Advertised drugs hottest sellers

WASHINGTON, Nov. 20 (UPI) -- A small number of widely advertised prescription drugs accounted for about half of the almost $21 billion increase in retail prescription drugs in 2000, according to a report released Wednesday by the National Institute for Health Care Management Research and Educational Foundation.

"A relatively small amount of prescription drugs which are heavily advertised are the reason for the largest increase in pharmaceutical spending," Steven Findlay of NIHCM told United Press International. "It is one of the drivers in the increasing cost of health care."

According to Prescription Drugs and Mass Media Advertising 2000, the top 50 of the most heavily advertised drugs to consumers were responsible for 48 percent of the 19 percent one-year increase in retail spending on prescription drugs in 2000. Retail sales of the 50 drugs rose an aggregate 32 percent in 2000 compared to 14 percent for all other prescription drugs, numbering about 9,850, the study found.

"Advertising works, that's why it's done, and people act on the ads by going to their doctor and asking for treatment with the drugs," Findlay said. "Usually the people have the condition the drugs address so the consumer pays attention -- usually the patient is already taking a drug and is switched to the advertised drug."

"The pharmaceutical companies are looking to brand, to have the public know the trade name of the drug, but a lot of people just retain the name and a few facts but not the conditions the drug should be taken or side effects," Findlay added.

The number of prescriptions dispensed for the 50 most heavily advertised drugs climbed 25 percent in 2000. In contrast, the number of prescriptions dispensed for all other drugs rose just 4.3 percent, according to the study, which used Scott-Levin data that tracks prescriptions written in the United States.

The finding adds to the circumstantial evidence that mass media ads may be an increasingly important factor in the recent trend toward the expanded use of newer and usually more expensive prescription drugs.

But the study notes other factors simultaneously affect which drugs, and how much of them, are prescribed and thus overall pharmaceutical spending. These factors include:

-- An increase in the number of drugs being approved in recent years for chronic conditions;

-- A rise in the incidence of many chronic conditions such as diabetes and asthma;

-- An aging population;

-- A rise in spending on the promotion of prescription drugs to doctors.

"While there are benefits to having people know about new drugs and having them seek them at their doctor's, all too often ads drive up prices of the drugs unnecessarily and consumers can demand the drugs even if it's an inappropriate treatment," John Rother, policy director for the AARP in Washington told United Press International.

According to surveys, people are taking more and more drugs and getting prescriptions from different health care providers -- the average is eight drugs from five different physicians.

Spending on mass media -- direct to consumer -- ads increased to $2.5 billion in 2000, from $1.8 billion in 1999 and $791 million in 1996, the study said. DTC ads followed a 1997 ruling by the U.S. Food and Drug Administration making it easier for pharmaceutical companies to promote their drugs in brief television and radio ads.

According to Findlay, drug companies have increased their advertising budgets but they continue to spend similar amounts for advertising to doctors, which does not involve the mass media.

"There are 75,000 'detail men' or drug company representatives whose job it is to get to the doctor and make their pitches on drugs and get orders and once that's done, the doctors get free samples valued in the thousands of dollars," Findlay said. "The drug companies also provide 'dine and dash' seminars where the physicians are given lunch or dinner and the latest pharmaceutical information."

DTC ads still are a relatively small component of all prescription drug promotion, said Nancy Chockley, president of the NIHCM Foundation. "But they are clearly becoming an important influence."

It is very important for the ads to generate buzz and get people to know there is a new drug, say for arthritis, Findlay said. At the golf course, several people are talking about their knees and someone says "my doctor gave me Celebrex" and then someone has seen the ad, recognized the drug and hears someone else is taking it, and then asks a doctor for it, he added.

Antidepressants remained the top-selling category of prescription drugs for 2000 with $10.4 billion in retail sales, up 21 percent from 1999. The

anti-ulcer drug Prilosec remained the top-selling prescription medicine in the United States with sales of $4.1 billion up 12 percent from 1999. The second-best selling drug was Lipitor, to treat high cholesterol with sales of $3.7 billion up 39 percent from 1999.

Medicaid spending for prescription drugs more than tripled from 1990 to 1999 from $5 billion to $17 billion.

Those people under private health insurance are not price sensitive to the rise in drug costs, often demanding the latest drugs because they only are responsible for a small co-payment.

However, some HMOs are now using a three-tier approach to prescription drugs. Co-pays of up to $10 are for generic drugs, up to $20 for brand name drugs and to $35 for preferred brand name medications.

NIHCM said it is a non-profit organization that promotes improvement in health care access, management and quality.

(Reporting by Alex Cukan in Albany, N.Y.)