Consumer advertising for prescription drugs had a
negligible impact on sales of products studied by Harvard Medical
School researchers -- in a finding that may confound both advertisers
and their opponents.
The study may undercut the arguments of opponents of
such ads, which have been allowed almost nowhere outside the U.S.
Critics say they lead to drug overuse and misuse by impressionable
patients pressing their doctors to prescribe what is seen on TV.
But the study also raises the question of whether the
pharmaceutical industry's $4.8 billion annual spending on such ads is a
waste of shareholders' money.
The U.S. Food and Drug Administration, which loosened
its regulations to widely permit such ads in the 1990s, is under
pressure to tighten its rules and has announced it will study the
issue. Meanwhile, the European Union, which bans consumer ads, is
considering a proposal to loosen its rules. In Canada, where ads are
also banned, a court battle could lead the government to allow them.
Other studies have found that direct-to-consumer
advertising of drugs does raise sales. But the new study will draw some
attention because it is among the first to compare the behavior of
people exposed to drug ads with people who weren't. The results were
published online by the British Medical Journal.
Several industry studies have calculated that for
every dollar spent on a drug ad aimed at consumers, a manufacturer can
expect to recover $2 in sales over the lifetime of a drug.
But those calculations are difficult to do correctly,
said Stephen Soumerai, a Harvard Medical School professor who
co-authored the new study. Just because a drug's sales are increasing
along with its advertising doesn't mean the ads are causing the sales,
Mr. Soumerai said. "They advertise popular drugs. They're going to be
going up, anyway," he said.
To try to correct for that issue, Mr. Soumerai and
colleagues needed to find a control group of patients not exposed to
American drug-company ads. They found one in Canada's French-speaking
province of Quebec -- a group of North Americans who spend less than 5%
of their television-watching time tuned to U.S. channels.
The researchers then compared prescribing behavior in
Quebec with that in Canada's English-speaking provinces -- where
residents are estimated to spend about 30% of their watching time on
The results: during two major ad campaigns -- for Amgen Inc.'s Enbrel arthritis treatment and Schering Plough
Corp.'s antiallergy drug Nasonex -- there was no change in the
difference between per-capita usage in Quebec and English-speaking
parts of Canada. During a third campaign -- for Novartis
AG's Zelnorm, a since-withdrawn treatment for irritable-bowel syndrome
-- usage in English-speaking Canada went up briefly over Quebec but
soon settled back.
"Direct consumer advertising is really a lousy way to
influence prescribing," Mr. Soumerai said. He said the group intended
to expand the results to cover more drugs.
Several advertising executives questioned the validity
of the study. "To conclude that DTC doesn't work based on the U.S.
advertising that spills into Canada is flawed," says Mel Sokotch, a
veteran ad executive who consults for ad firms and pharmaceutical
Sander Flaum, managing partner of Flaum Partners, said
there is ample evidence that DTC prescription-drug ads do work. "Had
anyone ever heard of erectile dysfunction or overactive bladder before
the drugs were advertised?"
Mr. Soumerai said he didn't necessarily disagree.
"Some advertising probably works," he said. But "it was pretty
unimpressive, on the whole, across three drugs."
Write to Keith J. Winstein at firstname.lastname@example.org and Suzanne Vranica at email@example.com
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