Marketing Tied to Increase
in Prescription Drug Sales
By ROBERT PEAR
WASHINGTON, Sept. 19 — Advertising to consumers has
stimulated a major increase in retail spending on prescription drugs, the
fastest-growing item in the nation's health care budget, a new study says.
The study, issued today, says 25 of the most heavily
advertised drugs accounted for more than 40 percent of the increase in
retail drug spending last year.
For example, it said, sales of Lipitor, a product of
Warner-Lambert (now part of Pfizer), that lowers cholesterol, rose 56
percent, to $2.6 billion last year. Consumer advertising for the drug rose
to $55.4 million, from $7.8 million in 1998.
The study was published by the National Institute for
Health Care Management, a nonprofit, nonpartisan group that conducts
research on health care issues.
Over all, it said, retail spending on prescription
drugs rose to $111.1 billion in 1999, from $93.4 billion the year
earlier. Spending on consumer advertising rose to $1.8 billion in
1999, from $1.3 billion in 1998.
The study suggests that advertisements may be
persuading consumers to push for newer, costlier medicines when less
expensive drugs would work just as well.
Consumer advertising of drug products has exploded
since the Food and Drug Administration relaxed the rules on such marketing
in 1997. Virtually anyone who reads a magazine or watches television sees
drug advertisements, most of them for only a handful of drugs.
"Mass media advertising of prescription medicines
is heavily concentrated among a relatively few drugs, about 50," the
study said. "Sales of these drugs contributed powerfully to the steep
increase in prescription drug spending in 1999."
Steven D. Findlay, the author of the report, said:
"Our analysis suggests that consumer advertising could be responsible
for 10 percent to 25 percent of the recent increase in prescription drug
spending. Other factors include the increase in insurance coverage of
drugs, the aging of the population and the fact that more medicines are
being approved by the Food and Drug Administration."
Jackie Cottrell, a spokeswoman for the Pharmaceutical
Research and Manufacturers of America, said advertising alerted consumers
to new drugs, encouraged people to visit doctors and provided useful
information about conditions that might otherwise go untreated.
"Consumers are getting their health care information from newspapers,
television, the Internet and advertising, not just from their
doctors," she said.
Mr. Findlay, the director of research and policy at the
National Institute for Health Care Management, agreed with all those
points but said, "The advertisements could also be inducing
inappropriate demand for some prescription drugs including anti-arthritic
medicines like Celebrex and Vioxx."
Mary Nell Lehnhard, senior vice president of the Blue
Cross and Blue Shield Association, said she shared this concern.
"Drugs advertised on television are often
high-cost substitutes for other therapies that are just as
effective," Ms. Lehnhard said. "Except in a small number
of people with gastrointestinal bleeding, Celebrex is no more effective
than generic Tylenol or ibuprofen that you can buy at the drug store for
pennies a day to treat arthritis pain."
The study gave these examples of advertising that
appeared to contribute to increased sales:
¶Schering-Plough spent $137 million advertising
various forms of Claritin, an allergies treatment, to consumers last year,
the largest amount spent on any drug. Claritin sales rose 21 percent, to
$2.6 billion in 1999.
¶Bristol-Myers Squibb spent $43 million on consumer
advertising for Glucophage, an oral diabetes drug, in 1999. Sales rose
nearly 50 percent, to $1.2 billion.
¶Sales of Prilosec, a widely used ulcer medication,
rose 24 percent last year, to $3.6 billion. The manufacturer, AstraZeneca,
spent $79.4 million advertising the drug in 1999.
The study said that advertising for allergy drugs
coincided with a significant increase in visits to doctors by people with
allergy symptoms. The number of such visits was relatively stable, at 13
million to 14 million a year from 1990 to 1998, but shot up to 18 million
in 1999, as advertising increased, the report said.
The study did not discuss the accuracy of drug
advertising. But in the last three years, the government has repeatedly
reprimanded drug companies after finding false or misleading claims in TV
commercials and magazine advertisements.
The F.D.A. has admonished companies about commercials
advertising drugs for allergies, asthma, high cholesterol, high blood
pressure, hair loss and sexually transmitted diseases, among others.
In many cases, the government said, the advertisements
violated the Food, Drug and Cosmetic Act because they overstated the
benefits of a particular drug, minimized the risks or falsely suggested
that one drug was superior to another.
The F.D.A. also found that many companies had been
promoting their drugs for uses not approved by the government.
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