The rise of digital direct-to-consumer advertising?: Comparison of direct-to-consumer advertising expenditure trends from publicly available data sources and global policy implications

Abstract

BackgroundPharmaceutical marketing is undergoing a major shift in the United States, in part due to new transparency regulations under the healthcare reform act. Changes in pharmaceutical marketing practices include a possible shift from more traditional forms of direct-to-consumer advertising towards emerging use of Internet-based DTCA (“eDTCA”) given the growing importance of digital health or “eHealth.” Though legally allowed only in the U.S. and New Zealand, eDTCA poses novel regulatory challenges, as it can cross geopolitical boundaries and impact health systems and populations outside of these countries.MethodsWe wished to assess whether changes in DTCA and eDTCA expenditure trends was occurring using publicly available pharmaceutical marketing data. DTCA data was analyzed to compare trends in aggregate marketing expenditures and to assess if there were statistically significant differences in trends and magnitudes for data sources and DTCA sub-categories (including eDTCA). This was accomplished using regression lines of DTCA trend data and conducting pairwise comparisons of regression coefficients using t-tests. Means testing was utilized for comparing magnitude of DTCA expenditure.ResultsData from multiple data sources indicate that aggregate DTCA expenditures have slightly declined during the period from 2005–2009 and are consistent with results from other studies. For DTCA sub-categories, television remained the most utilized form of DTCA, though experienced trends of declining expenditures (−13.2 %) similar to other traditional media platforms such as radio (−30.7 %) and outdoor ads (−12.1 %). The only DTCA sub-category that experienced substantial increased expenditures was eDTCA (+109.0 %) and it was the only medium that had statistically significant differences in its marketing expenditure trends compared to other DTCA sub-categories.ConclusionsOur study indicates that traditional DTCA marketing may be on the decline. Conversely, the only DTCA sub-category that experienced significant increases was eDTCA. However, to fully understand this possible shift to “digital” DTCA, improvements in publicly available DTCA data sources are necessary to confirm changing trends and validate existing data. Hence, utilizing the newly implemented U.S. physician-payment expenditure transparency requirements, we advocate for the mandatory disclosure of DTCA/eDTCA in order to inform future domestic and international health policy efforts regarding appropriate regulation of pharmaceutical promotion.

Online information seeking by patients with bipolar disorder: results from an international multisite survey

“…The survey did not address if patients visited sites in a language other than their native language or which specific websites were visited. The survey also did not address the use of problematic websites that encourage unwanted behaviors such as self-harm (Mitchell et al 2014), issues related to online purchase of prescription or illegal drugs (Monteith et al 2016; Orizio et al 2011), or the impacts of direct to consumer pharmaceutical advertising where applicable (Mackey et al 2015). …”

Trends and effects of pharmaceutical DTCA

“…The advantage of eDTCA is the ability for pharmaceutical companies to spread advertisement globally via multiple channels such as websites, satellite TV, and social media (Mintzes, Morgan, & Wright, 2009). Mackey, Cuomo, and Liang (2015) conducted research investigating the information regarding DTCA expenditures by pharmaceutical firms from 2005 to 2009. The data, collected from multiple marketing data firms such as IMS Health, Nielsen Co., Cegedim Strategic Data, and Kantar Media, allowed for analysis of total spending of DTCA and spending for each DTCA sub-category, which included television, print media, radio, outdoor ads, and internet (eDTCA).…”

“…Even though eDTCA sub-category accounted for a small amount of spending in total DTCA, it experienced a three-digit growth of 109 % in the same period. (Mackey et al, 2015). Additionally, the IMS Institute of Health Informatics estimated drug expenditure in the US of about $374 billion in 2014 and global spending on medications would reach $1.4 trillion by 2020 (IMS, 2014).…”

Disclosing accelerated approval on direct‐to‐consumer prescription drug websites

“…The number of drugs approved under the accelerated approval regulatory pathway has been increasing . At the same time, prescription drugs are increasingly marketed online to consumers, including promotion of products indicated for serious or life‐threatening medical conditions such as cancer . Information about the limitations inherent in the accelerated approval pathway may be relevant to patients making treatment decisions.…”

“…2 At the same time, prescription drugs are increasingly marketed online to consumers, including promotion of products indicated for serious or life-threatening medical conditions such as cancer. [7][8][9][10] Information about the limitations inherent in the accelerated approval pathway may be relevant to patients making treatment decisions. Communicating these limitations in clear and understandable language may help consumers make informed decisions about their medical treatments in consultation with health care providers.…”