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Direct-to-consumer drug advertising has developed as a cottage industry which has been used to increase prescriptions immensely.
In pharmaceuticals, the patients’ rights movement in the 1970s blended (as an unintended consequence) with the consumers’ rights movement in the 1990s (which required health insurance companies to provide information about benefits and policies) to lead to a cottage industry we now call direct-to-consumer advertising (DTCA). In 1997, FDA liberalized its policies on broadcast advertising by allowing for “adequate provision” of information about drug adverse effects and benefits by referring consumers to another source of information, such as a toll-free telephone number or a website (1).
Since then, spending on DTCA has dramatically increased. “From 1997 through 2016, spending on medical marketing of drugs, disease awareness campaigns, health services, and laboratory testing increased from $17.7 to $29.9 billion. The most rapid increase was in DTCA, which increased from $2.1 billion (11.9%) of total spending in 1997 to $9.6 billion (32.0%) of total spending in 2016. DTC prescription drug advertising increased from $1.3 billion (79,000 ads) to $6 billion (4.6 million ads [including 663,000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies” (2).
DexCom ran an advertisement during the 2023 Super Bowl featuring singer Nick Jonas, while Astellas Pharma aired a disease awareness commercial for women with vasomotor symptoms. Vanda Pharmaceuticals aired an ad for a motion sickness Phase III drug study, while Bristol-Myers Squibb ran a commercial for its plaque psoriasis drug Sotyktu. Pharmaceutical companies wonder if the return on investment is worthwhile compared with other approaches.
But they might be wrong. DTC drug advertising has proven to increase prescriptions immensely. A 2020 study about the 2015 and 2016 Super Bowl examined Bausch Health Companies’ toenail fungus treatment Jublia and tavaborole, a competitor and generic version of Pfizer’s Kerydin. Jublia advertised during Super Bowls XLIX and L in 2015 and 2016. The number of prescriptions per 100,000 Medicare beneficiaries increased by 91% for Jublia, and 275% for tavaborole. An analysis found that without the ad, Jublia scripts would have increased by 40% and tavaborole by only 90% (3).
For DTCA to be effective (from the pharmaceutical industry’s perspective), these ads must expand patients’ knowledge and influence over medical decision making. In Donohue’s study of drug advertising, she emphasizes, “Because of the unique history of prescription drugs and physicians’ important role as intermediaries between drug manufacturers and patients for more than a half century, DTCA represents a challenge to physicians’ roles as agents for their patients” (1).
1. Donohue, J. A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection, 2006, The Milbank Quarterly.
2. Schwartz, L.M. and Woloshin, S. Medical Marketing in the United States, 1997-2016, Special publication, January 2019, JAMA Network.
3. Gray, M.P.; San-Juan-Rodriguez, A; Chen, N. B.; Good, C.; Hernandez, I. Impact of Direct-to-Consumer Drug Advertising during the Super Bowl on Drug Utilization. Res Social Adm Pharm, August 2020, Elsevier.
Mike Hennessy Jr. is the President and CEO of MJH Life Sciences.
Vol. 36, No. 4
When referring to this article, please cite it as M. Hennessey. Who’s Got Game? BioPharm International 2023 36 (4).