The "moving wall" represents the time period between the last issue available in JSTOR and the most recently published issue of a journal. Moving walls are generally represented in years. In rare instances, a publisher has elected to have a "zero" moving wall, so their current issues are available in JSTOR shortly after publication. Note: In calculating the moving wall, the current year is not counted. For example, if the current year is 2008 and a journal has a 5 year moving wall, articles from the year 2002 are available.
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Other drugs that were heavily promoted to consumers have also been linked to safety advisories, FDA black-box warnings, and withdrawals from the market. 15 , 18 These include benoxaprofen (Oraflex, Eli Lilly) for arthritis, troglitazone (Rezulin, Parke-Davis) for diabetes, cisapride (Propulsid, Janssen) for gastric reflux, ceriva statin (Baycol, Bayer) for high cholesterol, and tegaserod (Zelnorm, Novartis) for irritable bowel syndrome in women. 15 , 18.
Supporters of DTCPA also claim that drug advertisements stimulate increased competition, which leads to lower prescription drug prices. 5 , 25 They argue that DTCPA also encourages early pharmacological management, resulting in cost-savings from avoiding more expensive surgical interventions. 13 Unfortunately, these claims are not verifiable, because data available regarding the effect of DTCPA on drug costs are limited. 13.
Types of Direct-to-Consumer Drug Advertisements and FDA Regulatory Requirements.
Several factors may be responsible for the apparent weakening of the FDA oversight of DTCPA. In 2002, the Secretary of Health and Human Services (HHS) began requiring that all draft regulatory warning letters be reviewed and approved by the FDA’s Office of Chief Counsel before they are issued. 6 A GAO report noted that this required legal review seems to have resulted in a reduced number of warning letters to be issued as well as in delays that frequently caused them to be sent long after an advertising campaign ended. 6 This conclusion was based on the fact that more than twice the number of regulatory letters (68 vs. 28) were sent by the FDA in 2001, compared with 2002, the year the legal review requirement was implemented ( Figure 2 ). 6 This decline in regulatory letters has continued, since in 2006, the FDA issued only 21 citations, in contrast to 142 that were sent in 1997. 6 , 24 Interestingly, during the same time period, the proportion of regulatory letters citing problems with DTCPA increased from 15.5% to 33.3%. 6.
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