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Direct-to-consumer advertising of antidepressants aims to increase pool of users

Does direct-to-consumer advertising (DTCA) for antidepressant medications educate consumers regarding the most appropriate drug for those already under treatment? Or, is its goal to increase the pool of consumers taking antidepressants by prompting new people to try them?

Two research economists, Chad Meyerhoefer, Ph.D., and Samuel Zuvekas, Ph.D., at the Agency for Healthcare Research and Quality (AHRQ), addressed these questions in a recent paper. They conclude that DTCA increases the likelihood that an individual will initiate antidepressant use, but has minimal effect on drug compliance at higher price levels. The researchers indicate that since most people with depression are untreated, bringing more of them into treatment might benefit both the individual and the public.

Using data from the 1996-2003 AHRQ Medical Expenditure Panel Survey (MEPS), the researchers investigated the impact of DCTA and consumer cost-sharing (out-of-pocket costs) on the demand curve for antidepressants. They constructed an econometric model using the number of newer-generation antidepressant prescriptions filled by individuals in a given calendar quarter. Newer-generation antidepressants included citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, buproprion, mirtazapine, nefazodone, trazodone, and venlafaxine. This model incorporated the MEPS data on antidepressant use and information on quarterly spending on DTCA (both national and local) during the study period.

The number of antidepressant users increased steadily between 1996 and 2003, while the average number of prescriptions filled per user increased only slightly. Also, refills were influenced by advertising only at very low or no out-of-pocket costs.

The researchers conclude that their findings tell more about the pharmaceutical companies' marketing strategies than the usefulness of DTCA for promoting adherence to treatment. They assert that the effect of DTCA during the period studied was consistent with a mass marketing approach that emphasized product characteristics that appealed to everyone, and that the role of matching patients to appropriate medications rested almost entirely with physicians.

More details are in "The shape of demand: What does it tell us about direct-to-consumer marketing of antidepressants?" by Drs. Meyerhoefer and Zuvekas, in the January 2008 Berkeley Electronic Journal of Economic Analysis and Policy 8(2).

Reprints (AHRQ Publication No. 08-R062) are available from the AHRQ Publications Clearinghouse.

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