Direct-to-consumer prescription drug advertising increased from $1.3 billion to $6 billion over the past 20 years, particularly for high-cost biologics and cancer immunotherapies.
Although medical marketing has increased dramatically from approximately $17.7 billion to $29.9 billion from 1997 to 2016, regulation of this area has not, according to researchers at the Dartmouth Institute for Health Policy & Clinical Practice.
According to the article, published in JAMA, the most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9% of total spending) in 1997 to $9.6 billion (32% of total spending) in 2016. Researchers found the following evidence in their review of spending:
Although marketing to health care professionals rose less rapidly than DTC advertising, promotional activities did increase in most areas. Marketing to health care professionals by drug companies accounted for most of the promotional spending, with an increase from $15.6 billion to $20.3 billion during this period. Other findings include:
Health care spending in the United States is the highest in the world: totaling $3.3 trillion (17.8% of total spending) in 2016. In order to capture market share and to expand the market, drug companies and health care organizations use a wide array of promotional activities, including TV and digital advertising, social media, disease awareness campaigns targeting consumers, and marketing to professionals through free drug samples or consulting payments.
The FDA’s Office of Prescription Drug Promotion (OPDP) is responsible for reviewing prescription drug advertising or other promotional materials for validity. However, when reviewing regulatory activity from 1997-2016, researchers found that the number of advertisements or materials submitted for FDA review increased from 34,182 to 97,252, yet FDA violation letters for misleading drug marketing decreased from 156 to 11.
Furthermore, although there have been 103 financial settlements between drug companies and federal and state governments since 1997 that resulted in more than $11 billion in fines for deceptive or off-label marketing practices, the Federal Trade Commission has acted against misleading marketing only in the case of a single for-profit cancer center.
The authors said these findings suggest that enacting better oversight of product detailing or adding tables that quantify the benefits and adverse effects of drugs to advertising could improve the quality of health information and cut back on overprescribing and unnecessary medical spending.