Healthy Skepticism Library item: 15713

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Avery S.
UNC-CH study gauges effect of drugmakers' ads
The News & Observer 2009 Jun 1
http://www.newsobserver.com/news/story/1550225.html

Abstract:

Pitches aimed at patients don’t boost sales much, but wooing doctors does

Full text:

An estimated 1million people flocked to their doctors in the months after TV commercials began airing for a new and ultimately short-lived drug to treat irritable bowel syndrome.
But the spike in doctor visits didn’t result in a lot of additional prescriptions for the drug Zelnorm, researchers at UNC-Chapel Hill reported Sunday in a study of how marketing strategies affect drug sales. Prescriptions for the drug were fueled by the manufacturer’s simultaneous campaign to influence physicians.

The findings add insight into the marketing success of drug companies when they target consumers and doctors directly — approaches that have long raised controversy.

Dr. Spencer Dorn, a gastroenterology fellow at the UNC-CH School of Medicine and lead author of the study, said there were “positives and negatives” to the advertising strategies by the maker of Zelnorm.

On the plus side, he said, the commercials raised awareness about a bowel condition that causes much discomfort and prompted many sufferers to seek help. At the same time, however, too many people may have gotten prescriptions for a drug with dubious benefit and potential risks, he said.

Zelnorm has since been pulled from the market because of safety concerns but not before an ad blitz made irritable bowel syndrome a household term, with ads featuring people raising their shirts to reveal messages drawn on their bellies.

Advocacy groups, health-care economists and some doctors have assailed television and print advertisements aimed at consumers since restrictions on such campaigns were lifted in 1997. The groups contend the ads fuel unnecessary spending on drugs when consumers demand high-dollar brands they’ve seen on TV.

According to an analysis of consumer advertising released in 2006, the Government Accountability Office found that drug companies spent $4.2 billion on ads hawking pills for all manner of problems — erectile dysfunction, seasonal allergies, herpes, arthritis, sleep difficulties and acid reflux. The GAO projected that ad spending would rise 20 percent a year.

Even so, that investment trails the money drug companies spend persuading doctors to prescribe their brands.

The same GAO study found that the manufacturers spent $7.2billion a year on promotional efforts aimed at doctors, including lunches to explain their products, trinkets emblazoned with their brands and ads in professional journals.

“Really, the two are parts of a strategy, and they’re intended to reinforce one another,” said Dr. Peter Lurie with the consumer advocacy group, Public Citizen. “First, you try to get patients to pressure doctors, and then soften up doctors with ads directed at them.”

That strategy paid off for Novartis, the manufacturer of Zelnorm, according to the UNC-CH study authors.

In 2005, the company spent $127million promoting the drug to doctors, and $122million buying ads targeting consumers. In the first three months after ads began running, the study authors calculated an additional 1million doctor appointments from patients complaining of abdominal pain, constipation and other symptoms of irritable bowel syndrome.

Those visits resulted in 400,000 new diagnoses of the condition, Dorn reported.

The increases tapered off and then fell back to normal, but prescriptions for Zelnorm continued to rise. Dorn said his analysis indicates that the ongoing rise in prescriptions for the drug suggests it was doctors who were influenced by the marketing.

He said for every $243 spent on promotional efforts to doctors, the drug company landed a new prescription for Zelnorm. It was a lucrative investment. A one-month supply of the drug cost about $180, and patients were supposed to take the drug indefinitely to control their symptoms.

Lurie, with the advocacy group, testified before a U.S. Senate committee that the zeal to market drugs can cause harm to consumers, who are wooed to try new therapies that have little or no track record.

In 2007, five years after Zelnorm was approved, the U.S. Food and Drug Administration asked Novartis to remove the drug from the market, citing an increased risk of heart attacks and strokes for patients who took it.