Sara Becker, a research assistant professor at the Brown University School of Public Health and the Warren Alpert Medical School and the lead author in the study said, “On a basic level, the goal of our review was to begin addressing an important and rarely examined public health question. Is this enormous multibillion dollar industry of direct-to-consumer advertising of psychiatric medication affecting public health in a positive or negative way? There are many possible ways to answer this question — we began by taking a close look at patient and physician behavior in response to these ads.”
Focusing on the marketing and prescribing of psychiatric medicines was a good place to start, since those mediations make up a huge chunk of direct to consumer ads for prescription drugs, and they are some of the biggest sellers. Is it because of the ads? Is the state of public health been improved by these ads? That’s what the team from Brown felt was an important question raise.
Finding the data that could answer this question was a tough task. Direct-to-consumer advertising (DTCA) has been around for a while, but there’s almost no research on how or if it impacts a patient/doctor conversation. While there were some studies, almost none of them focused on psychiatric medications, despite how many of them are heavily advertised and sold. The Brown study was only able to review four research studies that met all of their criteria. They wanted to look at studies that included psychiatric medications that had been advertised, that included data on prescribing information sorted by patient requests for those drugs and that also had information on the doctor/patient interaction at the point where care was being given (as opposed to asking doctors or patients to recall visits that had already happened)
In one study analyzed, researchers used paid actors to go to a doctor and describe symptoms of general depression. Some actors asked for a specific medication that had been advertised, some asked in general for medication, without naming any certain drug and some did not ask at all. The results showed patients were more likely to be prescribed a medication when asking for it by name, than not. The other studies reviewed by the Brown team were similar, and one compared prescribing rates in the US to those in Canada, where DTCA is illegal.
The issue the team noticed in all the studies that regardless of whether a patient exhibited signs of severe illness or just transient symptoms, the act of asking for a medication is likely to result in a prescription regardless of the severity of the symptoms, and this could lead to over-prescribing in some patients. While more information is always good for patients to have, and perhaps some of these ads have led those who need treatment to seek it, the flip side is the danger of over-prescribing. Dr. Becker summarized the study results when she said,
“The most important conclusion of our study is that more research is needed.”
The National Institute on Drug Abuse funded the study and it was published in the journal Clinical Psychiatry. Check out the video to learn more about the effect ads have on medical treatment.
Sources: Journal of Clinical Psychiatry, UPI, Brown University, Mad In America