Drug reps or DTC? Congress checks it out

Drug marketing is always under someone's microscope. Does DTC work? Are consumer ads misleading? Is spending on marketing delivering the kind of returns we need? And so on. It's not often, however, that the number-crunchers in Congress apply their spreadsheets to the problem. But that's what the Congressional Budget Office has done, and the analysis released yesterday offers a peek at just where companies are spending their marketing dollars.

What class of drugs gets the most consumer advertising? Try erectile dysfunction meds. Some $320 million went to DTC ads for Viagra, Cialis, and their ilk in 2008--40 percent more than companies spent hawking those drugs to doctors. Marketing for sleep drugs was overwhelmingly weighted on the consumer side as well, with about twice as much spent on DTC versus doctor marketing.

Conversely, statins got the most bucks for doctor detailing--about $425 million worth, more than twice what companies spent to advertise them to patients. Drugmakers also went heavy on the sales rep side for SNRI antidepressants, with a tad more than $400 million spent on detailing versus just over $200 million on ads. Third in line for doc-detailing money were atypical antipsychotics with almost $400 million spent on doctors, way more than twice the $150 million or so spent on DTC. Looking at these numbers, it's hard not to think about the off-label marketing allegations and payment-to-psychiatrist news that's hit the media for mental-health meds.

Another tasty nugget: Drugs that are the only option in their class are advertised much more aggressively than those with lots of competition. That makes sense; drugmakers' big hurdle at that point is consumer awareness, and as a new drug, there's plenty of patent life left to recoup on that spending. Plus, once generic competition hits, brand sales tend to drop, so why spend a lot to advertise then? Check out the report for more.

- see the CBO report
- check out the chart at PharmaGossip
- read the New York Times coverage