The Impact of Direct-to-Consumer Advertising on Outpatient Care Utilization


There is much debate about the effects of pharmaceutical direct to consumer advertising (DTCA)
on health care use. In this paper, we inform this debate by examining the effects of DTCA on
office visits, as well as treatment courses resulting from those visits, for five common chronic
conditions (hypertension, hyperlipidemia, diabetes, depression, and osteoporosis). In particular, we
examine whether office visits result in use of drug therapy and/or continued office visits over time.
We test these questions by combining data on pharmaceutical advertising from Nielsen with
claims data from 40 large national employers, covering 18 million person-years. We analyze a
non-elderly population by exploiting plausibly exogenous variation in advertising exposure across
areas due to the implementation of Medicare prescription drug coverage which led to larger
increases in advertising in areas with high elderly share of population compared to low elderly
share areas. We find that advertising increases the number of office visits for the non-elderly for
the advertised condition. We also find substantial spillovers — a large share of the increased office
visits from advertising are associated with use of non-advertised generic drugs or do not result in
use of any drugs. Finally, we find that the increase in office visits due to DTCA is associated with
continued engagement with a physician through multiple consecutive follow up visits over time.

The full study is available at NBER.

Eisenberg, M. D., Rabideau, B., Alpert, A. E., Avery, R. J., Niederdeppe, J., & Sood, N. (2022). The Impact of Direct-to-Consumer Advertising on Outpatient Care Utilization (No. w30791). National Bureau of Economic Research.