Use of Testosterone Treatments Boosted by DTC Ad Campaigns

Those with a stake in the pharmaceutical industry often question the effectiveness of direct-to-consumer (DTC) advertising, and whether it truly influences consumers to talk to their doctors about medical conditions and perhaps even ask for drugs by name. Now, a study published in the Journal of the American Medical Association (JAMA), has found that these ad campaigns have increased the use of medications used to treat low testosterone in men.

In the early 2000s, drugmakers began ad campaigns aimed at increasing awareness for decreased testosterone in older men, known as “low T.” Low hormone conditions, such as hypogonadism, which can occur following chemotherapy, can be quantitatively measured using testosterone tests.

Low T, on the other hand, is harder to diagnose due in part to the fact that symptoms including fatigue, decreased libido and depression, are general and could be attributed to a number of other conditions. This foggy definition of what constitutes low T has caused some to question whether the condition really exists and needs to be treated pharmacologically.

To assess the impact of low T ads on the use of testosterone treatments, the researchers studied data collected between 2009 and 2013. Using Nielsen ratings for DTC testosterone ads for 75 of the largest designated market areas in the US, they studied the link.

Of the 17,228,599 men with commercial insurance living in the designated market areas included in the study, 1,007,990 men underwent serum testosterone testing during the four year period. 283,317 of these men initiated treatment with testosterone after receiving their test results.

When comparing these numbers to data collected from the monthly Nielsen ratings, the researchers found that each exposure to a low T ad was associated with monthly increases in rates of new testosterone testing of 0.6 percent, new initiation of 0.7 percent, and initiation without a recent baseline test of 0.8 percent.

“Advertising intensity varied by geographic region and time, with the highest intensity seen in the southeastern United States and with months ranging from no ad exposures to a mean of 13.6 exposures per household,” wrote the study authors. “Nonbranded advertisements were common prior to 2012, with branded advertisements becoming more common during and after 2012.”

Currently, AbbVie’s AndroGel is commonly used off-label in the treatment of low-T. In 2013, the drug brought in over $1 billion in sales, becoming a blockbuster drug for the company.

Still, some are concerned about whether testosterone therapies are safe for treating this controversial condition. “When you take testosterone, your body shuts down its own production,” Dr. John La Puma, director of a men’s health clinic in Santa Barbara, California, told the AARP. “A lot of men don’t need testosterone replacement to feel and look better. All they need to do is eat a healthier diet and be a little more active.”