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  • Publication # 13-RA012

Declines seen in direct-to-consumer promotion of drugs

Health Care Costs and Financing

Pharmaceutical companies spend billions of dollars to promote their drugs, $30 billion in 2005 alone. The majority of this spending, 84 percent, goes toward physician detailing (visits by drug representatives) and free samples. However, a good portion is also set aside for direct promotion to consumers, called direct-to-consumer advertising (DTCA). 

A new study reveals that drug companies are reducing overall promotion efforts, largely in response to drugs going off patent. In the case of DTCA spending, it grew 68 percent between 2001 and 2006, then declined 25 percent by 2010. DTCA was also concentrated on a small number of drugs.

The researchers examined trends in drug promotion spending from 2001 to 2010 using data from several sources covering physician detailing, dispensed free samples, journal ads, electronic promotion spending, meeting/conference promotion, and DTCA. Top-promoted and top-selling drugs were categorized as either biologic therapies (manufactured using biologic processes) or small molecules, which represent the majority of all prescription medications.

Total promotional spending peaked in 2004, amounting to $36.1 billion. By 2010, however, it had declined 23 percent to just $27.7 billion. In the case of free samples, their retail value also declined 23 percent, from $18.1 billion in 2004 to $13.9 billion in 2010. Electronic promotion to providers increased twofold, although its share was just 2 percent of provider promotion. 

Across the study period, the largest expenditures were for office-based detailing and free samples. DTCA declined 25 percent from $5.9 billion in 2006 to $4.4 billion in 2010, when it accounted for 16 percent of all promotional spending. Less than 5 percent of DTCA was Internet-based. In 2010, the top three drugs promoted directly to consumers were the statin Lipitor®, the erectile dysfunction drug Cialis®, and the antidepressant Cymbalta®. Among biologic therapies, the agents with the most promotional spending were the diabetic drugs Lantus® and Byetta®. The study was supported in part by AHRQ (HS18960).

See "Promotion of prescription drugs to consumers and providers, 2001-2010," by Rachel Kornfield, M.A., Julie Donohue, Ph.D., Ernst R. Berndt, Ph.D., and G. Caleb Alexander, M.D., M.S., in PLoS ONE 8(3), p. e55504, 2013.


Page last reviewed September 2013
Internet Citation: Declines seen in direct-to-consumer promotion of drugs: Health Care Costs and Financing. September 2013. Agency for Healthcare Research and Quality, Rockville, MD.


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