Table 2. Select Characteristics of Top-Selling Drugs as Measured by 2020 US Drug Sales and With More Than 80% of Total Promotional Spending Allocated to Direct-to-Consumer Advertising.
| Product (nonproprietary name) | Share of promotional spending on direct-to-consumer advertising, % | Total, $ | Indication (WHO anatomical therapeutic chemical classification) | Added clinical benefita | Original assessment, country | |
|---|---|---|---|---|---|---|
| Promotional spending, millions | Product sales, billions | |||||
| Gammagard Liquid (immune globulin) | 99.9 | 0.275 | 1.02 | Hypogammaglobulinemia; multifocal motor neuropathy (anti-infectives for systemic use) | Low | None, France |
| Yervoy (ipilimumab) | 97.6 | 82.5 | 1.14 | Various cancers (antineoplastic and immunomodulating agents) | Low | Minor, France |
| Ocrevus (ocrelizumab) | 97.4 | 97.1 | 3.54 | Multiple sclerosis (antineoplastic and immunomodulating agents) | High | Moderate, France |
| Ibrance (palbociclib) | 95.8 | 131 | 3.79 | Breast cancer (antineoplastic and immunomodulating agents) | Low | Minor, France |
| Opdivo (nivolumab) | 92.2 | 95.3 | 3.95 | Various cancers (antineoplastic and immunomodulating agents) | High | Moderate, France |
| Odefsey (rilpivirine-emtricitabine-tenofovir alafenamide combination) | 91.7 | 0.52 | 1.44 | HIV-1 (anti-infectives for systemic use) | Low | Slight or none, Canada |
| Entyvio (vedolizumab) | 87.4 | 85.6 | 2.83 | Crohn disease; ulcerative colitis (antineoplastic and immunomodulating agents) | Low | None, France |
| Keytruda (pembrolizumab) | 86.5 | 144 | 8.31 | Various cancers (antineoplastic and immunomodulating agents) | High | Moderate, France |
| Neulasta (pegfilgrastim) | 85.5 | 10.4 | 2.83 | Hematopoietic radiation injury syndrome; prevention of chemotherapy-induced neutropenia (antineoplastic and immunomodulating agents) | High | Major, France |
| Genvoya (elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide combination) | 84.3 | 0.647 | 3.38 | HIV-1 (anti-infectives for systemic use) | Low | None, France |
| Hemlibra (emicizumab) | 84.2 | 0.564 | 1.33 | Hemophilia A (blood and blood-forming organs) | High | Important, France |
| Mavyret (glecaprevir-pibrentasvir combination) | 80.1 | 50.2 | 1.15 | Hepatitis C (anti-infectives for systemic use) | Low | Minor, France |
Abbreviation: WHO, World Health Organization.
Added clinical benefit was identified using assessments from health technology assessment agencies in France and Canada. The 5 possible ratings from France are major, important, moderate, minor, and none; the 4 ratings from Canada are breakthrough, substantial, moderate, and slight or none. The top 3 ratings from each country were aggregated into high added benefit and the remaining ratings into low added benefit. For each product, the most favorable ratings given to the drug (eg, major is more favorable than minor) was identified for any indication and regardless of the assessment date. Canada’s ratings for 27 drugs were used when there was no French rating available. See the Box and Methods section for details.