Journal of Medicine - Spending on the advertising of brand-name prescription drugs on television  — which not long ago was a fast-growing marketing venue for the pharmaceutical industry in the United States — has dropped more than 20 percent in the last five years.

According to new figures from Nielsen, spending on television advertising fell 23 percent to $2.4 billion from the beginning of 2007 to the end of last year. Spending in 2011 dropped 2 percent from 2010, and last year was the fourth consecutive year that such spending fell. Drug companies in the United States spent more than $3.1 billion on advertising pharmaceuticals on television in 2007, Nielsen said.

The decline is in sharp contrast to the decade-long drug-industry advertising spree that began in 1997, when the Food and Drug Administration loosened its regulations and allowed direct-to-consumer advertising of prescription drugs on TV.

Some industry analysts attribute part of the decline to controversy over such ads. Employers and health insurance companies have long complained that TV ads drive consumers to the latest, often most expensive, pills. And doctors complain that their patients often pressure them into prescribing these heavily advertised drugs.

Perhaps the most well-known criticism of  TV advertising of pharmaceuticals arose in 2004 when Merck withdrew the once heavily advertised painkiller Vioxx after studies showed it increased the risk of heart attacks and strokes.

Such controversies have led to greater scrutiny of drug ads by the F.D.A. as well as by doctor groups like the American Medical Association.

Analysts say spending on brand-name drug ads on television could deteriorate further because of generic competition to some top-selling drugs that have been widely advertised, like Pfizer’s Lipitor for cholesterol.

From 2011 to the end of 2015, more than $100 billion of brand-name drug sales will be exposed to generic competition, IMS Health said.

Pharmacies and health insurance companies offer incentives to patients with drug coverage to choose cheaper generics over brand-name drugs, limiting the power of television advertising.

This week, Pfizer said fourth-quarter sales of its Lipitor fell more than 40 percent in the United States, where the drug lost patent protection in late November.

Though Nielsen said the $156 million Pfizer spent on TV ads for Lipitor last year was more than the amount spent on any other branded prescription drug, the figure was down 14 percent from the Lipitor advertising in 2010.

Pfizer just entered the third month of a 180-day period of market exclusivity in which Lipitor is competing against just two generic versions, so it has continued to advertise on TV. But the company said it has not yet decided to make a long-term commitment to advertising Lipitor on television after that.

“We will continue to listen to patients over time and adjust our plans for Lipitor, including advertising, as needed to determine how we can continue to best meet the needs of patients,” said a Pfizer spokesman, MacKay Jimeson.

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