Effects of Drug Advertising on Prescription Choice

处方药支出是增长最快的卫生支出，目前约为每年20%。这一趋势与通过电视和其他媒体直接针对消费者的药品广告的急剧增长相吻合，特别是自1997年8月食品和药物管理局决定放宽广告限制以来。这就增加了一种可能性，即直接面向消费者的广告增加了处方药的使用，并挫败了支付者控制医疗保健费用的努力。拟议研究的主要目的是解决直接面向消费者的广告对处方药选择的影响。具体来说，它解决了两个问题：(1)直接面向消费者的广告在多大程度上增加了广告药物的利用率？(2)直接面向消费者的广告是否破坏了保险公司诱导处方行为价格敏感性的努力？本研究提供了一个概念框架来分析处方药需求和医生处方决策，特别关注直接面向消费者的广告、处方和成本分摊要求的影响。计量经济学分析利用了一个广泛的处方索赔小组，与直接面向消费者和医生的广告支出相匹配。估计利用随机系数多项logit程序，以说明异质性的病人和医生的口味和偏好。了解处方支出增长背后的机制以及控制这种增长的可能方法，对所有努力控制其药房成本的第三方支付者都很重要。这项研究对药物广告的监管也有潜在的影响，如果医疗保险药物福利成为现实，可能有助于构建这样的福利。

Prescription drug spending has been the fastest growing health expenditure, currently on the order of 20% per year. This trend coincides with the dramatic growth of drug advertising aimed directly at the consumers through television and other media, particularly since the August 1997 Food and Drug Administration decision to ease advertising restrictions. This raises the possibility that direct-to- consumer advertising contributes to increased utilization of prescription drugs and frustrates efforts by payers to control health care costs. The primary aim of the proposed study is to address the effects of direct-to-consumer advertising on prescription drug choice. Specifically, it addresses two questions: (1) To what extent does direct-to-consumer advertising increase the utilization of advertised drugs? (2) Does direct-to-consumer advertising undermine the insurers' efforts to induce price sensitivity in prescription behavior? This study provides a conceptual framework to analyze the demand for prescription drugs and physician prescription decision-making, with special attention to the influences of direct-to-consumer advertising, formularies, and cost-sharing requirements. The econometric analysis utilizes an extensive panel of prescription claims matched with direct-to-consumer and physician advertising expenditures. The estimation utilizes a random coefficients multinomial logit procedure to account for heterogeneity of patient and physician tastes and preferences. Understanding the mechanisms behind the growth of prescription expenditures and the possible ways of controlling that growth is important to all third-party payers that struggle with controlling their pharmacy costs. This research also has potential implications for the regulation of drug advertising and, if a Medicare drug benefit becomes reality, may aid in structuring such a benefit.