Increasing of Direct-to-Consumer Drugs Ads Continues Despite Deprecation

Drug company spending on direct-to-consumer marketing continues to skyrocket, even while criticisms against it have soared. Calling for a moratorium, instead of just restrictions, on this kind of advertising might be in order, say the authors of a study in the Aug. 16 issue of the brand new England Journal of Medication.”Direct-to-consumer advertising spending is increasing with regards to its talk about of total marketing budget, but it’s still a smaller sized share relative to promotion targeted at influencing prescribers,” stated study author Julie M. Donohue, an assistant professor of wellness policy and management at the University of Pittsburgh Graduate School of Public Wellness. The U. S. Food and Drug Administration started permitting direct-to-consumer advertising of prescription medications on television a decade ago. Since that time, dots of Dorothy Hamill and Sally Field peddling Vioxx and Boniva, respectively, cartoon personas illustrating the effects of the antidepressant Zoloft, and an array of similar promotions have grown to be commonplace on American TV displays and in other media. But so, too, has criticism of the practice. Skeptics say that direct-to-consumer marketing encourages overuse of medicines and drives up medication spending. The controversy reached critical proportions when the arthritis drug Vioxx, one of the most heavily promoted medications ever, was withdrawn from the market in 2004 due to serious cardiovascular risks.”It’s been a decade since the FDA clarified its plan regarding broadcast marketing and unleashed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 increased focus on the security of drugs and a focus on drug costs in light of the implementation of the new Medicare drug advantage, what industry and the FDA were doing regarding advertising.”For this evaluation, Donohue and her co-workers looked at pharmaceutical company shelling out for direct-to-consumer advertising and advertising 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. During that time, shelling out for direct-to-consumer advertising increased by 330 percent, yet this kind of advertising just produced up 14 percent of total promotional expenditures. These mass-media advertising blitzes generally start before a drug’s safety track record has been established in the marketplace, the researchers said.”For the majority of heavily advertised drugs, direct-to-consumer marketing starts within in regards to a year of FDA approval and typically well before the basic safety profile has been established,” Donohue stated. The the majority of 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 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 top 10 drug classes with regards to sales had at least one item that was promoted through DTC advertising. Manufacturers of proton pump inhibitors, statins and erythropoietin medications (drugs such as for example Procrit, which increase reddish blood cellular 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, in least one drug is advertised to customers and in more than half of the classes multiple drugs are advertising to consumers, so that it really does perform a major function,” Donohue said. “DTC marketing is used for a small subset of drugs, whereas other kinds of promotion like ‘detailing’ [person-to-person meetings] and totally free samples are utilized by manufacturers for practically all branded products.”The antidepressants known 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 volume of advertising of prescription medications. The number of warning letters going out to drug companies has reduced markedly [from 142 in 1997 to 21 in 2006], and the number of FDA staff responsible for ads was relatively flat in recent years, regardless of spending increases.”It could be that the rules themselves are sufficient, but that enforcement powers are not.”My look at is that the advertising regulations that are on the book today are adequate. Prescription drug ads are among the most heavily regulated advertisements if you look at all the consumer items,” Donohue said. “But the enforcement of the rules must be there as well, and resources necessary for reviewing advertisements have to be adequate.””And drug manufacturers don’t need to have FDA authorization of advertisements before airing them, so an advertisement campaign can operate its course prior to the FDA will be able to review the advertisements,” she added. In response to the analysis, Ken Johnson, senior vice president of the Pharmaceutical Analysis and Manufacturers of America (PhRMA), stated in a statement: “DTC advertising has been proven to play an integral role in educating and empowering patients, improving patient understanding of disease and offered treatments, and fostering strong 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 health.””Surveys show that DTC advertising brings patients into their doctors’ offices and helps start essential doctor-patient conversations about conditions that may otherwise go undiagnosed or untreated. In fact, a national study by Prevention Magazine discovered that 29 million patients talked with their doctor for the first time about a health condition after seeing a DTC advertisement. The survey also found that of the patients, the majority of discuss behavioral and changes in lifestyle and over fifty percent get a recommendation for nonprescription or generic alternatives,” the statement said. Dr. A. Tag Fendrick, a professor of health management policy at the University of Michigan School of Public Wellness in Ann Arbor, said: “As the health-care consumerism motion encourages more data on cost and quality, it is increasingly vital that you consider the foundation of information.””This study confirms that direct-to-consumer marketing of medications is here now to stay and can contribute to the info overload confronted by the normal consumer. Patients, clinicians and payers should interact to implement actions to maximize the positive aspect of DTC advertising —
increased use of drugs in those most likely to advantage — while minimizing the safety worries and unnecessary expenditure of inappropriate use,” this individual said.