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COMPANIES that advertise prescription drugs directly to consumers may not get as much bang for their buck as they 鈥� or their critics 鈥� assume.

Direct-to-consumer advertising (DTCA) of drugs is only permitted in the US and New Zealand and has long been controversial. Both proponents and opponents assume the ads increase prescriptions, with the former arguing they benefit society by raising awareness of diseases and available treatments and the latter that they pump up demand for drugs unnecessarily. However, DTCA is usually accompanied by other marketing directed at doctors, making it difficult to tease out the effects of the ads alone.

Enter , a health policy researcher at Harvard Medical School in Boston, who says that Canada provides a perfect test case. Doctors there receive the same vigorous sales pressure as their American counterparts. But while English-speaking Canadians see DTCA on US TV channels, which most Canadian households receive, Canadian TV is prohibited from running similar ads, so French-speaking viewers should have far less exposure, he says.

Law and his colleagues chose three drugs widely advertised on US TV and compared prescription rates in predominantly French-speaking Quebec with those in the rest of Canada. They found that only one of the three, a treatment for irritable bowel syndrome called Zelnorm, showed an increase in prescription rates in English-speaking Canada after the start of its US advertising campaign. Even this only lasted for a few months, suggesting that DTCA does little to boost the sale of drugs (BMJ, ).

鈥淎ll of this hoopla about drug advertising on TV might be exaggerated,鈥� says Law鈥檚 colleague . One reason may be that consumers must go through their doctors to get a prescription rather than buying them directly.

It is important not to draw firm conclusions from a study of just three drugs, says David Henry of the in Toronto, Canada. But he adds that television advertising may be losing its punch because patients are inundated with information from the internet.

鈥淭elevision advertising may be losing its punch because patients are inundated with information from the internet鈥�