直接面向消费者的广告对美国他汀类药物使用的影响。

Effect of Direct-to-Consumer Advertising on Statin Use in the United States.

作者信息

Chang Hsien-Yen, Murimi Irene, Daubresse Matthew, Qato Dima M, Emery Sherry L, Alexander G Caleb

机构信息

*Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health †Center for Drug Safety and Effectiveness, Johns Hopkins University ‡Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy ∥Center for Pharmacoepidemiology and Pharmacoeconomic Research ¶Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL #Department of Medicine, Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD.

出版信息

Med Care. 2017 Aug;55(8):759-764. doi: 10.1097/MLR.0000000000000752.

DOI:10.1097/MLR.0000000000000752

PMID:28598891

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5642991/

Abstract

IMPORTANCE

The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization.

OBJECTIVE

We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization.

DESIGN, SETTING, AND PARTICIPANTS: We conducted an ecological study for 75 designated market areas from 2005 to 2009 in the United States using linked data regarding televised DTCA volume, non-DTCA marketing and promotion, retail, mail order and long-term care prescription drug sales, prescription drug and ambulatory care health care utilization, and contextual factors such as health care density and socioeconomic status. Main outcomes and measures were volume of sales, number of dispensed prescriptions, and high cholesterol-related outpatient visits. Analyses were conducted in 2016.

RESULTS

The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across designated market areas. After adjustment for socioeconomic, demographic, and clinical characteristics, each 100-unit increase in advertisement viewership was associated with a 2.22% [95% confidence interval (CI), 0.30%-4.19%] increase in statin sales. Similar patterns were observed between DTCA and statin dispensing among the commercially insured. DTCA was associated with increases in high cholesterol-related outpatient visits among adults 18-45 years of age (3.15% increase in visits per 100-unit increase in viewership, 95% CI, 0.98%-5.37%) but not among those 46-65 years of age (0.51%, 95% CI, -1.49% to 2.55%).

CONCLUSION

DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.

摘要

重要性

处方药直接面向消费者的广告（DTCA）的价值存在广泛争议，DTCA对处方销量和医疗保健利用的影响也是如此。

目的

我们研究了他汀类药物的DTCA强度与处方销量以及与胆固醇相关的医疗保健利用之间的关联。

设计、地点和参与者：我们利用关于电视DTCA数量、非DTCA营销与推广、零售、邮购和长期护理处方药销售、处方药和门诊医疗保健利用以及诸如医疗保健密度和社会经济地位等背景因素的关联数据，于2005年至2009年在美国75个指定市场区域进行了一项生态研究。主要结局和指标为销量、配药处方数量以及与高胆固醇相关的门诊就诊次数。分析于2016年进行。

结果

每个家庭中瑞舒伐他汀和阿托伐他汀广告曝光的强度在各指定市场区域差异很大。在对社会经济、人口统计学和临床特征进行调整后，广告收视率每增加100个单位，他汀类药物销售额就会增加2.22%[95%置信区间（CI），0.30%-4.19%]。在商业保险人群中，DTCA与他汀类药物配药之间也观察到类似模式。DTCA与18至45岁成年人中与高胆固醇相关的门诊就诊次数增加相关（收视率每增加100个单位，就诊次数增加3.15%，95%CI，0.98%-5.37%），但与46至65岁成年人无关（0.51%，95%CI，-1.49%至2.55%）。