Effect of illicit direct to consumer advertising on use of etanercept, mometasone, and tegaserod in Canada: controlled longitudinal study
2008

Impact of US Drug Advertising on Canadian Prescribing

Sample size: 2700 publication 10 minutes Evidence: moderate

Author Information

Author(s): Michael R Law, Sumit R Majumdar, Stephen B Soumerai

Primary Institution: Harvard Medical School and Harvard Pilgrim Health Care

Hypothesis

US direct to consumer advertising campaigns would increase use of marketed drugs in English speaking Canadian provinces.

Conclusion

US direct to consumer advertising transiently influenced Canadian prescribing rates for tegaserod, a drug later withdrawn due to safety concerns.

Supporting Evidence

  • US direct to consumer advertising spending ranged from $194m to $314m.
  • Tegaserod prescriptions increased by 42% immediately after US advertising.
  • Prescription rates for etanercept and mometasone did not increase after advertising.

Takeaway

The study looked at how US drug ads affected Canadian prescriptions. It found that one drug's use went up for a short time after the ads, but then it went back down.

Methodology

Controlled quasi-experimental study using interrupted time series analysis.

Potential Biases

Potential selection bias due to differences in drug characteristics and advertising exposure.

Limitations

Generalizing beyond the three drugs studied is difficult, and there may be confounding factors affecting results.

Participant Demographics

Representative sample of Canadian pharmacies and US Medicaid programmes.

Statistical Information

P-Value

<0.001

Confidence Interval

0.37 to 0.76

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1136/bmj.a1055

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