Feature Archive

Like a Rocket: 'Direct-to-Consumer' Drug Ad Spending

The Impact of TV Ads

By Sean Martin
WebMD Feature

April 4, 2001 (Washington) -- Drug company spending on direct-to-consumer advertising rocketed 39% last year, and experts predict it's not going to slow down. The trend has doctors and health plans up in arms: They're concerned that the ads encourage consumers to ask for meds they don't really need.

The new advertising tally comes as the FDA indicates that it is reviewing its policies on direct-to-consumer advertising, which has exploded since 1997 legislation prompted the agency to loosen its standards for prescription drug ads that run on television.

According to new data from IMS Health, an independent firm that tracks pharmaceutical sales, direct-to-consumer ad spending totaled $2.5 billion in 2000, besting the $1.8 billion spent in 1999, IMS spokeswoman Kathrina Kulp tells WebMD.

There's been a lot of growth in just a few years. In 1998, IMS had reported that direct advertising spending totaled some $1.3 billion.

Most of the direct-to-consumer dollars go toward TV commercials, but consumers also may encounter ads in magazines, newspapers, on the radio, and even on outside billboards.

Under the new figures, growth in spending on these ads will continue to well exceed the nation's overall growth rate for prescription drug outlays. National drug spending grew nearly 17% in 1999, according to figures released about a month ago from federal health researchers.

Meanwhile, the nation's Blue Cross plans are likely to spend $16-20 billion on drugs this year, the BlueCross BlueShield Association's Senior Vice President Allan Korn, MD, tells WebMD. That's a 17-20% boost over last year. "We don't see that slowing down for several years, if then," he says.

According to 2000 data through last October, IMS said that the most heavily promoted drug was the arthritis drug Vioxx , with $145.8 million in consumer ad spending. It was followed by the popular allergy medication Claritin ($110.8 million), and Prilosec ($101.9 million), which treats ulcers and gastroesophageal reflux disease, or GERD.

Before 1997, FDA policies required that consumer-geared TV drug ads include exhaustive information on side effects. That changed with the enactment of industry-backed legislation to "modernize" the agency. As a result, TV ads must simply include mention of major health risks and suggestions on where consumers can go for additional information.

But is that enough information?

The agency's review, which may be complete by the end of the year, would seek to assess the impact of TV and other direct ads on public health.

Meredith Art, a spokeswoman for the Pharmaceutical Research and Manufacturers of America (PhRMA), the drug industry's trade association, tells WebMD that no changes are needed to the FDA's direct-to-consumer ad policy. "We continue to believe that this advertising empowers patients. It does help solve the problem of underdiagnosis and undertreatment, but still leaves the prescribing power up to the physician."

PhRMA notes that IMS Health research has found, for example, that physician visits by women concerned about osteoporosis doubled in the year after an ad campaign began for a new drug for the disease.

But the ads have troubled many doctors and health plan leaders, who believe it is stimulating inappropriate demand for drugs and damaging the patient-physician relationship.

"What has happened is that drug companies have taken a wonderful medium and brilliantly perverted it," Korn tells WebMD. "I'm in awe of their ability to recognize the power of the medium, that these drugs are perceived by most people to be virtually free. But Claritin, for example, costs a health plan over a $1,000 per person a year to prescribe."

UCLA researcher Michael Wilkes, MD, told WebMD, "I spend two-thirds of the time talking [with patients] about the ads and why they shouldn't pay any attention. That takes away from the time that I have to talk to them about potential preventions," such as diet and exercise.

Wilkes co-authored a Health Affairs piece last year that claimed that the ads "cultivate the belief among the public that there is a pill for every ill and contribute to the medicalization of trivial ailments, leading to an even more 'overmedicated' society."

And Richard Kravitz, MD, director of the University of California Davis Center for Health Services Research in Primary Care, said, "Most ads failed to provide information about how a drug works, its success rate, how long it must be taken, alternative treatments, or helpful lifestyle changes." Kravitz analyzed direct-to-consumer print ads for a study in the December Journal of Family Practice.

"I think that the FDA review is entirely appropriate," Korn tells WebMD. "Health plans originally thought that they could just count on doctors to say 'no' and these drugs would go away. That's not realistic. Talking someone out of something they really want is tough. You can't have the doctor say 'no' every time the patient walks in the door and then expect at the end of the year the patient is going to be satisfied with the care."

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