Donohue and Berndt's Effects of Direct-to-Consumer Advertising on Medication Choice-Case of Antidepr

Donohue and Berndt's Effects of Direct-to-Consumer Advertising on Medication Choice-Case of Antidepr

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Vol. 23 (2) Fall 2004, 115–127 Journal of Public Policy & Marketing 115 Effects of Direct-to-Consumer Advertising on Medication Choice: The Case of Antidepressants Julie M. Donohue and Ernst R. Berndt Although direct-to-consumer advertising (DTCA) has generated substantial controversy, little is known about its effects on consumer and physician behavior. In this article, the authors examine the impact of DTCA and physician detailing on the choice of antidepressant medication. The authors find that detailing has a much greater effect on medication choice in the antidepressant market than does DTCA. Julie M. Donohue is an assistant professor, Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health (e-mail: [email protected]). Ernst R. Berndt is Louis B. Seley Professor of Applied Economics, National Bureau of Eco- nomic Research, Sloan School of Management, Massachusetts Insti- tute of Technology (e-mail: [email protected]). Dr. Donohue was a research fellow in pharmaceutical policy at Harvard Medical School. Dr. Donohue gratefully acknowledges financial support from the Henry J. Kaiser Family Foundation, the National Institute of Mental Health (training grant T32 MH19733-08), and the Harvard Pilgrim Health Care Foundation. Rusty Tchernis and Alan Zaslavsky provided valuable statistical advice for the article. The authors also wish to thank Rena Conti, Haiden Huskamp, Laura Eselius, Shanna Shul- man, Tom McGuire, and two anonymous JPP&M reviewers for help- ful comments on previous drafts of this article. P harmaceutical promotion has traditionally been aimed at physicians, the “learned intermediaries” who are responsible for prescribing medications. From the mid-twentieth century, when federal regulations began requiring a doctor’s prescription for many pharmaceuticals, to the 1990s, pharmaceutical firms relied primarily on “detailing” by pharmaceutical sales representatives and advertising in medical journals to promote prescription drugs. Pharmaceutical marketing strategies have become more diversified in recent years. In addition to detailing and medical journal advertising, firms now promote their prod- ucts to medical professionals through educational events and directly to the public through mass media advertising. Spending on direct-to-consumer advertising (DTCA) increased from $266 million in 1994 to $2.6 billion in 2002, making this form of pharmaceutical marketing the object of substantial controversy (IMS Health 2003a). In 1997, a Food and Drug Administration (FDA) policy change made broadcast advertising of prescription drugs more feasible and may have contributed to the increase in the use of consumer-directed advertising by the pharmaceutical indus- try. One study of DTCA suggests that it increases demand for prescription drugs, accounting for roughly 12% of the increase in prescription drug sales between 1999 and 2000 (Rosenthal et al. 2003).
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