اطلاع رسانی ناآگاهانه : چگونه تبلیغات دارو ، چک آپ کردن را تحت تاثیر قرار می دهد؟

Direct-to-consumer drug advertising has recently become an important and controversial component of drug marketing. In this paper we examine one of the claimed benefits of drug advertising: encouraging the undiagnosed to seek out medical treatment. We measure how advertising affects an undiagnosed individual's decision to visit a physician for a check-up using detailed person-level panel data on more than 30,000 individuals from the Medical Care Expenditure Panel Survey. We find drug advertising is an important determinant of an individual's decision to get a check-up and that this effect of drug advertising appears to differ by demographic group. While the differences between demographic groups are not statistically different, our point estimates suggest that Blacks and the highly educated are the most responsive to drug advertising.

Quickly diagnosing serious medical conditions, such as hypertension, high cholesterol or diabetes, can enhance welfare directly by avoiding or delaying catastrophic health outcomes, and indirectly by lowering future medical care expenditures. Unfortunately, many individuals are unaware that they may have a serious medical condition and subsequently do not receive timely medical treatment. For example, the undiagnosed fraction of the population with hypertension, diabetes and high cholesterol populations are estimated to be 28%, 27%, and 22%, respectively (PhRMA 2008). Some, including the pharmaceutical industry, have suggested that direct-to-consumer (DTC) advertising for prescription drugs can play an important role in encouraging those at risk of serious medical conditions to seek out professional screening. Despite the potentially large social benefits associated with advertising to the uninformed, the efficacy of drug advertising in informing consumers about health conditions and treatment options remains a controversial topic. Pharmaceutical companies advertise their products to maximize profits, not to provide consumers with information to make optimal health care decisions. Thus, drug manufacturers may face incentives to provide consumers with biased or incomplete information.1 Because of the disparate interests of industry and consumers, the U.S. Food and Drug Administration (FDA) extensively regulates the content of drug advertisements. Until quite recently, the FDA required extensive disclosures of efficacy and risks in all drug advertisements. These regulations severely limited the efficacy of some forms of advertising, such as television. In 1997 the FDA issued a significant change in its regulatory guidance that simplified the types of statements required in advertisements. Following the change in regulation, drug advertising increased dramatically from roughly 764 million dollars in 1997 to 4.1 billion dollars in 2004. The increase in DTC drug advertising has occurred alongside substantial growth in prescription drug expenditures, from 11% to 19.8% of medical expenditures, over the same period.2 Coincidentally, a concern that the FDA has not adequately regulated the content of DTC drug advertisements has grown with the increase in prescription drug advertising and expenditures. A recent study by the U.S. Government Accountability Office (GAO) found that “The effectiveness of the FDA's regulatory letters as halting the dissemination of violative DTC materials has been limited" (United States Government Accountability Office, 2006). These concerns regarding the content and effect of drug advertising have led to calls for additional limitations on drug advertising such as banning drug advertising for the first two years a drug is on the market.3

The regulation of prescription drug advertising has been and remains a controversial policy issue. As recently as 1997, FDA regulations severely limited the use of television drug advertising. Since 1997, the FDA relaxed these regulations and both drug advertising and drug expenditures have increased dramatically. Coincidently, concerns have been raised that the FDA has not been effective in regulating the content of drug advertising. This has led some to suggest that the U.S. should act to limit the role of direct-to-consumer drug advertising. While limiting drug advertising may lower medical costs and lessen misleading advertisements, our study suggests that a restriction would have negative effects on some consumers. We find that drug advertising encourages those with no previous medical diagnosis to see a physician for a check-up. Members of this “undiagnosed” population have much less frequent contact with the medical profession than the general population, and are a group likely to benefit from informative advertising. We find that drug advertising has a significant impact on an undiagnosed individual's decision to see a physician for a check-up: a 10% increase in drug advertising is predicted to increase the likelihood of a check-up in a six month time period by about 6.9%. We also find that the estimated effect of drug advertising on the likelihood of seeing a physician for a check-up varies across demographic groups. While our estimates are imprecisely estimated, our results suggest that Blacks and the more highly educated are more likely to visit a physician for a check-up in response to drug advertising. In contrast, Hispanics appear much less responsive to drug advertising than either Blacks or Whites.