cation was appropriately prescribed or an underdi-
agnosed condition was given the television spotlight,
patients benefited. However, surveyed physicians re-
ported that patients often came to their offices with
incomplete information about a medication and
more easily recalled the benefits of a drug rather
than the potential risks. Doctors also reported some-
times feeling pressured to write a prescription when
a change in diet or exercise would have been more
appropriate and beneficial for the patient. By the
late 1990’s, most doctors that were surveyed did
not believe that DTC advertising had enhanced the
physician-patient relationship.
Drugmakers pointed to the economic necessity
of advertising new medications. Capital spent on re-
search and development can climb to $1 billion in a
year. Such an investment in research is not sustain-
able if new drugs do not sell in sufficient quantities.
Added to this is the fact that rival drugs, which have
the same biological effects, are often on the market
within three months of a commercial drug release.
Because of the increasingly overcrowded market-
place, the launch of a new medication is extremely
important. Because of these factors, and data show-
ing that advertising drugs leads to more prescrip-
tions, DTC marketing will continue to be a major as-
pect of the pharmaceutical industry well into the
twenty-first century.
DTC Advertising a Decade Later After the 1990’s,
DTC advertising continued to be a priority for the
pharmaceutical industry, eventually showing a 400
percent increase in spending from 1996 to 2003
($791 million to $3.2 billion). The decade following
the FDA’s new regulations would lead to questions
about large advertising budgets, particularly after sev-
eral high-profile prescription drugs were removed
from the market, most notably Merck’s Vioxx.
Impact The 1990’s saw an explosion of growth in
direct-to-consumer advertising by pharmaceutical
companies. Drug companies were now able to by-
pass physicians and have direct contact with consum-
ers. It remains unclear if this has been beneficial, but
such advertising will undoubtedly remain a mainstay
of the pharmaceutical industry for the foreseeable
future.
Further Reading
Baylor-Henry, Minnie, and Norman A. Drezin. “Reg-
ulation of Prescription Drug Promotion: Direct-
to-Consumer Advertising.” Clinical Therapeutics
20, suppl. C (1998): C86-C95. Discusses the FDA’s
role in drug advertising.
Bell, Robert A., Richard L. Kravitz, and Michael S.
Wilkes. “Direct-to-Consumer Prescription Drug
Advertising, 1989-1998.”The Journal of Family Prac-
tice49, no. 4 (April, 2000): 329-335. A description
of what 1990’s advertising looked like in various
print sources.
Gellad, Ziad F., and Kenneth W. Lyles. “Direct-to-
Consumer Advertising of Pharmaceuticals.”The
American Journal of Medicine120, no. 6 (June,
2007): 475-480. A great review of the topic.
Kelly, Tim. “DTC Grows Up.”Guide to Branding,Oc-
tober 15, 2007, 4-16. An article describing the
money spent on advertising, as well as returns on
investment, over the previous ten years.
Perri, Matthew, Shashank Shinde, and Reshma
Banavali. “The Past, Present, and Future of Direct-
to-Consumer Prescription Drug Advertising.”Clin-
ical Therapeutics21, no. 10 (October, 1999): 1798-- A comprehensive review of the topic.
Michael P. Fitzgerald
See also Antidepressants; Attention-deficit dis-
order; Depo-Provera; Fen-phen; Health care; Medi-
cine; Nicotine patch; Pharmaceutical industry;
Viagra. Drug use
Definition Consumption of psychoactive
substances
Despite huge sums of federal and state dollars allocated to-
ward eradicating the supply of illegal drugs and treating
drug users, the consumption of illegal substances contin-
ued unabated throughout the 1990’s.
The Controlled Substances Act (CSA), Title II of the
Comprehensive Drug Abuse Prevention and Con-
trol Act of 1970, is the legal foundation by which the
federal government regulates controlled substances,
including marijuana, stimulants, hallucinogens, de-
pressants, and opiates and their derivatives. In re-
sponse to the widespread use of crack cocaine
through the 1980’s, the federal government passed
the Anti-Drug Abuse Act in 1986, which imposed
stiff, mandatory minimum penalties for persons pos-
sessing the drug.The Nineties in America Drug use 275