Online Program

Prescription drug coupons: Evolution and hidden cost in direct-to-consumer advertising

Tuesday, November 5, 2013

Timothy Mackey, MAS, PhD, Dept of Anesthesiology, UC San Diego - School of Medicine, La Jolla, CA
Nozomi Yagi, Joint Masters Degree in Health Law-University of California, San Diego-California Western School of Law, University of California, San Diego-California Western School of Law, San Diego, CA
Bryan Liang, MD, JD, PhD, School of Medicine (UCSD),, Global He, San Diego, CA
Pharmaceutical marketing in the United States had undergone a fundamental shift from targeting physicians to targeting patients through direct-to-consumer advertising (“DTCA”). Recently, attempted use of Prescription Drug Coupons (“PDCs”) DTCA claiming purported patient cost-savings, but focused on maintaining brand awareness and market share during patent expiration, has occurred, with active PDC programs currently in operation for top selling pharmaceuticals. As an example, in a simple online searches using Google we conducted from Nov 2011 – Nov 2012, we found nine of the top-10 selling drugs (90%) of 2010, which include Lipitor, Nexium, Plavix, Advair Diskus, Abilify, Seroquel, Singulair, Crestor, and Actos, had PDCs available on their manufacturers' websites. Further, the number of PDC drug product programs has proliferated rapidly, more than quadrupling from 86 in 2009 to 362 in 2012. However, this form of DTCA may be misleading to consumers and lead to both an increase in individual as well as national prescription drug expenditures. To address these negative implications, we propose targeted regulation of PDC DTCA. This would include appropriate disclosure of marketing claims, transparency in pricing of pharmaceuticals using PDCs, and disclosing clinically equivalent therapy options to promote more informed patient and physician decision-making.

Learning Areas:

Ethics, professional and legal requirements
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the current shift in pharmaceutical marketing away from physician detailing and increase in use of direct-to-consumer advertising, including the use of prescription drug coupons. Assess the adverse healthcare cost and patient safety consequences of prescription drug coupon forms of marketing. Formulate a policy proposal that appropriately regulates this new form of direct-to-consumer advertising and promotion to ensure transparency and informed decision making for patients.

Keyword(s): Marketing, Cost Issues

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold a masters degree in health law and am a current PhD Candidate in global health. I am a co-author on several peer-review manuscripts on global health policy and direct-to-consumer advertising and have also given oral presentations at several international and domestic public health conferences including APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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