Healthy Skepticism Library item: 2341

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: Journal Article

Wang TJ, Ausiello JC, Stafford RS.
Trends in antihypertensive drug advertising, 1985-1996.
Circulation 1999 Apr 20; 99:(15):2055-7
http://circ.ahajournals.org/cgi/reprint/99/15/2055

Abstract:

BACKGROUND: Over the past decade, calcium channel blockers (CCBs) and ACE inhibitors have been used increasingly in the treatment of hypertension. In contrast, beta-blocker and diuretic use has decreased. It has been suggested that pharmaceutical marketing has influenced these prescribing patterns. No objective analysis of advertising for antihypertensive therapies exists, however.

METHODS AND RESULTS: We reviewed the January, April, July, and October issues of the New England Journal of Medicine from 1985 to 1996 (210 issues). The intensity of drug promotion was measured as the proportion of advertising pages used to promote a given medication. Statistical analyses used the chi2 test for trend. Advertising for CCBs increased from 4.6% of advertising pages in 1985 to 26.9% in 1996, while advertising for beta-blockers (12.4% in 1985 to 0% in 1996) and diuretics (4.2% to 0%) decreased (all P<0.0001). A nonsignificant increase was observed in advertising for ACE inhibitors (3.5% to 4.3%, P=0.17). Although the total number of drug advertising pages per issue decreased from 60 pages in 1985 to 42 pages in 1996 (P<0.001), the number of pages devoted to calcium channel blocker advertisements nearly quadrupled.

CONCLUSIONS: Increasing promotion of CCBs has mirrored trends in physician prescribing. An association between advertising and prescribing patterns could explain why CCBs have supplanted better-substantiated therapies for hypertension.

Keywords:
hypertension practice patterns drug therapy advertising MeSH Terms: Adrenergic beta-Antagonists Angiotensin-Converting Enzyme Inhibitors Antihypertensive Agents*/classification Bibliometrics* Calcium Channel Blockers Diuretics, Thiazide Drug Industry/trends* Drug Utilization/trends Humans Hypertension/drug therapy Hypertension/epidemiology Marketing of Health Services/statistics & numerical data Marketing of Health Services/trends* Physician's Practice Patterns/statistics & numerical data Prescriptions, Drug/statistics & numerical data Publishing Research Support, U.S. Gov't, P.H.S.