Studies show pharmaceutical ads piquing patient interest

Spending on consumer advertising has soared, especially for the newest and most costly drugs.

By Susan J. Landers, amednews staff. Dec. 24/31, 2001.

Washington -- One in eight Americans has asked for and received a specific prescription from their physicians in response to seeing a drug ad on television, according to a survey conducted by the Kaiser Family Foundation.

Nearly one-third of the 1,872 adults queried by the foundation said they had talked to their physicians about a drug they saw advertised, and 44% of those reported receiving a prescription for the medication.

Selected national health expenditures
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Participants viewed ads for three popular drugs on their own televisions and were then asked a series of questions, explained Mollyanne Brodie, PhD, vice president and director of public opinion and media research at Kaiser.

The ads were for the cholesterol-lowering drug Lipitor; Nexium for the relief of heartburn; and Singulair for asthma management.

It's difficult to escape seeing such ads, noted Diane Rowland, ScD, executive vice president of the Kaiser Family Foundation, at a Nov. 29 news briefing on the survey. Ads ranging from birth control products to medications that promise relief from arthritis pain fill the airwaves.

In 1997, the Food and Drug Administration loosened restrictions for drug advertising on television, and the floodgates opened. The amount of all direct-to-consumer advertising totaled about $2.5 billion last year.

While DTC advertising attracts the most controversy, the provision of drug samples to physicians, at a cost of nearly $8 million last year, constitutes an even larger proportion of pharmaceutical company promotional spending, the foundation said.

Consumers are spending about $117 billion per year on prescription drugs, almost triple the amount spent in 1990. The rise is primarily due to the increased use of drugs, coupled with shifts from older, cheaper drugs to newer and more expensive drugs, said Larry Levitt, director of the foundation's Changing Health Care Marketplace Project.

The newer drugs are also the ones being more heavily promoted. For example, Merck & Co. Inc. spent $161 million on ads for Vioxx last year, according to a study by the National Institute for Health Care Management. At the same time, Vioxx sales were a whopping $1.5 billion.

Proponents of the ads say they empower consumers to work with doctors to chart a path toward proper care. Opponents, however, maintain that the ads only confuse consumers and drive up health care costs.

The AMA decided against supporting a prohibition of DTC advertising of prescription drugs at last June's Annual Meeting because such a prohibition could be a possible violation of First Amendment rights. Instead, the AMA is advocating that consumer ads include the phrase, "Your physician may recommend other appropriate treatments."

Physicians would love to have patients discuss medical decisions with them, said Sharon Levine, MD, associate executive director of the Permanente Medical Group, in remarks at the briefing. But the ads often require physicians to spend a lot of time explaining why a drug isn't the right choice for treatment, she said.

Dr. Levine also questioned the value provided by the ads, considering how much expense goes into producing them. "Most of what we are likely to get from the ads is brand-name recognition."

The most expensive brand name drugs, like Vioxx and another anti-arthritic drug, Celebrex, account for 10% of the growth in spending on ads, Dr. Levine said. "But are they better than other drugs?" Motrin, for example, may work as well for most people yet is 60% to 70% cheaper, she noted.

It is questionable how much information consumers actually take away from the ads, according to the survey. About 70% of viewers said they had learned little or nothing about the health condition featured in the ad, and a majority, or 59%, said they knew little or nothing more about the drug after viewing the ads.

But those same viewers did, apparently, pick up some information from the ads, as surveyors found they knew more about a particular medical condition advertised than did others who had not viewed the ads.

While the FDA requires the ads to include information about possible side effects, the survey found that people who had just watched an ad were not always able to remember them although they did recall that the side effects were serious. But nearly half of the viewers remembered that the ads mentioned getting more information from a physician or pharmacist.

ADDITIONAL INFORMATION:

Selected national health expenditures

Annual change in spending for hospital care, physician/clinical service, and drugs. Figures for 1971-1990 are the average annual change over the 10 years.

        Hospital  Doctor  
          care     care     Drugs
        --------  ------   -------
1971-80   13.9%    12.9%     8.1%
1981-90    8.8%    11.9%    13.1%
1991      10.1%    11.0%    11.4%
1992       8.2%     8.4%     7.3%
1993       5.9%     6.1%     6.2%
1994       3.9%     4.6%     6.6%
1995       3.4%     4.8%    11.4%
1996       3.6%     4.0%    10.5%
1997       3.3%     5.1%    11.8%
1998       2.6%     5.5%    13.4%
1999       3.7%     6.0%    16.9%
2000*      6.4%     7.3%    17.4%

* Projected

Source: Prescription Drug Trends -- A Chartbook Update, Kaiser Family Foundation, November

Weblink

Kaiser Family Foundation report, "Understanding the Effects of Direct-to-Consumer Prescription Drug Advertising" (http://www.kff.org/content/2001/3197/)