Big pharma spends more money on advertising for drugs that have lower health benefits for patients, according to a study published in JAMA on Tuesday, shedding new light on the almost uniquely American practice amid fierce debate over whether direct-to-consumer prescription drug ads should be banned. The proportion of advertising spending allocated to direct-to-consumer ads was an average of 14.3 percentage points higher for drugs with a low added benefit compared to those with a high added benefit, according to the peer-reviewed analysis of the 150 best-selling branded prescription drugs. Manufacturers of the top six best-selling drugs spent the bulk of their promotional budgets"more than 90%"targeting consumers directly rather than clinicians for a range of treatment options for conditions including HIV, multiple sclerosis and numerous cancers. The findings could suggest pharma firms are aiming promotional dollars directly towards consumers ... as part of a "strategy to drive patient demand for drugs that clinicians would be less likely to prescribe," said the study's lead author Michael DiStefano. Just two countries in the world allow drug makers to market prescription medications directly to consumers: the U.S. and New Zealand. Most countries prohibit directly advertising prescription medications to the public, something the WHO says influences both people and, indirectly, the medical professionals treating them, making it "harder to make decisions on evidence based medicine."