Direct-to-consumer Advertising of COX-2 Inhibitors

Effect on Appropriateness of Prescribing

Published in: Medical Care Research and Review, v. 62, no. 5, Oct. 1, 2005, p. 544-559

Posted on RAND.org on December 31, 2004

by Michele M. Spence, Stephanie S. Teleki, T. Craig Cheetham, Stuart O. Schweitzer, Mirta Millares

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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.

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