Drug Companies Triple Money on Direct-to-Consumer Drug Ads
Per Harvard?: Drug Ads Take Increasing--Though Still Small--Share of Pharmaceutical Promotion Budget
[Karl Note: Here is the same story from two different sources. The first listed, from the traditional Harvard Medical source -- puts the emphasis on the "small" percentage of drug company promotional money going for direct-to-consumer ads.
The second article, below, is headlined with the emphasis on the huge increase in direct-to-the-consumer promotion by drug companies. I believe this headline is the more accurate -- and Harvard, as expected, is trying to hide the truth.]
Drug Ads Take Increasing--Though Still Small--Share of Pharmaceutical Promotion BudgetSpending on direct-to-consumer advertising of prescription drugs increased threefold to nearly $2.5 billion a year between 1996 and 2000, a new study led by HSPH researchers has found. Meredith Rosenthal, HSPH assistant professor of health economics and policy in the Department of Health Policy and Management; Arnold Epstein, the John H. Foster professor of health policy and management and head of that department at HSPH; and co-authors from HMS and MIT performed the first analysis of advertising patterns before and after 1997 guidelines from the Food and Drug Administration clarified the requirements for consumer ads. They used information from two companies, Competitive Media Reporting and IMS Health, that collect data on drug sales and advertising. The report appears in the Feb. 14 New England Journal of Medicine.
Pharmaceutical company spending on consumer advertising has risen markedly since 1996, but total promotional spending as a percentage of sales has remained steady. The greatest growth occurred in TV advertising, which increased more than sevenfold. However, consumer ads still account for a small proportion of all drug company spending on drug promotion, rising from 9 percent in 1996 to about 16 percent in 2000. These figures represent 1.2 percent and 2.2 percent, respectively, of total drug sales revenue (see chart). The proportion of drug revenues spent on all promotional efforts remained fairly constant at about 14 to 15 percent over the study period. More than 80 percent of promotional spending goes to personal visits of drug representatives with physicians, free samples, and print ads in medical journals. Unlike advertising to medical professionals, direct-to-consumer advertising is highly concentrated on popular drugs with relatively uncommon and mild side effects. The top 20 drugs accounted for 60 percent of spending in this area. Drugs most heavily promoted to consumers include the anti-inflammatory Vioxx, the antireflux agent Prilosec, the antihistamine Claritin, the antidepressant Paxil, the cholesterol-lowering drug Zocor, and the erectile drug Viagra. Although they document substantial growth in direct-to-consumer advertising, the findings run counter to perceptions that this type of advertising is coming to dominate drug companies' promotional spending. The authors suggest this perception may be a result of the rapid growth and high visibility of TV drug ads. Still uncertain are the public health and economic consequences of consumer drug advertising. "We simply have no evidence yet on the appropriateness of prescribing that results from consumers requesting an advertised drug," said Rosenthal. "Conceivably, advertising could improve health through raising awareness of a treatable condition or have a negative effect if it leads to unnecessary and inappropriate prescribing."
--Briefs by Tom Reynolds |
Drug Companies Triple Money on Direct-to-Consumer Drug Ads
For anyone who watches television or reads magazines, where ads for prescription drugs have become commonplace, the results of a new study will come as no surprise.
Since the mid-1990s, pharmaceutical companies have tripled the amount of money they spend on advertising prescription drugs directly to consumers.
Despite the huge increase, drug companies continue to direct the overwhelming majority of their advertising spending toward physicians, not consumers. And most direct-to-consumer advertising is concentrated on a few medications.
Still, some physicians and health professionals are concerned that advertising drugs and medical tests directly to consumers interferes with the doctor-patient relationship and may raise medical costs by trumpeting expensive new medications.
Spending on prescription drugs is on the rise and is now the fastest growing portion of healthcare spending in the US.
This increase is due no doubt in part to a rise in the number of effective medications, but "there is widespread concern" that part of the increase is due to advertising of drugs that do not provide better care.
Though broadcast advertising of prescription drugs has been legal for years, guidelines released by the Food and Drug Administration (FDA) in 1997 clarified the rules for advertising directly to consumers. According to these guidelines, drug companies can fulfill their obligations for informing consumers about prescription drugs by referring in advertisements to four sources of additional information: their doctor, a toll-free number, a magazine or newspaper ad and a Web site.
From 1996 to 2000, spending on these ads more than tripled, rising from $791 million to nearly $2.5 billion.
There has been a dramatic growth in advertising of prescription drugs. Most advertising dollars are spent on television ads.
The big question, of course, is whether advertising leads to improvements in health or unnecessary spending and inappropriate treatment. Unfortunately, according to the Harvard researcher who did the study, there is no solid evidence on the appropriateness of prescribing that results from consumers requesting an advertised drug.
Despite claims by the pharmaceutical industry that direct-to-consumer advertising is educational, the public is often misinformed about these ads, according to Dr. Sidney M. Wolfe, of the Public Citizen Health Research Group in Washington, DC.
He points out in an accompanying editorial that one study found that a substantial proportion of people mistakenly believe that the FDA reviews all ads before they are released and allows only the safest and most effective drugs to be promoted directly to the public.
Though a ban on direct-to-consumer advertising would be unconstitutional, Wolfe urges the FDA to increase its control over such ads. He points out that FDA actions to enforce advertising rules have decreased as direct-to-consumer pharmaceutical advertising has mushroomed.
The education of patients -- or physicians -- is too important to be left to the pharmaceutical industry," whose primary aim is to promote drugs.
Public Health Service agencies such as the National Institutes of Health and the FDA, along with medical educators in schools and residency programs, 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.
Direct-to-consumer medical advertising is not
limited to pharmaceutical industry.
Two commonly advertised tests are
electron-beam computed tomography (CT) to
screen for undetected coronary artery disease
and low-dose spiral CT to screen for lung
cancer and other malignancies.
For people thinking about paying to have one of these screens, this is not a good way to spend your money."
These tests are perfectly legal, but their benefits for detecting these diseases in low-risk people who have no symptoms have not been proven.
In the meantime, there is a pretty good chance that an abnormal test will be needlessly frightening to you and a negative test will be giving false reassurance.
Doctors do not know what to do with the information these tests provide. This uncertainty is normal, he said, and will be resolved within a few years. In the meantime, there is no reason to throw away your money to enrich entrepreneurs.
What is even more troubling than the unconfirmed accuracy of these tests is that patients must undergo invasive diagnostic procedures to confirm the results. These tests have high false-positive rates, so the results have to be confirmed.
The New England Journal of Medicine February 14, 2002;346:498-505,524-531
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