DTC Advertising Effect on Adherence to Statin Therapy

描述（由申请人提供）：1997年8月，美国食品药品监督管理局（FDA）放宽了处方药广播广告的规定。此后不久，处方药的直接面向消费者广告（DTCA）支出飙升。这在医疗行业、医疗保险公司和管理式医疗机构之间引发了大量争论。我们建议研究DTCA的一个可能的作用——是否暴露于DTCA可以提高患者对治疗高脂血症的处方药治疗（他汀类药物）的依从性。众所周知，坚持治疗是许多慢性病有效治疗的障碍。处方他汀类药物治疗已成为治疗高脂血症的主要方式。自1997年以来，他汀类药物中有几种是广告宣传最多的药物。我们假设，生活在这些药物广告铺天盖地的地区的患者会比生活在这些药物没有广告的地区的患者更好地坚持他们的处方治疗，因此会有更好的结果。该建议有四个主要目的：1)确定DTCA对医生患者群体的影响程度；2)确定DTCA对患者服用降脂药物可能性的影响；3)考虑到患者有处方，确定DTCA对治疗依从性的影响；4)确定DTCA对他汀类药物处方治疗有效性的影响。本研究将利用一个独特的研究数据库，该数据库结合了详细的临床信息（来自65个地理分散的初级保健实践的电子病历摘录）和详细的广告数据（品牌、月份和媒体市场特定）。将估计一系列计量经济模型，以确定DTCA的依从性和健康影响。

DESCRIPTION (provided by applicant): In August of 1997 the Food and Drug Administration (FDA) relaxed the rules governing broadcast advertising of prescription pharmaceutical products. Shortly thereafter, expenditures on direct to consumer advertising (DTCA) for prescription pharmaceuticals soared. This has lead to a great deal of debate in the medical profession and among health care insurers and managed care organizations. We propose to study one possible effect of DTCA - whether exposure to DTCA can improve patient adherence to prescribe pharmaceutical therapy (statins) for the treatment of hyperlipidemia. Adherence to therapy is known to be a barrier to effective care for many chronic diseases. Treatment with prescription statins has become a principal modality for managing hyperlipidemia. Several of the statins are among the most heavily advertised pharmaceuticals since 1997. We hypothesize that patients who are in areas where these drugs are heavily advertised will have better adherence to their prescription therapy than patients who live in areas where these drugs are not advertised, and as a consequence will have better outcomes. This proposal has four principle aims: 1) determine the degree to which DTCA affects physician patient populations; 2) determine the impact of DTCA on the likelihood that a patient is prescribed a lipid-lowering drug; 3) determine the impact of DTCA on adherence to therapy, given that a patient has a prescription; and 4) Determine the impact of DTCA on the effectiveness of prescription statin therapy. This study will utilize a unique research data base which combines detailed clinical information (from an extract of the electronic medical records of 65 geographically dispersed primary care practices) with detailed advertising data (brand, month, and media-market specific). A series of econometric models will be estimated to determine the adherence and health effects of DTCA.