Pharmaceutical companies have increased their spending on direct-to-consumer advertising 330 percent since 1996, but regulatory controls on such ads have slipped, a new report concludes.

Reuters reported Aug. 15 that overall, pharmaceutical firms spend almost $30 billion annually to promote their products, and that such spending is increasing at about 10 percent annually. Researcher Julie Donohue of the University of Pittsburgh Graduate School of Public Health and colleagues based their findings on government and industry reports.

Even as spending has increased, criticism of pharmaceutical advertising has grown, and some heavily promoted drugs have been withdrawn over safety concerns, the U.S. Food and Drug Administration has been issuing fewer warnings to pharmaceutical firms about their ads. In 2006, for example, only 21 warning letters were issued, compared to 142 in 1997.

The number of FDA warnings fell sharply in 2002, when former HHS Secretary Tommy Thompson ordered that the FDA Office of Chief Counsel review all such letters before they were sent to manufacturers.

“In 2004, four (FDA) staffers were reviewing such advertisements, even though spending on this form of advertising (and probably the volume of ads to review) had increased by 45 percent, from $2.9 billion to $4.2 billion,” the researchers noted. FDA reviewed only 32 percent of ads aired in 2004, compared to 64 percent in 1999.

The research was reported in the Aug. 16, 2007 issue of the New England Journal of Medicine.