Background Spending on prescription drugs is the fastest growingcomponent of the health care budget. There is public concernabout the possibility that direct-to-consumer advertising ofprescription drugs will result in inappropriate prescribingand higher costs of care. Guidelines issued in 1997 by the Foodand Drug Administration (FDA) regarding advertising to consumersthrough electronic media are considered by some to be responsiblefor unleashing a flood of direct-to-consumer advertising.
Methods Using data on spending for promotional purposes andsales of prescription drugs, we examined industrywide trendsfor various types of promotion. We also tracked the relationbetween promotional efforts and sales over time. Finally, wedocumented the variation in direct-to-consumer advertising amongand within five therapeutic classes of drugs and compared thevariation in the intensity of such advertising with variationin the intensity of promotion to health care professionals.
Results Annual spending on direct-to-consumer advertising forprescription drugs tripled between 1996 and 2000, when it reachednearly $2.5 billion. Despite this increase, such advertisingaccounts for only 15 percent of the money spent on drug promotionand is highly concentrated on a subgroup of products. Withina therapeutic class, there is marked variation in the intensityof direct-to-consumer advertising, and the amount of such advertisingfor specific products fluctuates over time. The initial surgein direct-to-consumer advertising preceded the 1997 FDA guidelinesthat clarified the rules for electronic direct-to-consumer advertising,and thus the 1997 guidelines may not have been the most importantreason for the overall increase.
Conclusions Although the use of direct-to-consumer advertisinghas grown disproportionately to other forms of promotion, itcontinues to account for a small proportion of total promotionalefforts. Nevertheless, physicians must assist patients in evaluatinghealth-related information obtained through direct advertising.
Source Information
From the Department of Health Policy and Management, Harvard School of Public Health, Boston (M.B.R., A.M.E.); the Sloan School of Management, Massachusetts Institute of Technology, Cambridge (E.R.B.); and the Department of Health Care Policy, Harvard Medical School, Boston (J.M.D., R.G.F.).
Address reprint requests to Dr. Rosenthal at the Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115, or at mrosenth{at}hsph.harvard.edu.
Direct-to-Consumer Marketing
Weinberg S. K., Ackman D., Glied S., Nunes J. P. L., Hurst J. W., Ehrlich J. E., Rumberger J. A., Wasserman A. G., Rosenthal M., Frank R. G., Epstein A. M., Lee T. H., Brennan T. A., Wolfe S. M.
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N Engl J Med 2002;
346:2010-2013, Jun 20, 2002.
Correspondence
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