Direct-To-Consumer Television Advertising Exposure, Diagnosis with High Cholesterol, and Statin Use
While statin drugs are recommended for secondary prevention of coronary heart disease (CHD), there is no medical consensus on whether or not a statin should be added to lifestyle change efforts for primary prevention of CHD. Previous research suggests that exposure to direct-to-consumer advertising (DTCA) increases drug demand among those at comparatively low risk. Research has yet to examine whether individual-level DTCA exposure may influence statin use among men and women at high, moderate, or low risk for future cardiac events.
To determine the relationship between estimated exposure to DTCA for statin drugs and two clinical variables: diagnosis with high cholesterol and statin use.
We used logistic regression to analyze repeated cross-sectional surveys of the United States population, merged with data on the frequency of DTCA appearances on national, cable, and local television, between 2001 and 2007.
American adults (n = 106,685) aged 18 and older.
Levels of exposure to statin DTCA, based on ad appearances and TV viewing patterns; self-reports of whether or not a respondent has been diagnosed with high cholesterol, and whether or not a respondent took a statin in the past year.
Adjusting for potential confounders, we estimate that exposure to statin ads increased the odds of being diagnosed with high cholesterol by 16 to 20 %, and increased statin use by 16 to 22 %, among both men and women (p < 0.05). These associations were driven almost exclusively by men and women at low risk for future cardiac events. There was also evidence of a negative association between DTCA exposure and statin use among high-risk women (p < 0.05)
This study provides new evidence that DTCA may promote over-diagnosis of high cholesterol and over-treatment for populations where risks of statin use may outweigh potential benefits.
KEY WORDSDTCA direct-to-consumer advertising statins cholesterol screening treatment
- 1.Miniño AM, Murphy SL, Xu J, Kochanek KD. Deaths: final Data for 2008. National Vital Statistics Reports; vol 59 no 10. Hyattsville, MD: National Center for Health Statistics; 2011.Google Scholar
- 2.National Heart, Lung and Blood Institute (NHLBI). High Blood Cholesterol: what You Need to Know. NIH Publication 05–3290. Washington, DC: US Department of Health and Human Services. Available at: http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm. Last accessed January 16, 2013.
- 3.US Preventive Services Task Force (USPSTF). Screening for Lipid Disorders in Adults: Recommendation Statement. Rockville, MD: US Preventive Services Task Force. Available at: http://www.uspreventiveservicestaskforce.org/uspstf08/lipid/lipidrs.htm. Last accessed January 16, 2013.
- 6.National Cholesterol Education Program (NCEP). Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (adult treatment panel III). Washington, DC: US Department of Health and Human Services. Available at: US Department of Health and Human Services. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm. Last accessed January 16, 2013.
- 15.Weissman JS, Blumenthal D, Silk AJ, Zapert K, Newman M, Leitman R. Consumers’ reports on the health effects of direct-to-consumer drug advertising. Health Aff (Milwood). 2003;W3(Suppl Web Exclusives):82–95.Google Scholar
- 16.Rosenthal M, Berndt E, Donohue J, et al. In: Cutler DM, Garber AM, eds. Demand Effects of Recent Changes in Prescription Drug Promotion. Frontiers in Health Policy Research, vol. 6. Cambridge: MIT Press; 2003.Google Scholar
- 22.Avery RJ, Eisenberg M, Simon KI. The impact of direct-to-consumer television and magazine advertising on antidepressant use. Health Econ. In press.Google Scholar
- 28.Simmons National Consumer Survey. Available at: http://www.experian.com/simmons-research/consumer-study.html. Last accessed January 16, 2013.
- 29.Kantar Media. Available at: http://kantarmediana.com/intelligence. Last accessed Jaunary 16, 2013.
- 30.US Centers for Disease Control and Prevention (CDC). Cholesterol: facts. Atlanta, GA: US Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/cholesterol/facts.htm. Last accessed January 16, 2013.
- 31.Stagnitti MN. Statin Use Among Persons 18 and Older in the U S: Civilian Non-Institutionalized Population Reported as Receiving Medical Care For The Treatment Of High Cholesterol, 2002. Statistical Brief #95. Rockville, MD: Agency for Healthcare Research and Quality. 2005. Available at: http://meps.ahrq.gov/mepsweb/data_files/publications/st95/stat95.pdf. Last accessed January 16, 2013.