NCPA - National Center for Policy Analysis


April 1, 2008

Few Canadians are taking a controversial new cholesterol-lowering drug compared with millions in the United States, where the medication has been heavily promoted, according to a new study published in the New England Journal of Medicine.  The results suggest that advertising may have a greater influence on the use of a medication than scientific evidence.

Other major findings:

  • More than 33 million prescriptions for ezetimibe, sold under the brand names Zetia, Ezetrol and Vytorin, were issued in the United States in 2006, compared with just 824,000 in Canada during the same period.
  • The drug accounted for more than 15 per cent of all prescriptions for cholesterol-lowering medication in the United States that year, but only 3.4 per cent in Canada.
  • More than $200-million (U.S.) was spent on direct-to-consumer advertising for Vytorin in 2007 and that sales of the drug recently eclipsed $5-billion.

Ezetimibe is not recommended by health authorities as the first option for patients seeking to control cholesterol in Canada or the United States, according to the study, and has been the subject of growing debate over its effectiveness compared with other medication.

That has led researchers to believe that other factors -- particularly heavy promotion to U.S. consumers -- have contributed to its rapid sales growth in that country and its sluggish performance here.

In Canada, drug companies are not allowed to directly advertise a medication and its benefits to the public, but they can promote their products to physicians.  They have much more freedom to publicly promote drugs in the United States, which many medical experts say has a major impact on the types of medications that are being prescribed.

Source: Carly Weeks, "Advertising may have more influence on prescriptions than science," Globe and Mail, March 31, 2008; based upon: Cynthia A. Jackevicius et al., "Use of Ezetmibe in the United States and Canada," New England Journal of Medicine, March 30, 2008.


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