Effect of Direct-to-Consumer Advertising on Statin Use in the United States.
Effect of Direct-to-Consumer Advertising on Statin Use in the United States.
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DOI：
10.1097/mlr.0000000000000752
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发表时间：
2017-08
期刊：
影响因子：
3
通讯作者：
Alexander GC
中科院分区：
文献类型：
--
作者：
Chang HY;Murimi I;Daubresse M;Qato DM;Emery SL;Alexander GC
处方药的直接面向消费者广告（DTCA）的价值被广泛争论，DTCA对处方销售和医疗保健利用的影响也是如此。我们检查了他汀类药物DTCA强度与处方销售和胆固醇相关医疗保健利用之间的关系。从2005年到2009年，我们对美国75个指定市场区域（dma）进行了生态研究，使用有关电视DTCA量的相关数据；非dtca营销推广；零售、邮购及长期护理处方药销售；处方药与门诊医疗保健的利用；以及环境因素，比如医疗密度和社会经济地位。主要结果和指标为销售量；配发处方数；和高胆固醇相关的门诊就诊。分析于2016年进行。瑞舒伐他汀和阿托伐他汀的强度和每个家庭的暴露在不同的dma中有很大的不同。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，他汀类药物的销量就会增加2.22%（95%可信区间[CI] 0.30至4.19%）。类似的模式被观察到在DTCA和他汀类药物分配之间的商业保险。在18-45岁的成年人中，DTCA与高胆固醇相关的门诊就诊增加有关（每100单位观众增加的就诊次数增加3.15%,95% CI: 0.98至5.37%），但在46-65岁的成年人中没有（0.51%,95% CI: - 1.49至2.55%）。他汀类药物的DTCA与他汀类药物使用率和高脂血症相关门诊就诊的增加有关，特别是对年轻人。
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. We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. We conducted an ecological study for 75 designated market areas (DMAs) 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. The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across DMAs. 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 to 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 to 5.37%) but not among those 46–65 years of age (0.51%, 95% CI: −1.49 to 2.55%). DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.