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# Lower Added Benefit Associated with Higher DTC Spend
- URL: https://www.fdaweb.com/lower-added-benefit-associated-with-higher-dtc-spend/
- Published: 2023-02-07T12:00:00.000Z
- Updated: 2026-09-14T18:14:55.000Z
- Author: David McFarland
- Tags: FDA Policy/General, #legacy-id-D5153724

Johns Hopkins University researchers say that higher direct-to-consumer (DTC) ad spending is associated with drugs that have a lower added benefit and higher total drug sales. Writing in *JAMA*, the researchers say further research is needed to understand the implications of their findings.

In this study of 150 prescription drugs with the highest U.S. sales in 2020, they reported that a higher proportion of promotional spending allocated to DTC advertising was associated with drugs rated as having lower added clinical benefit than those having higher added clinical benefit, and with total drug sales.

“Allocating a greater share of proportional spending to consumer advertising (versus promotions that target clinicians) may … reflect a strategy to drive patient demand for drugs that clinicians might be less likely to prescribe because either there are several similarly effective alternative treatments available or there is a more effective alternative available,” the researchers write. “Drugs with lower added clinical benefit may also be more likely to have lower cost alternatives, be part of a step-therapy regimen, or have unfavorable formulary placement. Whether including information on added clinical benefit in direct-to-consumer advertising would affect the frequency of patient requests for the advertised product may be a future research question.”