Wall Street Journal Continues to Examine Prescription Drug Advertising

The Wall Street Journal today continues to examine issues related to prescription drug advertising, following several articles on the issue yesterday. A brief summary of the paper's two articles on the subject appears below.

• "More Than Ads, Drug Makers Rely on Sales Reps": The number of sales representatives in the drug industry has nearly doubled to 80,000 over the last five years, the Journal reports, and drug companies now spend two-and-a-half times as much on their sales forces -- about $7.2 billion last year -- as they do on direct-to-consumer advertisements. There is "no substitute for salesmen," according to the Journal, particularly when a pharmaceutical company is trying to launch a new drug. According to ImpactRx, a firm that tracks how drug companies promote products to doctors who write the most prescriptions, nine out of 10 physicians decide within six months of a drug's launch whether to incorporate it into their practice. In addition, ImpactRx found that 55% of "high-prescribing primary care doctors" say that drug representatives who visit their offices are their "primary source of information" on new treatments. Only 26% of doctors say they get information on new drugs from medical journals (Hensley, Wall Street Journal, 3/14).
  
• "FDA Inundated Trying to Assess Drug Ad Pitches": Between 1996 and 2001, the number of advertisements submitted annually to the FDA for approval, including television commercials, magazine ads and Internet promotions, increased nearly 35% from 25,236 to more than 34,000, the Journal reports. But FDA records show that over that same period the agency issued fewer citations to drug companies alleging that their ads or marketing materials were "false, misleading or otherwise out of compliance." While the FDA sent 150 such citations between 1996 and 1997, it sent just 71 in 2001. Thomas Abrams, director of the FDA's Division of Drug Marketing Advertising and Communications, said he has "limited resources" to police drug companies -- between 1996 and 2001, Abrams' staff has only increased from 28 to 30 full-time workers. Under these constraints, Abrams said he focuses his regulation efforts on the "ads deemed most critical" -- television commercials and those ads that "make unusual claims or raise a major public health issue." Drug companies say that they are "much more knowledgeable" about FDA rules on advertising today than they were five years ago, and they contend that their ads are "cleaner than before." But the Journal reports that some drug companies "push the limits" of the FDA's rules on advertising "until told to stop." As "slaps on the wrist are about all the FDA ever issues for infractions" to companies that break the rules, critics say the agency is "unwilling to take on the powerful drug industry" (Adams, Wall Street Journal, 3/14).