Survey of Consumers Finds DTC Ads Have Mixed Effects

About one in eight Americans has obtained a prescription drug from their doctor in response to a direct-to-consumer advertisement, according to a new survey released yesterday from the Kaiser Family Foundation released yesterday. The survey found that direct-to-consumer (DTC) television ads are successful in conveying the name of a medication and the condition it treats, but consumers are often unclear about potential side effects and where they can get more information about the drug. The use of DTC ads has greatly increased since the FDA issued new regulations in 1997 making it much easier for drug companies to advertise medications on television. Proponents of the ads say they encourage consumers to seek more information about treatments that could help them, while critics say they lead to unnecessary and expensive prescriptions. According to KFF statistics released in a study examining prescription drug trends, the pharmaceutical industry spent $1.57 billion on DTC television ads in 2000, and an additional $898,000 on advertisements in print and other media, compared to an overall total of $266 million in 1994. A study released last week by the National Institute for Health Care Management found the 50 most heavily advertised drugs accounted for 47.8% of the $20.8 billion increase in retail spending on pharmaceuticals from 1999 to 2000.

To gain a sense of how consumers react to these ads, KFF researchers, in coordination with the public opinion company Knowledge Networks, surveyed 2,511 adults in August and September. About 75% of respondents were shown one of three DTC ads for either the cholesterol drug Lipitor, the asthma drug Singulair or the heartburn drug Nexium, and then asked for their views. Thirty percent of all participants said they had talked to their doctor about a drug they saw advertised, and 44% of this group - or a total of one in eight -- said they received a prescription from their physician for this particular medication. Forty percent of people who were shown an ad said they were likely to talk to their doctor about the health condition mentioned in the ad, while 37% said they were likely to discuss the drug mentioned with their physician. People who had or were close to someone who has the condition discussed in the ads were about twice as likely to follow up with a doctor. Speaking at a KFF conference unveiling the study, Christopher Molineaux, vice president for public affairs at the Pharmaceutical Research and Manufacturers of America, said that the survey supports the drug industry's view that DTC ads increase consumer awareness about their health and encourage communication with physicians. "Clearly this study ... confirms [that] not only do direct-to-consumer ads raise awareness of health problems and available treatments, they also prompt individuals to seek additional information about the health condition and ... medicine that's been advertised."

But the survey also found that a majority of people who viewed the DTC ads said they did not know more about either the medication or the condition it treats. In some cases, viewers of the three ads demonstrated greater knowledge about a drug than the non-viewers who were asked about their general perceptions of DTC ads. Seventy-one percent of people who watched the Singulair ad, for instance, correctly said that there are pills that can reduce asthma attacks, compared to only 36% of non-viewers. But 19% of viewers incorrectly said that pills exist for people to take during an asthma attack, compared to only 12% of non-viewers. And while supporters of DTC advertising say it encourages consumers to seek information about a drug from additional sources, only 12% of viewers identified sources mentioned in the ad other than a doctor or pharmacist, such as a toll free number or a Web site, while 40% said they didn't know of any. "Unfortunately ... the survey indicates that a lot of the messages aren't getting across to consumers through the DTC ads, and one of those messages is where to go for more information," Linda Golodner, president of the National Consumers' League, said.

Still, the survey found that viewers were much more likely to say they trusted the information presented in the ads and to say the ads did a good job in detailing a particular drug than the non-viewers. Viewers were also more likely to perceive the side effects of the medications than non-viewers. But according to Dr. Sharon Levine, associate executive director of the Permanente Medical Group, this discrepancy simply indicates that consumers do not retain the information they see in DTC ads. "I think we would all be appalled if our educational institutions produced the kind of results in terms of what people take away from these ads," she said. Levine added that the issue is not whether brand-name drugs marketed through DTC ads are effective, but whether consumers are best served by expensive marketing from drug companies. "Given the cost, particularly of television ads, are we getting value for the dollars we are spending, because [consumers] are paying for this in one way or another," Levine said. As both the use and price of prescription drugs continues to grow, the amount of DTC advertising is likely to increase accordingly. While the debate surrounding the ads will also continue, KFF President Drew Altman says that both consumers and drug companies stand to benefit. "Drug ads may drive up health care costs and drug company profits, but the drugs people get may also make them healthier," he said (John Kastellec, California Healthline, 11/30).