Biomedical Engineering Reference
In-Depth Information
Table 22.1
DTCA regulations worldwide
Product claim
messages
Help-seeking
messages
Reminder
messages
Regulatory
content
Therapeutic category
information
√
√
X
Symptoms
√
√
X
Health claims
√
√
X
Risk information
√R
NR
NR
Price information
√
X
√
Brand name
√
X
√
Dosage information
√R
X
√
Direct to a physician
√R
√
NR
Regulatory
context
USA and New Zealand
√
√
√
Canada
X
√
√
Australia and EU
X
X
X
NR: not required, √: allowed, √R: required, X: forbidden
message type may contain, and context, which refers to the country in which each
type of ad is allowed in practice. Regarding the latter, one can clearly distinguish
between three types of regulatory regimes: “liberal” (USA, New Zealand), “moder-
ate” (Canada), and “strict” (all others).
22.3
Academic Research on DTCA Influence
Table
22.2
summarizes the main conclusions from research on DTCA effects. The
shaded cells indicate conclusions for which more studies are needed to further solidify
them. In sum, the evidence so far does not support a “destructive” effect of DTCA:
(a) Brand sales elasticities are low and comparable to the elasticities for consumer
packaged goods. For example, in their meta-analysis, Kremer et al. (
2008
)
found that the average DTCA elasticity is 0.07.
(b) DTCA has mainly a (small) market expansion effect, either through increased
category sales or doctor visits (e.g., Iizuka and Jin
2007
; Iizuka and Jin
2005
;
Liu and Gupta
2011
). The meta-analytic study of Fischer and Albers (
2010
)
found the long-term DTCA elasticity of category sales to be 0.08.
(c) There is no evidence to support that DTCA is associated with higher prices
(e.g., Narayanan et al.
2004
; Capella et al.
2009
). Further, Iizuka and Jin (
2007
)
found no interaction between price and DTCA.
Thus, it seems that DTCA does not contribute to increased health costs besides
the increased drug utilization effect which is desirable from a public health perspec-
tive (GAO
2002
). In fact, Liu and Gupta (
2011
) found that DTCA for cholesterol-
lowering drugs is cost-effective by reducing the under-diagnosis and under-treatment,
in other words the category expansion effect of DTCA counterweighs its market-
share stealing effect.
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