Study: For good and bad, TV ads promote higher prescribing volume of psychiatric medications

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couple_watching_televisionHow Are Direct-to-Con­sumer-Adver­tise­ments Chang­ing Psy­chi­atric Drug Use? (The Dana Foundation):

“Flip on your tele­vi­sion to a com­mer­cial sta­tion and you are like­ly to see ads for cars, snacks, and home appliances—and pre­scrip­tion med­ica­tions. Some ads specif­i­cal­ly tar­get psy­chi­atric ill­ness­es: Only this week, I saw com­mer­cials for Latuda®(lurasidone HCI), a drug used to treat bipo­lar depres­sion, and Abil­i­fy® (arip­ipra­zole), an anti-depres­sant. In 1997, the Food and Drug Admin­is­tra­tion (FDA) relaxed reg­u­la­tions sur­round­ing direct-to-con­sumer-adver­tis­ing (DTCA) of pre­scrip­tion drugs, open­ing the door for broad­cast com­mer­cials on radio and television…Psychiatric med­ica­tions are among the most heav­i­ly adver­tised med­ica­tions, says Sara Beck­er, a researcher at Brown University’s School of Pub­lic Health. Peo­ple with psy­chi­atric con­di­tions may be more sus­cep­ti­ble to the effects of adver­tis­ing, she says, so it’s impor­tant that we bet­ter under­stand how DTCA may affect pre­scrip­tions and usage in man­ag­ing men­tal health.

Beck­er says that across those four stud­ies, some of the find­ings were con­sis­tent. “There is evi­dence that peo­ple active­ly request­ing a med­ica­tion they saw on TV or heard on the radio did seem to increase pre­scrib­ing. That is, the sheer act of ask­ing for med­ica­tions result­ed in more pre­scrib­ing,” she says. “And that could be a good or a bad thing. If a per­son is seri­ous­ly depressed and needs help, they were more like­ly to get the med­ica­tion they need­ed. But if a patient asked for a med­ica­tion who maybe didn’t meet the full cri­te­ria for depres­sion and shouldn’t have got­ten a med­ica­tion, they were like­ly to get it as well.”

Study: Effects of Direct-To-Con­sumer Adver­tis­ing on Patient Pre­scrip­tion Requests and Physi­cian Pre­scrib­ing: A Sys­tem­at­ic Review of Psy­chi­a­try-Rel­e­vant Stud­ies (Jour­nal of Clin­i­cal Psychiatry)

  • Objec­tive: To sys­tem­at­i­cal­ly ana­lyze the effects of direct-to-con­sumer adver­tis­ing (DTCA) on patient requests for med­ica­tion and physi­cian pre­scrib­ing across psy­chi­a­try-rel­e­vant studies.
  • Find­ings: Due to lack of repli­ca­tion across strong ran­dom­ized con­trolled tri­als (RCTs), no con­clu­sions mer­it­ed high con­fi­dence. With mod­er­ate con­fi­dence, we con­clud­ed that DTCA requests (1) are grant­ed most of the time (1 RCT, 3 obser­va­tion­al), (2) prompt high­er pre­scrib­ing vol­ume (1 RCT, 1 obser­va­tion­al), (3) pro­mote greater adher­ence to min­i­mal­ly accept­able treat­ment guide­lines for patients with depres­sion (1 RCT), and (4) stim­u­late over­pre­scrib­ing among patients with an adjust­ment dis­or­der (1 RCT).
  • Con­clu­sions: Find­ings sug­gest that DTCA requests are typ­i­cal­ly accom­mo­dat­ed, pro­mote high­er pre­scrib­ing vol­ume, and have com­pet­ing effects on treat­ment qual­i­ty. More method­olog­i­cal­ly strong stud­ies are need­ed to increase con­fi­dence in conclusions.

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