Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use

Daubresse, Matthew; Hutfless, Susan; Kim, Yoonsang; Kornfield, Rachel; Qato, Dima M.; Huang, Jidong; Miller, Kay; Emery, Sherry; Alexander, G. Caleb

doi:10.1164/rccm.201409-1585oc

Cited by 29 publications

(20 citation statements)

References 27 publications

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“…34 Even so, a recent study found little evidence of association between DCTA and Advair prescriptions, and it therefore seems unlikely that DCTA alone is responsible. 35 …”

Section: Commentmentioning

confidence: 99%

Trends in Prescription Drug Use Among Adults in the United States From 1999-2012

Kantor

Rehm

Haas

et al. 2015

JAMA

1,045

699

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Importance It is important to document patterns of prescription drug use to inform both clinical practice and research. Objective To evaluate trends in prescription drug use among adults living in the United States. Design, Setting, and Participants Temporal trends in prescription drug use were evaluated using nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Participants include 37,959 non-institutionalized US adults, aged 20 years and older. Seven NHANES cycles were included (1999–2000 to 2011–2012), and the sample size per cycle ranged from 4,861 to 6,212. Exposures Calendar year, as represented by continuous NHANES cycle. Main Outcome(s) and Measure(s) Within each NHANES cycle, use of prescription drugs in the prior 30 days was assessed overall and by drug class. Temporal trends across cycles were evaluated. Analyses were weighted to represent the US adult population. Results Results indicate an increase in overall use of prescription drugs among US adults between 1999–2000 and 2011–2012 with an estimated 51% of US adults reporting use of any prescription drugs in 1999–2000 and an estimated 59% reporting use in 2011–2012 (Difference: 8%; 95% CI: 3.8%–12%; p-trend<0.001). The prevalence of polypharmacy (use of ≥5 prescription drugs) increased from an estimated 8.2% in 1999–2000 to 15% in 2011–2012 (Difference: 6.6%; 95% CI: 4.4%–8.2%; p-trend<0.001). These trends remained statistically significant with age adjustment. Among the 18 drug classes used by more than 2.5% of the population at any point over the study period, the prevalence of use increased in 11 drug classes including antihyperlipidemic agents, antidepressants, prescription proton-pump inhibitors, and muscle relaxants. Conclusions and Relevance In this nationally representative survey, significant increases in overall prescription drug use and polypharmacy were observed. These increases persisted after accounting for changes in the age distribution of the population. The prevalence of prescription drug use increased in the majority of, but not all, drug classes.

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“…34 Even so, a recent study found little evidence of association between DCTA and Advair prescriptions, and it therefore seems unlikely that DCTA alone is responsible. 35 …”

Section: Commentmentioning

confidence: 99%

Trends in Prescription Drug Use Among Adults in the United States From 1999-2012

Kantor

Rehm

Haas

et al. 2015

JAMA

1,045

699

View full text Add to dashboard Cite

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“…Local stakeholders (patient, family, physician, and consultant) and global stakeholders (industry, regulators, academics, and the public) interact in complex ways (social media, literature, lay press, guidelines, advertising, formularies, package inserts, and direct interaction) to generate choices based on a variety of inputs (indication, feasibility, preference, and cost) (11)(12)(13)(14)(15)(16). Because of this complexity, actual practice can be characterized only empirically, answering questions such as what treatment choices are being made in clinical practice, how many patients experience which combination of therapies, and how patterns may change over time or across different locations and practice types.…”

mentioning

confidence: 99%

Characterizing treatment pathways at scale using the OHDSI network

Hripcsak

Ryan

Duke

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

282

222

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Observational research promises to complement experimental research by providing large, diverse populations that would be infeasible for an experiment. Observational research can test its own clinical hypotheses, and observational studies also can contribute to the design of experiments and inform the generalizability of experimental research. Understanding the diversity of populations and the variance in care is one component. In this study, the Observational Health Data Sciences and Informatics (OHDSI) collaboration created an international data network with 11 data sources from four countries, including electronic health records and administrative claims data on 250 million patients. All data were mapped to common data standards, patient privacy was maintained by using a distributed model, and results were aggregated centrally. Treatment pathways were elucidated for type 2 diabetes mellitus, hypertension, and depression. The pathways revealed that the world is moving toward more consistent therapy over time across diseases and across locations, but significant heterogeneity remains among sources, pointing to challenges in generalizing clinical trial results. Diabetes favored a single first-line medication, metformin, to a much greater extent than hypertension or depression. About 10% of diabetes and depression patients and almost 25% of hypertension patients followed a treatment pathway that was unique within the cohort. Aside from factors such as sample size and underlying population (academic medical center versus general population), electronic health records data and administrative claims data revealed similar results. Large-scale international observational research is feasible.observational research | data network | treatment pathways A learning health system (1) must systematically evaluate the effects of medical interventions to enable evidence-based medical decision-making. Randomized clinical trials serve as the cornerstone for causal evidence about medical products (2, 3), but evidence from these trials may be limited by an insufficient number of persons exposed, insufficient length of exposure, and inadequate coverage of the target population, factors that limit external generalizability. Observational studies can contribute to the larger goal of causal inference at three stages: (i) the design of experiments, such as determining what are the current therapies that should be compared with a new therapy; (ii) the direct testing of clinical hypotheses on observational data (4-8) using methods to correct for nonrandom treatment assignment as part of the effect estimation process; and (iii) better understanding of population characteristics to improve the extrapolation of both observational and experimental results to new groups.Without sufficiently broad databases available in the first stage, randomized trials are designed without explicit knowledge of actual disease status and treatment practice. Literature reviews are restricted to the population choices of previous investigations, and pilot studi...

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“…De hecho, los gastos de promoción y publicidad de medicamentos suponen entre el doble o triple del presupuesto destinado a investigar (Bolaños Dávila y Herrera Cedeño, 2012). Unos investigadores (Daubresse et al, 2015) demostraron que la publicidad a través de televisión de medicamentos para el asma tiene una relación directa con el aumento de venta de esos medicamentos. Además, paralelamente, también encontraron un aumento de visitas a urgencias debido a problemas de asma.…”

Section: A-la Publicidad De Medicamentosunclassified

Avances en investigación y buenas prácticas en comunicación y salud

Terrón¹,

Peñafiel²,

Catalán³

2017

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Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use

Cited by 29 publications

References 27 publications

Trends in Prescription Drug Use Among Adults in the United States From 1999-2012

Trends in Prescription Drug Use Among Adults in the United States From 1999-2012

Characterizing treatment pathways at scale using the OHDSI network

Avances en investigación y buenas prácticas en comunicación y salud

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