Online Program

Effects of televised direct-to-consumer advertising for varenicline on prescription dispensing in the United States, 2006-2009

Tuesday, November 3, 2015

Yoonsang Kim, PhD, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Yaru Shi, MS, Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Lisa Vera, BA, Moores Cancer Center, University of California San Diego, La Jolla, CA
Sherry Emery, PhD, MBA, Institute for Health Research and Policy - Health Media Collaboratory, University of Illinois at Chicago, Chicago, IL
background: Televised direct-to-consumer advertising (DTCA) for prescription drugs is controversial, especially for tobacco cessation products such as varenicline, given mixed evidence of varenicline’s effectiveness as well as safety concerns that arose only after its market approval. We aim to quantify the extent to which DTCA influenced varenicline use.

methods: We linked monthly Nielsen DTCA television ratings with monthly data from IMS Health’s National Prescription Audit to examine relationships between DTCA for smoking cessation aids and varenicline prescribing across 75 media markets. We used Poisson GEE models to analyze effects of exposures to DTCA for both varenicline and nicotine replacement therapies (NRT) on varenicline prescriptions among smokers, controlling for population characteristics and varenicline-related events.

results: Varenicline prescriptions increased dramatically following DTCA launch and declined sharply after safety risks were made public: sales dropped by 40% in 6 months after the FDA public health advisory. Varenicline DTCA had significant impact on new prescription volume in the subsequent month: before the FDA advisory, one additional exposure to varenicline DTCA was associated with a 1.8% higher rate of new prescriptions (p<.0001); while no effect was observed after the advisory (RR=1.0, p=0.95). Cross-product effects of NRT advertising on varenicline prescribing were significant after the FDA advisory (RR=1.015, p<.0001), while the effects were negligible before the advisory (RR=1.002, p=0.14).

conclusions: DTCA for varenicline had a significant impact on varenicline prescribing during a time when the drug’s safety profile was not fully understood, supporting arguments to limit DTCA for newly-approved products whose real-world safety is particularly unclear.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Analyze the extent to which DTCA for varenicline influenced prescribing and use of the drug between 2006 and 2009. Discuss evidence in support of limiting DTCA for prescription drugs whose safety profile has yet to be clarified.

Keyword(s): Prescription Drug Abuse and Misuse, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I earned my doctorate in biostatistics in 2011. I was an assistant professor of research at the University of Oklahoma Health Sciences Center. Since 2012, I have provided statistical analysis for public health research projects at the University of Illinois at Chicago. My primary research interests are modeling geographical variation in disease prevalence and public health campaign influence, with emphasis on tobacco and pharmaceutical drug-related behaviors.
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.