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A young man laments his thinning hair. It runs in the family. But it's OK. He takes Propecia.

Time was, people pretty much kept their medical problems to themselves, and most people didn't know the names of the medicines they took. Their doctor prescribed something for them and they took it. Not anymore. Turn on any morning show, afternoon talk show or the news on CNN and at the commercial breaks you're likely to get a pitch for some prescription drug from one of the nation's pharmaceutical manufacturers.

Also Today Diapers and drugs A new study shows a three-fold increase in mind-altering drugs being given to preschoolers. By Arthur Allen

It's called DTC advertising: direct-to-consumer. "The No. 1 story in health advertising is this boom in DTC advertising," says David Goetzl, who has followed this phenomenon for Ad Age magazine. According to IMS Health, a London-based analyst, pharmaceutical companies in the United States spent $529 million on such television advertising for the first half of 1999, a 68 percent increase in spending over the same time in 1998.

Claritin, medicine for controlling allergies, is the mother of all of this advertising. It was the top-spending brand for TV advertising at $48 million. Last fall the product was even linked with baseball. "They called themselves the official allergy medicine of Major League Baseball," says Goetzl. That's marketing strategy you usually associate with cars, airlines or soft drinks. After Claritin, the leaders were Propecia ($42 million), Meridia ($29 million), Nasonex ($29 million) and Flonase ($25 million).

The difference between this advertising and the usual direct selling to consumers is that the person who sees the ad can't go right out and buy the product. They have to get their doctor to agree to write them a prescription.

Dr. Alan Sheff, an internist in a Maryland suburb of Washington, sees pluses and minuses in this new phenomenon. "Taking the positive side, I think many patients are unaware of newer treatments that are available and effective for conditions," Sheff says. He used heartburn as an example. A patient may see an add for a heartburn drug and instead of continuing to pop antacids they may go to their doctor and find out they have digestive problems. Or take the Valtrex ads for the suppression of herpes. That ad might bring people into the physician's office to get treatment even when they're not having an outbreak.

Sheff also thinks such advertising could break down some fears or hesitancy some patients have about taking their medicine. "If I have to prescribe a medication and they've heard of it because they've seen it associated with pretty pictures on television, it might lower their resistance to taking it," Sheff says.

That's the kind of thing the drug manufacturers want to hear. At Schering-Plough, the makers of Claritin, executives don't talk about their marketing strategies or how effective their ad campaigns have been. "We believe such advertising can play a key role in informing the public about meaningful advances in drug therapies," says Bill O'Donnell, a spokesman for the New Jersey-based company.

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