What was the total amount of money spent on DTC (direct-to-consumer) advertising by the drug manufacturers between January and September 2000?

What were the top 5 drugs?

Total DTC advertising expenditures between January and September 2000 $1.94 Billion.  Total DTC advertising expenditures between January and October 1999 $1.48 Billion.

Top 5 drugs between January and September 2000

Rofecoxib [Vioxx®] - $138.3 million

Omeprazole [Prilosec®] - $99.7 million

Loratadine [Claritin®] - $84.9 million

Paroxetine [Paxil®] - $73.5 million

Sildenafil [Viagra®] - $67.7 million

Other DTC facts:

2 Major therapeutic classes generated 20% of all DTC dollars

- Non-sedating and low sedating antihistamines (loratidine, fexofenadine, cetirizine) - $197.2 million

- COX-2 inhibitors - Celecoxib, rofecoxib - $192.9 million

Why do the companies spend this kind of money on DTC advertising?  Because DTC advertising works.  It increases their sales.  We often forget that PATIENTS drive the system.

This should prompt us ALL to consider the following whenever making formulary or prescribing decisions:

- Is the incremental cost of an agent worth the incremental clinical benefit?  For example, generic terazosin is on the BCF, and is under a joint DoD/VA contract (see http://www.pec.ha.osd.mil/national_contracts.htm )

-  Doxazosin [Cardura®] is still only available as a brand name drug.  For example, is the incremental clinical benefit of Cardura (compared to generic terazosin) worth the incremental cost ($0.55-0.61/dose of Cardura vs. $0.05-0.08/dose for generic terazosin)?

- Are we using BCF drugs to the maximum extent possible to ensure uniformity of the pharmacy benefit, limit the changing of drugs when PCSing, and taking advantage of price savings through national contracts?  The Basic Core Formulary (BCF) is available on the PEC website http://www.pec.ha.osd.mil.  National contracts are also available through a link on this site.

- Is the decision to use drug "X" based on sound clinical evidence and literature support?  Or is my decision to use drug "X" based on hearsay, opinion, or other non-evidence based information?

- Was the article that concluded that drug "X" is the best agent well done?  Did the authors follow the appropriate scientific methods?  Were their conclusions supported by the results of the trial?  

In today's resource constrained healthcare environment, we must all work together to give our patients the best agent available for the most reasonable price.  The best agent may not always be the least expensive agent.  Drug cost alone is only one way to compare the cost of different medications.  By the same token, the most expensive agent is not always the best choice.  Also, high use of a particular drug dose not always indicate appropriate use.