Impact of oncology‐related direct‐to‐consumer advertising

Abstract

BACKGROUND:Little is known about the impact of direct-to-consumer advertising (DTCA) on appropriate versus inappropriate prescribing. Aromatase inhibitor (AI) therapy for breast cancer provides an ideal paradigm for studying this issue, because AIs have been the focus of substantial DTCA, and because they should only be used in postmenopausal women, age can serve as a simple surrogate marker of appropriateness. METHODS: Data regarding national DTCA spending for the AIs were obtained from TNS Multimedia; hormonal therapy prescription data were obtained from IMS Health. Time series analyses were performed to characterize the association between monthly changes in DTCA spending for the AIs and monthly changes in the proportion of all new hormonal therapy prescriptions represented by the AIs from October 2005 to September 2007. Analyses were stratified by age, considering prescriptions for women 40 (likely premenopausal) to be inappropriate and those for women > 60 (likely postmenopausal) to be appropriate. RESULTS: Monthly dollars spent on AI-associated DTCA varied considerably ($118,600 to $22,019,660). Time series analysis revealed that for every million dollars spent on DTCA for the AIs, there was an associated increase 3 months later in the new AI prescription proportion of 0.15% for all ages (P < .0001) and 0.18% for those > 60 years (P < .0001), but no significant change for those 40 at any time from 0 to 6 months. CONCLUSIONS: DTCA for the AIs was associated with increases in appropriate prescriptions with no significant effect on inappropriate prescriptions, suggesting that DTCA may not foster inappropriate medication use for certain drug classes. Cancer 2013;119:1065-72.

Potential Spillover Educational Effects of Cancer-Related Direct-to-Consumer Advertising on Cancer Patients’ Increased Information Seeking Behaviors: Results from a Cohort Study

“…On one hand, these results lend support to an argument by proponents that DTCA indirectly benefits patients by encouraging broader health information seeking behaviors that may in turn lead to more appropriate cancer care [50]. As a result, policies governing DTCA should be relaxed to promote greater dissemination of valuable health information to consumers [10].…”

A Study of the Frequency and Social Determinants of Exposure to Cancer-Related Direct-to-Consumer Advertising Among Breast, Prostate, and Colorectal Cancer Patients

“…Another study reported that overall spending on DTCA for aromatase inhibitors (a class of oral medications for reducing the risk of breast cancer recurrence) is associated with a small but significant increase in appropriate prescriptions for women diagnosed with breast cancer (i.e., postmenopausal women) at the population level. Conversely, ad spending is not associated with an increase in inappropriate prescriptions (i.e., premenopausal women) (Abel et al, 2013). …”

Effect of Direct-to-Consumer Advertising on Statin Use in the United States

“…Such estimates are imprecise measures of exposure both because they are geographically aggregated and also because expenditures may not accurately reflect the actual exposure of individuals to such messaging. 6,7,10 In addition, many prior studies have been unable to account for physician-targeted promotion, yet the use of samples and office-based detailing is common and may be heavily correlated with consumer-targeted promotion. 5,7,11 Finally, contextual factors such as health care density and socioeconomic status may also be influential in driving the outcomes of interest, yet studies of the effects of DTCA have not consistently accounted for these factors.…”

“…6,7,10 In addition, many prior studies have been unable to account for physician-targeted promotion, yet the use of samples and office-based detailing is common and may be heavily correlated with consumer-targeted promotion. 5,7,11 Finally, contextual factors such as health care density and socioeconomic status may also be influential in driving the outcomes of interest, yet studies of the effects of DTCA have not consistently accounted for these factors. 5–7,10 In order to address these limitations, we examined the association between statin advertising and both non-drug and prescription drug health care utilization for each of the top 75 designated market areas (DMAs) in the United States.…”

“…5,7,11 Finally, contextual factors such as health care density and socioeconomic status may also be influential in driving the outcomes of interest, yet studies of the effects of DTCA have not consistently accounted for these factors. 5–7,10 In order to address these limitations, we examined the association between statin advertising and both non-drug and prescription drug health care utilization for each of the top 75 designated market areas (DMAs) in the United States. We hypothesized that DTCA would be associated with an increase in statin use, albeit with smaller effects than that observed for symptomatic conditions such as asthma.…”