By Dennis Quick
Senior Staff Writer
Charleston Regional Business Journal

Since 1997, when the Food and Drug Administration eased regulations on prescription drug television and radio advertisements, permitting advertisers to mention the product’s name and the diseases and symptoms it treats, feverish controversy has surrounded the ads.

A major concern of medical and pharmaceutical industry watchdogs is that the influx of drug ads compels consumers to request what they see on television, leading to doctors over-prescribing the medications.

Not so, said David Bradford, a professor in the Medical University of South Carolina’s Center for Health Economic and Policy Studies.

In a study involving televised advertisements for the arthritis pain medications Vioxx and Celebrex, Bradford and three other researchers found that the ads encouraged the patients least likely to suffer from the drugs’ side effects to ask for the medications, while patients most likely to suffer from side effects refrained from requesting the drugs.

Greater exposure to the ads led to better matching between the drugs and the patients who should take them, Bradford explained.

The data

Between 2000 and 2002, Bradford and MUSC colleagues Paul Nietert and Dr. Steven Ornstein and Pennsylvania State University’s Andrew Kleit collected electronic data on 18,235 osteoarthritis patients from 67 medical practices in the nation’s 75 largest media markets. Vioxx and Celebrex were widely advertised in those markets.

In 2001, television advertisements began informing viewers that Vioxx and Celebrex could be harmful to patients with cardiovascular disease.

The researchers determined that those patients with a history of treatment for gastrointestinal problems were “good candidates” for Vioxx or Celebrex, while patients with a history of hypertension or other cardiovascular disorders were “bad candidates.”

Bradford and his colleagues noted the number of visits to the doctor patients made each month, the number of prescriptions written each month and the number of days between the date of diagnosis and the date either drug was prescribed.

They found that the ads encouraged the good candidates to get treatment from the pain medications sooner and the bad candidates to get treatment later, Bradford said.

The researchers compiled their findings in a report, “The Effect of Direct to Consumer Television Advertising on the Timing of Treatment,” presented to the FDA during a November testimony.

In short, the effect is a good one, the researchers maintain.

“The ads create communication between doctors and patients,” Bradford said.

Advertising overdose

In 2001, the Henry J. Kaiser Foundation, an independent health care philanthropic organization based in Menlo Park, Calif., released a report about the effects of prescription-drug advertising.

In response to an ad they saw, nearly one in three adults talked with their doctor about the drug, and one in eight received a prescription.

Also, while many said the drug ads did a good job explaining what the medication does, most of the FDA-required information, including statements about where to find more information, did not register with patients.

Over the years, pharmaceutical companies have reached deeper into their pockets to get the word out about their products. Direct-to-consumer advertising increased from $266 million in 1994 to nearly $2.5 billion in 2000, largely because of growth in television advertising, according to a 2002 article in The New England Journal of Medicine.

The article noted that 40% of doctors think the ads have a positive effect on their patients and practice. Yet 30% say the opposite, while another 30% see no effect at all.

“We’re creating a ‘pill for every ill’ mentality in (our) society,” said Gary Schwitzer, a University of Minnesota journalism professor who plans to launch a U.S. health news Web site in January. “And we’re paying for it. Ads are intended to drive up demand. But alternative options, generic options and true need get lost in the wave of advertising.”

Evening network newscasts on ABC, NBC and CBS have carried as many as 11 drug advertisements within a 30-minute newscast, according to Schwitzer.

Despite the apparent overdose of television drug ads, Bradford thinks the advertisements should be left alone.

“They shouldn’t be regulated,” he said.

Dennis Quick is the senior staff writer for the Business Journal. E-mail him at dquick@charlestonbusiness.com.