(HealthDay News) — From 1997 through 2016, there was an increase in medical marketing, especially direct-to-consumer (DTC) advertising, according to research published in the Journal of the American Medical Association.

Lisa M. Schwartz, MD, and Steven Woloshin, MD from the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire, reviewed the marketing of prescription drugs, disease awareness campaigns, health services, and laboratory tests and related consequences from 1997 to 2006.

The researchers found that spending on medical marketing of drugs, disease awareness campaigns, health services, and laboratory testing increased from $17.7 billion to $29.9 billion from 1997 through 2016. The most rapid increase was in DTC advertising (from 11.9 to 32.0% of total spending). There was an increase in DTC prescription drug advertising from $1.3 billion to $6 billion, with a shift toward the advertising of high-cost biologics and cancer immunotherapies. Pharmaceutical companies increased DTC marketing about diseases treated by their drugs; disease awareness campaigns increased from 44 to 401. There was also an increase in DTC advertising for health services from $542 million to $2.9 billion. Marketing to health care professionals increased from $15.6 billion to $20.3 billion, accounting for most promotional spending.

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“Despite the increase in marketing over 20 years, regulatory oversight remains limited,” the authors write.

The authors served as medical experts in testosterone litigation and were cofounders of Informulary.

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Schwartz LM and Woloshin S. Medical Marketing in the United States, 1997-2016. JAMA. 2019;321(1):80-96. doi:10.1001/jama.2018.19320

Ortiz SE and Rosenthal MB. Medical Marketing, Trust, and the Patient-Physician Relationship. JAMA. 2019;321(1):40-41. DOI:10.1001/jama.2018.19324

Bauchner H and Fontanarosa PB. Medical Marketing in the United States—A Truly Special Communication. JAMA. 2019;321(1):42-43. DOI:10.1001/jama.2018.20505

Bauchner H. A Tribute to Lisa M. Schwartz. JAMA. 2019;321(1):96. DOI:10.1001/jama.2018.20566