June 1, 2011 — Ongoing attacks on direct-to-consumer (DTC) advertising for new prescription drugs may be deflected by a recent report from the Congressional Budget Office (CBO), which states that a two year moratorium on DTC advertising “could worsen – rather than enhance – public health.”
“The CBO report recognizes the multiple factors in medical marketing and communication public policy and avoids the too prevalent negative bias of many DTC studies,” said Coalition for Healthcare Communication Executive Director John Kamp. “The report recognizes that a ban would limit the adoption of new drug options, clearly harming many patients and public health,” he said. “The CBO report helps us change the terms of the DTC debate on Capitol Hill, benefiting patients as well as sellers of new medicines.”
In its May 2011 Economic and Budget Issue Brief: “Potential Effects of a Ban on Direct-to-Consumer Advertising of New Prescription Drugs,” the CBO said a DTC moratorium would:
- Likely cause sellers to just shift marketing spend from DTC advertising to physician advertising;
- Decrease prescriptions for some new drugs; but
- Not likely change drug prices.
Addressing questions on costs and spending, the CBO found that banning DTC advertising of new drugs might have a “substantial impact on sales and use of individual drugs,” but it noted that the number of new drugs approved each year is so low that it would not have a significant impact on overall sales and use of prescription drugs. It also recognized that, despite their cost, new drugs often decrease overall spending for patient care.
Also, the CBO acknowledges that “distinguishing cause and effect between marketing and sales is difficult,” because manufacturers tend to use DTC marketing for common conditions that affect a large population. Further, drug companies subject to any ban on DTC marketing likely would shift their marketing efforts to focus more on physicians through detailing, professional meetings and journal ads.
Further, the CBO makes the point that the public benefits from DTC ads that drive individuals to their doctors for treatment, and that doctors and insurance companies play a pivotal role in determining which drugs will be used to treat those patients. In other words, DTC advertising may increase overall drug spending because it gets patients into doctors’ offices, but patients often may not be prescribed the advertised drug.
The report also includes findings regarding drug safety concerns relating to broader use of a drug following approval, including the perception that “the newest drugs on the market tend to be among the most heavily promoted, raising the risk that more people will be adversely affected before steps can be taken to identify and address such safety problems.” The CBO asserts that this same rapid uptake rate decreases the time needed to identify and address safety factors not recognized in initial clinical trials.
Accordingly, the CBO concluded that a two-year moratorium on DTC advertising for new drugs could actually “postpone the realization of a drug’s true risks – if, for example, the number of people taking the drug was reduced enough by a moratorium that the full risks were not discovered as quickly.”
A DTC drug ban also could have a negative effect on drug development, according to the CBO. “Without the possibility of DTC advertising, pharmaceutical manufacturers may see their opportunity to create a market for a first-in-class drug and to benefit from its monopoly status delayed or diminished,” the CBO stated. “That outcome could, in turn, reduce their incentive to research and
develop new breakthrough therapies.”