DTC ads in US having huge impact on drug sales

New research indicates that direct-to-consumer (DTC) advertising of prescription drugs via television, magazines and billboards has become one of the hottest revenue producers in the history of mass media in the US and has also given some drugs the kind of instant brand recognition previously reserved for autos, soft drinks and detergents.

The National Institute for Health Care Management, a Washington-based nonprofit research group, says increased sales of the 50 drugs with the largest advertising budgets accounted for 47.8% of the US$20.8-billion increase in retail spending on prescription drugs from 1999 to 2000. Increases in the sales of all other prescription drugs — approximately 9850 of them — accounted for the rest.

The institute says Merck's DTC advertising bill for the COX-2 inhibitor rofecoxib (Vioxx) totalled US$161 million in 2000. This is equal to the amount spent promoting Dell computers.

From 1999 to 2000, sales of rofecoxib quadrupled to US$1.5 billion; sales of omeprazole (Prilosec) jumped by 13% to $4.1 billion, and sales of atorvastatin (Lipitor) rose by 39%.

Since the Food and Drug Administration relaxed its rules on DTC advertising in 1997, it has become difficult to watch even a 30-minute TV program without seeing at least one drug commercial.

Do the ads lead to inappropriate use of some drugs? The institute says this and other questions remain unanswered. Writing in the New England Journal of Medicine (2002;346:524-6), Dr. Sidney Wolfe, director of health research for the consumer agency Public Citizen, argued that federal agencies “must move much more forcefully to replace tainted drug company ‘education’ with scientifically based, useful information that will stimulate better conversations between doctors and patients and lead to true empowerment.”

Christopher Molineaux, vice-president of public affairs for the Pharmaceutical Research and Manufacturers of America, responded that “prescription drug ads prompt people to talk to their doctor about either the health condition the drug is intended to treat, or the specific medication being advertised.”

The American Medical Association doesn't know how DTC advertising affects physician–patient relationships, but has asked the industry to place disclaimers on the ads stating: “Your physician may recommend other appropriate treatments.” — Milan Korcok, Florida

Figure. Photo by: Barbara Sibbald