Do pharmaceutical ads educate patients and improve health -- or merely spur drug sales?
Researchers at the University of Illinois at Chicago's Institute for Health Research and Policy will conduct the first comprehensive study of televised drug commercials using Nielsen Media Research and health care utilization data.
The research is funded by a $3 million, four-year grant from the National Heart, Lung, and Blood Institute.
The U.S. is the only country that allows televised ads for prescription drugs. Direct-to-consumer drug commercials are the fourth most common category of television advertising.
"The increase in the amount of advertising has coincided with huge increases in health care costs," said Sherry Emery, principal investigator of the project at UIC, who notes that advertising has not likely caused the entire rise in health care costs.
"On the one hand, the pharmaceutical industry claims that these advertisements provide a public service by educating consumers and giving people information to take to their doctors that might improve their health and ultimately result in lower health care costs," Emery said. "But there are a lot of economists who would suggest that you don't advertise a product unless you expect to make money from it -- and these ads might be driving excess demand."
Previous research has not demonstrated either effect conclusively, said Emery, a senior research scientist at the UIC institute, perhaps because such studies have focused on single categories of drugs. Several studies have examined the effect of direct-to-consumer advertising on consumers' behavior and health outcomes, but most have used aggregate spending rather than more refined measures of ad exposure.
"It seems reasonable that an advertisement for a cholesterol medication that treats a non-symptomatic condition might be different than an advertisement for an asthma medication, where if you don't adhere to the medication, you may end up in the hospital with a flare-up of your asthma," she said.
Emery and colleagues will use the Nielsen data to examine direct-to-consumer advertising on health care utilization and pharmaceutical sales of eight therapeutic classes of drugs promoted in the top 75 U.S. media markets from 2005-2009. The drugs include those for allergies, asthma, arthritis, depression, erectile dysfunction, hyperlipidemia, sleep disorder, and smoking cessation. Data from millions of patients will be examined for doctor visits, hospitalizations, new prescriptions, and prescription refills. The study will take into account different patient characteristics and regional differences in access to physicians.
The researchers will also evaluate the content of the ads to see how they vary among drug classes -- and whether these differences affect their impact.
There are three types of pharmaceutical ads, which are subject to different levels of regulation by the FDA: product claim ads, which include the drug name, an FDA-approved use, and the most significant risks; reminder ads, which give the name of the drug but not its uses, which do not have to contain risk information; and help-seeking ads, which describe a disease or condition but do not recommend a specific treatment.
"It's conceivable that the different types of advertising are used differently by drug class and that they might affect the way people respond to the advertisement in terms of their health-seeking behavior and their demand for the medication," said Emery.