Direct-to-consumer medical marketing spending increased over last eighteen years

1. From 1997 to 2016, overall medical marketing spending increased by over $12 billion dollars, with Direct-To-Consumer (DTC) marketing representing the largest category of increase.

2. U.S. Food and Drug Administration violation letters for misleading drug marketing decreased over the same period.

Evidence Rating Level: 2 (Good)

Study Rundown: The United States had the highest health care spending in the world at nearly 20% of the gross domestic product in 2016. To influence medication spending, medical marketers utilize a number of strategies geared towards both physicians and consumers, including direct-to-consumer (DTC) marketing. Over the past eighteen years, medical marketing spending has increased by over $12 billion, with DTC advertising increasing by nearly $5 billion, the most compared to other marketing strategies. Additionally, pharmaceutical companies paid physicians nearly one billion dollars for things including but not limited to speaking fees and meals. Despite the increases in marketing expenses, the U.S. Food and Drug Administration violation letters for misleading drug marketing decreased over the same period.

Increases in medical marketing spending may reflect rapid medical advances turning life-threatening diseases into chronic illnesses, but the shift in marketing strategies highlight differences in the relationships between physicians, consumers, pharmaceutical companies, and health care systems. Physicians will likely need to be increasingly more cautious when interpreting marketing information brought to them by patients, as many ads leave out quantitative data, minimize adverse effects, or suggest other nondrug therapies with little evidence supporting them.

Click to read the study in JAMA

Relevant Reading: Health care spending in the United States and other high-income countries

In-Depth [cross-sectional study]: Medical marketing spending was reviewed from 1997 through 2016 and included: DTC prescription drug monitoring, disease awareness campaigns, health services, laboratory tests, and professional medical marketing for prescription drugs. Overall spending from 1997 to 2016 increased $12.2 billion dollars, with the largest proportion of spending allotted for marketing to medical professionals (68% of total spending). During this timeframe, DTC prescription drug marketing spending increased $4.7 billion dollars, and the largest spending increase was for drugs related to diabetes/endocrine diseases ($703 million) and dermatology conditions ($538 million). DTC prescription drug marketing spending declined for medications related to allergies (decrease of $272 million) and cholesterol (decrease of $90 million). DTC advertising for health services was made up in large part by hospitals, dental centers, and cancer care systems, accounting for a large proportion of DTC health services advertising, with the largest increase from cancer centers with $18 million dollars of spending in 1997 to $200 million in 2016.

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