Viewers Unmoved By Price Info in Heart Drug Commercials

Disclosure of moderate price tags in direct-to-consumer advertising (DTCA) did not put the brakes on people wanting to switch medications after viewing commercials for heart drugs, online studies showed.

Among survey participants at high risk of cardiovascular disease, those randomized to view pharmaceutical commercials — for ticagrelor (Brilinta), sacubitril/valsartan (Entresto), evolocumab (Repatha), and rivaroxaban (Xarelto) — were more likely than other consumers assigned to view nonpharmaceutical advertising to subsequently report:

• Intention to switch medication

• Intention to search for information about the medication online

• More favorable perceptions of pharmaceutical manufacturers

• Belief that medication is an effective treatment for heart disease

• Belief that heart disease is a serious condition

There was no change in people’s intentions and beliefs when the videos added price information sourced from the SSR Health database, according to researchers led by Matthew Eisenberg, PhD, of Johns Hopkins Bloomberg School of Public Health in Baltimore.

“These results are in line with the broader literature on price transparency in health care, which suggests that public information does not shift demand in appreciable ways,” the group reported in JAMA Health Forum. “Lack of associations with price disclosure in DTCA suggests that policy makers should consider alternative strategies to promote value-based decision-making for prescription drugs.”

For many heart patients, it may simply be unaffordable to take established cardiovascular drugs. One study estimated that a 30-day supply of quadruple therapy for heart failure cost almost $100 out-of-pocket for Medicare Advantage and Part D patients.

For years, policymakers have expressed interest in different ways to lower the high prescription drug costs in the country.

The Department of Health and Human Services tried unsuccessfully to force pharmaceutical companies to start putting prices in all television advertisements in 2019.

The idea behind price disclosures in DTCA is that they might discourage consumers from seeking treatment with high advertised prices, forcing drug manufacturers to meet the market at a lower price point. “Alternatively, disclosure may be ineffective if consumers cannot evaluate prescription drug prices or if they view price as a signal of quality,” Eisenberg’s group noted.

Other efforts to reduce prices include a provision in the Inflation Reduction Act, approved by the Senate and expected to pass the House on Friday, that would finally allow Medicare to negotiate on drug prices and potentially bring them down.

For their study, Eisenberg and colleagues sought a nationally representative cohort of people at high risk of cardiovascular disease. They recruited volunteers from the Ipsos online survey platform who were age 40 to 64 years and had high cholesterol, were cigarette smokers, or were overweight or obese.

Surveys were conducted in the summer of 2021. Participants were randomized to exposure to ads for heart disease medications (n=926), exposure to those ads with price disclosure (n=921), or exposure to nonpharmaceutical advertising (n=902). Each study arm viewed five 1-minute video advertisements.

Mean age was 53.8 years, and 54% were men.

The study authors acknowledged that their online platform does not capture the experience of viewing ads through various media platforms. Additionally, the link between stated behavioral intentions and eventual behavior change can be weak, they said.

Harms of DTCA suggested in prior studies include patients receiving prescriptions for drugs that were not appropriate or necessary, and a potential drop-off in medication adherence in some populations.