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US: U.S. Drug Ads Questioned


Targeting Consumers
Had Little Impact
On Sales of Products


by KEITH J. WINSTEIN and SUZANNE VRANICAThe Wall Street Journal
September 3rd, 2008

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 American channels.

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 companies.

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 keith.winstein@wsj.com and Suzanne Vranica at suzanne.vranica@wsj.com





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