Opponents of Direct-to-Consumer Drug Ads Cannot Reduce Its Booming

Drug company shelling out for direct-to-consumer marketing continues to skyrocket, even while criticisms against it have soared. Calling to get a moratorium, instead of just restrictions, on such advertising might be in order, state 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 when it comes to its discuss of total marketing spending 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 administration at the University of Pittsburgh Graduate School of Public Health. The U. S. Food and Medication Administration started enabling direct-to-consumer advertising of prescription drugs on television a decade ago. Since that time, spots of Dorothy Hamill and Sally Field peddling Vioxx and Boniva, respectively, cartoon character types illustrating the consequences of the antidepressant Zoloft, and a wide selection of similar promotions have become commonplace on American TV screens and in other press. But so, too, has criticism of the practice. Skeptics say that direct-to-consumer advertising encourages overuse of medicines and drives up drug spending. The controversy reached critical proportions when the arthritis medication Vioxx, probably the most heavily promoted medications ever, was withdrawn from the market in 2004 because of serious cardiovascular risks.”It’s been a decade because the FDA clarified its policy regarding broadcast marketing and unleashed direct-to-consumer marketing on television, which was new,” Donohue said. “We wished to see, in the wake of the Vioxx withdrawal and an elevated focus on the security of medicines and a concentrate on drug costs in light of the implementation of the new Medicare drug advantage, what market and the FDA had been doing regarding advertising.”Because of this evaluation, Donohue and her colleagues looked at 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. Throughout that time, shelling out for direct-to-consumer marketing improved by 330 percent, yet this kind of advertising just made up 14 percent of total marketing 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 drugs, direct-to-consumer marketing starts within about a season of FDA approval and typically prior to the safety profile provides been established,” Donohue said. The most heavily marketed drug in 2005 was that “little purple pill,” Nexium, a proton pump inhibitor heartburn medication, on which AstraZeneca spent $224 million. Next came the sleeping pill Lunesta ($214 million), accompanied by the cholesterol-decreasing 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 crimson blood cellular counts) spent 34 percent, 34 percent and 31 percent of their total advertising budget on direct-to-consumer marketing in 2005, respectively.”In the majority of top-selling classes, in least one medication is advertised to customers and in more than half of the classes multiple drugs are advertising to consumers, so it really does play a major part,” Donohue said. “DTC marketing is used for a little subset of medications, whereas other forms of promotion like ‘detailing’ [person-to-person meetings] and free samples are used by manufacturers for practically all branded products.”The antidepressants known as selective serotonin reuptake inhibitors (SSRIs), such as Celexa, Paxil, Prozac and Zoloft, led the field in promotional spending with more 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 hasn’t kept pace with the quantity of advertising of prescription drugs. The amount of warning letters venturing out to drug companies has reduced markedly [from 142 in 1997 to 21 in 2006], and the amount of FDA staff accountable for ads was relatively flat in recent years, in spite of spending boosts.”It may be that the rules themselves are sufficient, but that enforcement powers are not.”My look at is that the marketing rules that are on the book now are adequate. Prescription medication ads are among the most heavily regulated advertisements if you look at all the consumer products,” Donohue said. “But the enforcement of the rules needs to be there aswell, and resources necessary for reviewing advertisements need to be sufficient.””And drug manufacturers don’t need to have FDA acceptance of advertisements before airing them, so an ad campaign can operate its course prior to the FDA will be able to review the advertisements,” she added. In response to the study, Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America (PhRMA), said in a statement: “DTC advertising has been demonstrated to play a key role in educating and empowering sufferers, improving patient understanding of disease and available treatments, and fostering strong relationships between patients and their health-care providers. Unfortunately, the study released today in the New England Journal of Medicine all but overlooks these important contributions to patient wellness.””Surveys display that DTC marketing brings patients into their doctors’ offices and helps start essential doctor-patient conversations about conditions that might otherwise proceed undiagnosed or untreated. Actually, a national survey by Prevention Magazine found that 29 million individuals talked with their doctor for the very first time about a health condition after viewing a DTC ad. The survey also found that of these patients, the majority of 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 health management plan at the University of Michigan School of Public Health in Ann Arbor, stated: “As the health-care consumerism movement encourages more data on cost and quality, it is increasingly important to consider the source of information.””This research confirms that direct-to-consumer marketing of medications is here to stay and can contribute to the information overload confronted by the normal consumer. Patients, clinicians and payers should interact to implement steps to maximize the positive aspect of DTC advertising —
increased utilization of drugs in those most likely to benefit — while minimizing the safety concerns and unnecessary expenditure of inappropriate use,” this individual said.