Drug ads top med­i­cal mar­ket­ing surge to $30 bil­lion

The Charlotte Observer (Sunday) - - Business - BY LIND­SEY TAN­NER As­so­ci­ated Press

Ads for pre­scrip­tion drugs ap­peared 5 mil­lion times in just one year, cap­ping a re­cent surge in U.S. med­i­cal mar­ket­ing, a new anal­y­sis found.

The ad­ver­tise­ments for var­i­ous medicines showed up on TV, news­pa­pers, on­line sites and else­where in 2016. Their num­bers soared over 20 years as part of broad health in­dus­try ef­forts to pro­mote drugs, de­vices, lab tests and even hos­pi­tals.

The re­searchers es­ti­mated that med­i­cal mar­ket­ing reached $30 bil­lion in 2016, up from $18 bil­lion in 1997. Spend­ing on con­sumer-fo­cused ads climbed fastest. But mar­ket­ing to doc­tors and other health pro­fes­sion­als still grabbed the big­gest share with the bulk of it pay­ing for free drug sam­ples.

“Mar­ket­ing drives more treat­ments, more test­ing” that pa­tients don’t al­ways need, said Dr. Steven Woloshin, a Dart­mouth Col­lege health pol­icy ex­pert. Woloshin wrote the re­port with his wife, Dr. Lisa Schwartz, both long­time crit­ics of over­diag­no­sis and overtreat­ment. She died in Novem­ber.

They an­a­lyzed mar­ket­ing data from the U.S. Food and Drug Ad­min­is­tra­tion, Medi­care, other fed­eral and state agen­cies, pri­vate com­pa­nies and med­i­cal re­search. The re­port cov­ers 1997, when the FDA eased rules for TV ads, through 2016. Al­though some types of spend­ing waxed and waned dur­ing those years, Woloshin said the up­ward trend is con­cern­ing and sug­gests con­sumers need to be in­creas­ingly skep­ti­cal about mar­ket­ing claims.

The re­port was pub­lished Tues­day in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion. All mar­ket­ing spend­ing was ad­justed to 2016 dollars.

A jour­nal ed­i­to­rial notes that med­i­cal mar­ket­ing has sur­vived le­gal chal­lenges and “needs no apol­o­gist.” It has helped make pa­tients more in­formed con­sumers and it’s up to doc­tors to help their pa­tients un­der­stand prod­uct claims, al­though some physi­cians need more ed­u­ca­tion them­selves about de­cep­tive mar­ket­ing, the ed­i­to­rial sug­gests. Con­sumer-fo­cused mar­ket­ing: Spend­ing on di­rect-to-con­sumer mar­ket­ing climbed fastest, from $2 bil­lion or 12 per­cent of to­tal mar­ket­ing to al­most $10 bil­lion and one-third of over­all spend­ing. Only the U.S. and New Zealand al­low pre­scrip­tion drug ad­ver­tis­ing, which in the U.S. went from just over $1 bil­lion and 79,000 ads to $6 bil­lion and 5 mil­lion ads in 2016.

The cat­e­gory also in­cludes TV ads and other mar­ket­ing for hos­pi­tals, which sky­rock­eted to al­most $3 bil­lion.

Spend­ing on dis­easea­ware­ness ads more than dou­bled, to $430 mil­lion spent on 401 cam­paigns. Woloshin said this was among the most dis­turb­ing trends. Drug names aren’t men­tioned, but man­u­fac­tur­ers of­ten use th­ese to “sell” dis­eases that can be treated by costly new drugs, he said.

Doc­tor-fo­cused mar­ket­ing: Mar­ket­ing aimed at doc­tors, nurses and other health pro­fes­sion­als went from $16 bil­lion to $20 bil­lion, about two-thirds of all spend­ing. About $12 bil­lion went for free drug sam­ples, al­though that spend­ing has dropped re­cently. Spend­ing on per­sonal pitches from drug com­pany sales reps was mostly un­changed at $5 bil­lion af­ter an early in­crease.

The gov­ern­ment’s Open Pay­ments web­site lists doc­tors with fi­nan­cial ties to drug and med­i­cal de­vice mak­ers and in 2022 it will ex­pand to in­clude physi­cian as­sis­tants and nurses with ad­vanced train­ing.

Reg­u­la­tory over­sight: Fed­eral law says ad­ver­tis­ing must be truth­ful, not de­cep­tive and backed by sci­en­tific ev­i­dence. The FDA over­sees pre­scrip­tion drug and de­vice ad­ver­tis­ing; the Fed­eral Trade Com­mis­sion reg­u­lates over-the-counter prod­ucts. The anal­y­sis sug­gests that the surge in med­i­cal mar­ket­ing has led to spotty over­sight by both agen­cies. It notes that while com­pany sub­mis­sions more than dou­bled over the two decades, reach­ing nearly 100,000, FDA vi­o­la­tion let­ters for mis­lead­ing drug mar­ket­ing dropped from 156 to 11. That could mean drug com­pa­nies are do­ing a bet­ter job of self-polic­ing but Woloshin said it’s more likely reg­u­la­tors are over­whelmed by the vol­ume and can’t keep up.

Still, the re­port notes an in­crease in FDA vi­o­la­tion let­ters about mar­ket­ing of un­ap­proved ge­netic tests. And off-la­bel or de­cep­tive mar­ket­ing prac­tices have re­sulted in $11 bil­lion in fines and 103 set­tle­ments be­tween drug com­pa­nies and fed­eral and state reg­u­la­tors since 1997. What doc­tors say: The Amer­i­can Med­i­cal As­so­ci­a­tion in 2015 sup­ported ban­ning di­rect-to-con­sumer ads for pre­scrip­tion drugs and says doc­tors should not ac­cept med­i­cal in­dus­try pay­ments or gifts in­tended to in­flu­ence pre­scrib­ing habits. “The vast ma­jor­ity of physi­cians pre­scribe drugs and treat­ments they be­lieve are in the best in­ter­est of their pa­tients,” the AMA said in a re­sponse to the new anal­y­sis.

What in­dus­try says: Holly Camp­bell, spokes­woman for the Phar­ma­ceu­ti­cal Re­search and Man­u­fac­tur­ers of Amer­ica, de­fended in­dus­try mar­ket­ing prac­tices and said di­rect-to­con­sumer ads can make pa­tients bet­ter in­formed about their health and treat­ment op­tions. She said th­ese ads also “in­crease aware­ness of the ben­e­fits and risks of new medicines and en­cour­age ap­pro­pri­ate use of medicines.”

JULIO CORTEZ AP

An­nual spend­ing by the U.S. health in­dus­try on ads and pro­mo­tions has reached $30 bil­lion. That’s a huge in­crease in 20 years and just part of broad health in­dus­try ef­forts to pro­mote health-re­lated prod­ucts and ser­vices.

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