Amid the ongoing debate over the wisdom of pharmaceutical advertising, a new analysis suggests that doctors agree more often than not to write prescriptions for patients who have seen drug ads. At the same time, however, the analysis also found that only 1 in 10 consumers were moved by such advertising to ask a doctor for a prescription.
The results present a slightly conflicting picture of the extent to which so-called direct-to-consumer advertising poses an unhealthy dilemma, according to the authors of the analysis, published Tuesday in the Journal of Clinical Psychiatry. While the pharmaceutical industry insists its ads educate consumers, doctors argue some ads too often encourage patients to seek medicines unnecessarily.
“I think the data suggests that, if you take a deep dive, we see a mixed bag,” said Sara Becker, an assistant professor of behavioral and social sciences at Brown University, who coauthored the analysis. “Across the board, consumer requests (for prescriptions in response to drug ads) are not happening all that often. But when it does, it raises prescribing volumes.”
The analysis arrives as drug ads — which are only permitted in the United States and New Zealand — come under fire as a means by which the pharmaceutical industry promotes expensive medicines that increase health care costs. Ad spending soared more than 60 percent in the last four years, hitting $5.2 billion last year. The American Medical Association has called for a ban, and one Washington lawmaker wants to eliminate advertising tax breaks for drug makers.
Whether such efforts will prompt any changes is uncertain, but they are being raised partly in response to the increasing cost of prescription medicines, a hot-button issue that has angered many Americans. As a result, the virtues of drug advertising — which has been widely debated on and off for many years — are once again being scrutinized.
The latest analysis does have some limitations, though.
In an effort to capture what the researchers considered real-time activity involving patient requests and physician prescribing, they ignored after-the-fact surveys. Instead, they reviewed studies that tracked interactions between patients and doctors at what they called the point of service. However, they found just four studies to analyze, but these had not uniformly explored the topic in the same way.
For instance, one was a randomized, controlled trial that looked only at the effect of advertising on prescribing antidepressants, and actors were hired to role play. The other three were observational studies, including one that examined prescribing a wider variety of medicines in Canada, where drug advertising is not permitted, although many Canadians may well view ads that can be seen in the US.
[UPDATE: It is also worth noting that those three observational studies did not address the extent to which patients may have actually needed medicines for which they sought prescriptions. Becker called this a “big, unanswered question.”]
“Our review doesn’t necessarily suggest that advertising is horrible or great,” said Becker. “Although we’re moderately confident that this tells us there can be competing effects on the quality of treatment quality — both better patient adherence and overprescribing. It may have helped in some cases, but less so in others. But more research is needed.”