DTC-Generated Rx Script Volume Remains Flat - 1999 Prevention Survey

The percentage of consumers who received a prescription as a result of direct-to-consumer advertising has not changed in the past year, Prevention magazine's 1999 DTC survey reveals.

"As many as 15.3 mil. consumers asked their doctor for prescriptions specifically because they heard or saw a DTC ad for the product. About 84% of these consumers - approximately 12.9 mil. people - received a prescription medicine as a result," Prevention's second annual "Consumer Reactions to Direct-to-Consumer Advertising" study reports, noting the figures "remain essentially unchanged from last year."

In Prevention's 1998 survey, approximately 15.1 mil. consumers asked their physician to prescribe a drug they had seen advertised, and 80% of them reported that their physician honored that request (¹ (Also see "DTC Ads Spur Increased Patient Compliance, Prevention Study Maintains" - Pink Sheet, 17 Aug, 1998.)).

The 1998 survey found that 33% of consumers "spoke with their doctor" about a medication after seeing an advertisement, compared to 31% in the 1999 survey.

While the number of patients receiving scripts has remained flat, the number of consumers exposed to DTC continues to increase. As of April 1999, 81% of adult consumers had seen or heard an ad for an Rx medication, an 11% jump from the 70% reported in 1998, and a significant rise from the 63% reported in 1997.

Prevention highlighted the increasingly important role of DTC advertising within America's growing "self-care" trend in the executive summary of survey findings. "The direct self-care benefit of DTC advertising, as far as consumers are concerned, is apparent in the 63% who feel that the advertising helps them make their own decisions about prescription medicines," the survey states.

FDA has expressed concerns that DTC ads are encouraging consumers to believe that they can make decisions about their treatment without the intervention of a learned intermediary (² (Also see "DTC Ad Effect On Consumer Regard For Physician Advice Is Problematic - FDA" - Pink Sheet, 14 Sep, 1998.)). A recent New Jersey Supreme Court ruling suggests that DTC advertising of prescription drugs may increase manufacturer liability by eliminating the "learned intermediary" defense typically used in medical litigation (³ (Also see "DTC Ads Fall Outside "Learned Intermediary" Protections, N.J. Court Rules" - Pink Sheet, 16 Aug, 1999.)).

The study revealed 76% of consumers believe the ads help them become more involved in their own health care.

However, the study also points to consumers' widespread under-utilization of the brief summary page that accompanies DTC print ads: only 54% of consumers who had seen a print DTC ad report "noticing" the brief summary page and 24% say they read or refer to the page for additional information.

FDA has been encouraging industry to develop DTC brief summaries in more consumer-friendly language (⁴ (Also see "Lipid-Lowering And Anti-Infective Promotional Guidances Coming From FDA" - Pink Sheet, 9 Mar, 1998.)).

The survey results demonstrate the benefit of providing adequate and candid discussions of risk: consumers who believe that DTC advertising does an "excellent job providing information about serious product warnings" spoke with their doctor as a direct result of seeing a DTC ad more often than those who believe otherwise.

Approximately 30% of patients who think DTC ads do a "good" (31%) or "fair-to-poor" (32%) job spoke to physicians after seeing an ad, compared to 53% for those who think the risk communication is "excellent."

More than 50% of consumers could recall seeing or hearing ads for Merck's Propecia (55%), Hoechst's Allegra (66%) Glaxo's Zyban (68%) and Schering's Claritin (75%) when asked if they had seen or heard ads for 13 specific products. Recall of DTC advertisement for Bristol's Glucophage was lowest among the tested group at 13%, the study found.

The market spend on DTC advertising continues to grow: Schering spent $36.9 mil. in DTC advertising for Claritin in the first quarter of 1999, placing the brand as the top DTC spender for that time period, Prevention reports. Merck's spend on Propecia was a close second at $33.9 mil. Knoll spent $21.5 mil. for the quarter promoting Meridia while Glaxo contributed $19.4 mil. to Zyban ads. Wyeth spent $18.2 mil. on Premarin and Pharmacia & Upjohn spent $18.6 mil. on Detrol.

Survey results are based on a national telephone survey of 1,200 adults age 18 or older conducted by Princeton Survey Research Associates from March 30 to April 26. The survey tool was originally developed with technical assistance from FDA's ad division.