 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 become commonplace on American Television displays and in other mass media. But so, too, has criticism of the practice. Skeptics state that direct-to-consumer advertising encourages overuse of medications and drives up medication spending. The controversy reached critical proportions when the arthritis drug Vioxx, probably the most heavily promoted medications ever, was withdrawn from the marketplace in 2004 because of serious cardiovascular risks.”It has been 10 years because the FDA clarified its plan with respect to broadcast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 advertising on television, which was new,” Donohue said. “We wanted to discover, 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 new Medicare drug benefit, what market and the FDA were doing with respect to advertising.”Because of this evaluation, Donohue and her co-workers viewed pharmaceutical company shelling out for direct-to-consumer advertising and promotion to physicians over the past decade. Total pharmaceutical industry spending on 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 only made 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.”For the majority of heavily advertised medications, direct-to-consumer advertising starts within about a season of FDA approval and typically well before the protection profile has been established,” Donohue stated. The most heavily marketed medication in 2005 was that “little purple pill,” Nexium, a proton pump inhibitor heartburn medication, which AstraZeneca spent $224 million. Next arrived the sleeping tablet Lunesta ($214 million), followed by the cholesterol-reducing 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 in terms of sales had in least one item that was promoted through DTC marketing. Manufacturers of proton pump inhibitors, statins and erythropoietin medicines (drugs such as Procrit, which increase red blood cell counts) spent 34 percent, 34 percent and 31 percent of their total advertising budget on direct-to-consumer advertising in 2005, respectively.”In nearly all top-selling classes, in least one drug is advertised to consumers and in more than half of the classes multiple medicines are advertising to consumers, so that it really does perform a major role,” Donohue said. “DTC marketing is used for a little subset of medications, whereas other kinds of promotion like ‘detailing’ [person-to-person meetings] and free samples are used by manufacturers for virtually 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), 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 volume of advertising of prescription drugs. The number of warning letters going out to drug businesses has reduced markedly [from 142 in 1997 to 21 in 2006], and the amount of FDA staff responsible for ads was relatively flat recently, in spite of spending improves.”It may be that the guidelines themselves are sufficient, but that enforcement powers are not.”My look at is that the advertising regulations that are on the book now are adequate. Prescription drug ads are being among the most heavily regulated advertisements if you look at all the consumer items,” Donohue said. “But the enforcement of the regulations needs to be there as well, and resources necessary for reviewing advertisements need to be adequate.””And drug manufacturers do not have to have FDA acceptance of advertisements before airing them, so an advertisement campaign can operate its course before the FDA can review the ads,” she added. In response to the study, Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America (PhRMA), stated in a statement: “DTC advertising has been shown to play an integral role in educating and empowering patients, improving patient knowledge of disease and offered treatments, and fostering strong relationships between patients and their health-care providers. Unfortunately, the study published today in the brand new England Journal of Medication all but overlooks these essential 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 study by Prevention Magazine found that 29 million patients talked with their doctor for the first time about a health after viewing a DTC advertisement. The survey also discovered that of these patients, most discuss behavioral and lifestyle changes and over fifty percent get a recommendation for nonprescription or generic alternatives,” the declaration said. Dr. A. Mark Fendrick, a professor of wellness management policy at the University of Michigan College of Public Wellness in Ann Arbor, stated: “As the health-care consumerism movement encourages more data on cost and quality, it really is increasingly important to consider the source of information.””This study confirms that direct-to-consumer marketing of medicines is here now to stay and will contribute to the info overload confronted by the typical consumer. Patients, clinicians and payers should work together to implement procedures to increase the positive aspect of DTC advertising —
increased utilization of drugs in all those most likely to advantage — while minimizing the safety issues and unnecessary expenditure of inappropriate use,” this individual said.