Drugmakers spent $17.8 billion on direct-to-consumer advertising (DTCA) from 2016 to 2018, the U.S. Government Accountability Office (GAO) detailed in a May 2021 report to Congress. Meanwhile, 58% of the $560 billion that Medicare Parts B and D spent on drugs in the same time period was spent on advertised drugs. While the GAO said other factors such as increased unit prices and doctor prescribing habits make it difficult to establish a strong link between DTCA, beneficiary use and Medicare spending, the agency identified four drugs that were among the costliest for Medicare and had the highest DTCA spending: Eliquis, Humira, Keytruda and Lyrica. Bristol Myers Squibb (BMS)’s Eliquis in particular stands out, as the blood-thinning agent became Part D’s most expensive drug in 2018, reaching nearly $5 billion in spending. The GAO highlighted a marked increase in the use of Eliquis from 2013 to 2014 that correlated to a nearly doubled advertising budget, in addition to its FDA approval for new indications. The use of Eliquis among seniors and its Medicare spend continued to grow even as BMS reduced the drug’s DTCA budget.

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• RADAR on Medicare Advantage