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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/research/resarch.htm" class="crumb_link"><em>Research Activities</em> Archive</a> > <a href="." class="crumb_link">December 2006</a> </span></p>
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<td><h1><a name="h1" id="h1"></a>Pharmaceutical Research </h1>
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<h2>Direct-to-consumer drug advertising on television may have led to increased prescribing of Vioxx® and Celebrex®</h2>
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<p>The cyclooxygenase-2 (COX-2) inhibitor Vioxx® was one of the most heavily advertised prescription drugs in recent years. According to a new study, direct-to-consumer (DTC) drug advertising on television may have led to an increase in doctor's visits by osteoarthritis patients and an increase in prescriptions for Merck's Vioxx® and Pfizer's Celebrex® prior to the 2004 removal of Vioxx® from the market because of evidence it increased the risk of heart attack and stroke.</p>
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<p>W. David Bradford, Ph.D., of the Medical University of South Carolina, and colleagues matched monthly clinical information from 57 primary care practices in 2000-2002 to monthly brand-specific drug advertising data for local and network television. The researchers estimated that a 100 percent increase in local and national Vioxx® ads would, on average, have increased the number of visits by osteoarthritis patients per month by 0.8 percent and 7.4 percent, respectively. They estimated that a 100 percent increase in DTC national advertising of Celebrex® would have led to a 2 percent increase in monthly visits. Local Celebrex® advertising did not influence office visit rates.</p>
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<p>DTC advertising of Vioxx® increased the likelihood that patients would be prescribed both Vioxx® and Celebrex® during these office visits; however, Celebrex® ads only affected Vioxx® use. For example, a tenfold increase in local Vioxx® DTC spots would have generated about a 0.5 percent increase in the rate of Vioxx® prescribing each month. A 50 percent increase in monthly national Celebrex® ads would have led to an increase of about 0.5 percent in Vioxx® prescribing. This may have been because in 2000 Merck invested in nearly twice as many DTC ads for Vioxx® as Pfizer did for Celebrex®. Pfizer concentrated on direct-to-physician marketing of Celebrex® via office visits by pharmaceutical representatives. The study was supported in part by the Agency for Healthcare Research and Quality (HS11326).</p>
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<p>See "How direct-to-consumer television advertising for osteoarthritis drugs affects physicians' prescribing behavior," by Dr. Bradford, Andrew N. Kleit, Ph.D., Paul J. Neitert, Ph.D., and others, in the September 2006 <em>Health Affairs</em> 25(5), pp. 1371-1377.</p>
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