title: Trends in direct-to-consumer advertising of prescription contraceptives.
abstract: Despite much speculation about the role of direct-to-consumer advertising (DTCA) in increasing demand for prescription contraceptives in the United States, there is little published research on this topic. We sought to quantify the prevalence and magnitude of DTCA for prescription contraceptives over the last decade.
  
  
  
  Using cross-sectional data from January 2005 through December 2014, we performed descriptive analyses on trends in DTCA expenditure for prescription contraceptives. We also quantified the amount of DTCA according to contraceptive method category and individual brand.
  
  
  
  During the study period, pharmaceutical companies spent a total of US$1.57 billion in the United States on DTCA of prescription contraceptives. Annual expenditure for contraceptive DTCA reached a peak value of US$260 million in 2008, with a progressive decline to a nadir of US$69 million by 2013. Of the contraceptive methods, oral contraceptive pills (OCPs) have been the most heavily promoted, with Yaz (drospirenone/ethinyl estradiol) - the most advertised brand - accounting for US$347 million of cumulative DTCA expenditure. However, DTCA spending on OCPs peaked in 2007 and was overtaken in 2012 by the DTCA of long-acting reversible contraceptives (LARCs), the contraceptive method now receiving the largest amount of DTCA promotion.
  
  
  
  DTCA is a major form of promotion for prescription contraceptives. Recent trends in DTCA expenditure indicate a shift from promotion of the OCPs to the LARCs. DTCA's effect on provider and patient utilization of various contraceptive methods has yet to be determined.
  
  
  
  This study provides the first quantitative evaluation of DTCA of prescription contraceptive methods and reveals DTCA's importance as a form of promotion. Recent DTCA trends indicate increased promotion of LARCs, coinciding with greater uptake of LARC methods by patients and prescribers.
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. Electronic address: min_wu@hms.harvard.edu.
authors.forename: Min H
authors.initials: MH
authors.lastname: Wu
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address: dbartz@partners.org.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bartz
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. Electronic address: javorn@partners.org.
authors.forename: Jerry
authors.initials: J
authors.lastname: Avorn
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. Electronic address: jdseeger@partners.org.
authors.forename: John D
authors.initials: JD
authors.lastname: Seeger
mesh_terms: D003267:Contraception / Q000191:economics / Q000706:statistics & numerical data*; D003276:Contraceptives, Oral / Q000191:economics / Q000600:supply & distribution*; D003430:Cross-Sectional Studies; D000067088:Direct-to-Consumer Advertising / Q000639:trends*; D004345:Drug Industry; D005260:Female; D006801:Humans; D008402:Mass Media; D014481:United States
chemical_list: D003276:Contraceptives, Oral
keywords: Contraception; Contraceptive devices; Direct-to-consumer advertising; Long-acting reversible contraceptives; Prescription drugs