Healthy Skepticism Library item: 795

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Publication type: news

Many Americans Seek Drug Information - But Not Drugs - Online
News Briefs 2005 Jan 21

Full text:

Approximately 26% of Americans have used the Internet to research information on prescription drugs, but only 4% have purchased prescription drugs online. Findings are from a study, Prescription Drugs Online, by Pew Internet & American Life Project, in which 2200 US adults were surveyed.

Forty-five percent of American adults, or about 91 million persons, take prescription drugs on a regular basis, and 41% live with someone who takes prescription drugs on a regular basis, for a total of 64% of American households that have a regular connection to the prescription drug marketplace.

Most online drug purchasers first obtained a prescription from their own physician, and the typical transaction was through a US-based Web site that required a prescription. Online drug purchasers cite convenience and cost savings as the main reasons for their purchases.

Despite widespread use of prescription drugs and the increase in use of the Internet, consumers remain cautious about purchasing prescription drugs online. Of the 2200 adults surveyed, only 93 persons (4%) said they had purchased prescription drugs online. Some 62% of respondents thought that purchasing prescription drugs online is less safe than purchasing them at a local pharmacy. Only 20% said online purchases were as safe, with 18% either unsure or saying that it depends on the situation.

Although the number of prescription drug purchasers in the study was only 93, most were satisfied with their last contact with an online pharmacy. Nine of 10 persons who purchased prescription drugs online plan to do so again. Three quarters of purchases were for medications to treat chronic conditions, such as hypertension or arthritis, and one quarter were for drugs for another purpose, such as weight loss or sexual performance.

Rx Sales at Independents Are Up 14%
Independent community pharmacies averaged $3.24 million in sales in 2003, a 14% increase, according to the National Community Pharmacists Association (NCPA). Total prescription drug sales averaged $2.9 million. Survey findings are from the 2004 NCPA-Pfizer Digest.

Other key findings include:

· Many independent pharmacists provide disease-management services. Some 59% of pharmacies surveyed offer blood pressure monitoring, 48% offer diabetes education, and 28% make available asthma education. In addition, nearly 1 in 4 offer immunizations. Also increasing significantly over the last year were services offered by independents related to complementary medicines and veterinary pharmacy.

· Gross margins as a percentage of pharmacy sales increased slightly to 24% in 2003, and total expenses as a percentage of sales averaged 20%.

· The median net profits before taxes were $114,319, representing 4% of sales, up slightly from 3.8% in 2003. NCPA attributes the increase to pharmacists expanding into niche services, such as health screenings, immunizations, and diabetes management.

· The number of prescriptions dispensed annually increased to 56,399, for an average of 181 prescriptions filled a day. Eighty percent of all prescriptions dispensed in independent pharmacies were covered by either private health insurance (56%) or Medicaid (24%).

· Independent pharmacists consult with physicians an average of 7 times daily about prescription drug therapy. Physicians accept the pharmacist’s recommendations 89% of the time for a generic product and 93% of the time for other therapeutic interchanges.

· Fifty-three percent of prescriptions that were dispensed were for generics, exceeding the industry average of 51%.

· Nearly half (48%) of respondents reported that the pharmacy operates a Web site.

Consumers Now Less Likely to Request Rx Following Ad Exposure
The intensity of consumer response to direct-to-consumer (DTC) advertising of prescription medications has been declining steadily since 2002 and is expected to erode further following the recall of rofecoxib (Vioxx), according to findings from Ipsos Health.

About 19% of 10 consumers said that DTC advertising prompted them to call or visit their physician to discuss the prescription drug advertised. This represents a drop from a February 2002 peak, when 25% of consumers said that they had contacted their physicians to discuss a drug that they had seen advertised.

“The situation with Vioxx may cause consumers to be more skeptical about the safety of prescription drugs, particularly those seen advertised,” said Fariba Zamaniyan, vice president of Ipsos Health. “As a result, we anticipate declining levels of call to action following ad exposure to continue.”

Nearly 60% of Americans stated that they recall seeing an advertisement for a prescription drug in the past 12 months. Consistent with the growth of advertising expenditures, consumer recall of prescription drug ads has increased from 50% in August 2002 to 58% in August 2004. While recall remains high, fewer consumers are taking action. Just 10% of consumers reported that they asked their physician for the prescription drug seen advertised.

“It’s simply getting tougher to persuade more consumers to ask for your branded prescription drug following ad exposure,” said Zamaniyan. “Advertising for prescription drugs has reached maturity. What was new or novel 7 years ago has worn off as prescription drug ads have become more mainstream. The marketplace has become much more crowded, with more than 60 brands being advertised for a variety of ailments.”

Persons who have the condition for which products are advertised respond to DTC advertising at a greater rate. While the average response rate is 19%, one third of persons with chronic pain reported that they called or visited their doctor to discuss a prescription drug as a result of an advertisement. Other conditions with higher-than-average response rates were insomnia, 32%; anxiety, 29%; recurrent constipation, 29%; recurrent diarrhea, 29%;

irritable bowel syndrome, 29%; migraine headache, 28%; asthma, 27%; eczema/dermatitis, 27%; overactive bladder, 27%; erectile dysfunction, 26%; and arthritis, 24%. Conditions for which there are no obvious symptoms, such as elevated cholesterol levels, have call-to-action levels similar to the average.

Lifestyle Counseling to Prevent Heart Disease in At-Risk Patients Often Lacking
Despite evidence that better diet and exercise habits can reduce the risk of heart disease, physicians often do not counsel patients at risk for heart disease about the health benefits of exercising regularly and improving their diet.

Diet counseling and exercise counseling were provided during a physician visit less than half and less than a third of the time, respectively, for patients who had at least 1 risk factor for heart disease, according to findings of a study by Stanford University School of Medicine researchers, led by Randall Stafford, MD, PhD. The researchers tracked the results of physician office visits between 1992 and 2000 using 2 large databases: one that tracks services provided during visits to office-based physicians and another that surveys hospital outpatient departments. Findings were published in the October issue of Preventive Medicine.

The likelihood that patients with 1 or more risk factors for heart disease received physician counseling about diet and exercise increased over the study period. In 1992, diet counseling was provided during 30% of the visits and exercise counseling was provided during 15% of visits. By 2000, the rates had increased to nearly 45% for diet counseling and about 30% for exercise counseling. “It’s clearly a good thing that counseling is increasing,” said Stafford, “but the rate of counseling is still less than desirable.”

Stafford said he believes that physicians think they lack the tools and training to provide effective lifestyle counseling for their patients. In addition, reimbursements under the current managed care system incentivize physicians to keep visits as brief as possible so that they can see more patients, which makes it difficult to offer meaningful counseling.