Direct-to-Consumer Advertising of COX-2 Inhibitors: Effect on Appropriateness of Prescribing

• Published in: Medical care research and review Vol. 62; no. 5; pp. 544 - 559
• Main Authors: Spence, Michele M., Teleki, Stephanie S., Cheetham, T. Craig, Schweitzer, Stuart O., Millares, Mirta
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA Sage Publications 01-10-2005; SAGE PUBLICATIONS, INC
• Subjects: Advertising; Advertising as Topic - methods; Advertising expenditures; Aged; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; California; Consumer participation; Cyclooxygenase 2 Inhibitors - adverse effects; Cyclooxygenase 2 Inhibitors - economics; Cyclooxygenase 2 Inhibitors - therapeutic use; Drug Industry; Drug Information Services; Drug Prescriptions - economics; Drug Prescriptions - standards; Drug Utilization - standards; Female; Gastrointestinal Hemorrhage - chemically induced; Health Maintenance Organizations - standards; Humans; Inappropriateness; Linear Models; Male; Middle Aged; Nonsteroidal antiinflammatory drugs; Patient Participation; Patient-Doctor communication; Physician patient relationships; Physician-Patient Relations; Prescription drugs; Prescriptions; Risk Assessment; Surveys and Questionnaires; California; drug utilization; advertising; drugs; physician-patient relations; prescriptions
• ISSN: 1077-5587; 1552-6801
• DOI: 10.1177/1077558705279314

Spending on direct-to-consumer advertising (DTCA) of prescription drugs has increased dramatically in the past several years. An unresolved question is whether such advertising leads to inappropriate prescribing. In this study, the authors use survey and administrative data to determine the association of DTCA with the appropriate prescribing of cyclooxygenase-2 (COX-2) inhibitors for 1,382 patients. Treatment with either a COX-2 or a traditional nonsteroidal anti-inflammatory drug (NSAID) was defined as appropriate or not according to three different definitions of gastrointestinal risk. Patients who saw or heard a COX-2 advertisement and asked their physician about the advertised drug were significantly more likely to be prescribed a COX-2 (versus a NSAID, as recommended by evidence-based guidelines) than all other patients. Findings also suggest that some patients may benefit from DTCA. The authors discuss the need for balanced drug information for consumers, increased physician vigilance in prescribing appropriately, and further study of DTCA.