Effects of Direct-to-Consumer Advertising on Medication Choice: the Case of Antidepressants

Effect of Direct-to-Consumer Advertising on Medication Choice: the Case of Antidepressants

Abstract

While direct-to-consumer advertising (DTCA) has generated substantial controversy, little is known about its effects on consumer and physician behavior. This paper examines the impact of DTCA and physician detailing on choice of antidepressant medication. We find that detailing has a much larger effect on medication choice in the antidepressant market than does DTCA.

Key words

Direct-to-consumer, advertising, detailing, antidepressants, pharmaceutical promotion

1. Introduction

Pharmaceutical promotion has traditionally been aimed at physicians, “learned intermediaries,” who are responsible for prescribing medications. From the mid-20th century, when federal regulations began requiring a doctor’s prescription for many pharmaceuticals, to the 1990’s pharmaceutical firms relied primarily on pharmaceutical sales representatives (“detailing”) and advertising in medical journals to promote prescription drugs. Pharmaceutical marketing strategies have become more diversified in recent years. In addition to detailing and medical journal advertising, firms now promote their products to medical professionals through educational events and directly to the public through mass media advertising. Spending on direct-to-consumer advertising (DTCA) increased from $266 million in 1994 to $2.6 billion in 2002, making this form of pharmaceutical marketing the object of substantial controversy. (IMS Health, 2003a). In 1997, a Food and Drug Administration policy change made broadcast advertising of prescription drugs more feasible and may have contributed to the trend in the use of consumer-directed advertising by the pharmaceutical industry. One study of DTCA suggests that it increases demand for prescription drugs, accounting for roughly 12% of the increase in prescription drug sales between 1999 and 2000 (Rosenthal et al 2003).

That DTCA increases prescription...