 By 2011, spending on pharmaceutical advertising had grown to approximately US$4.5 billion per year, and increased to $5.2 billion by 2016.With the increasing spending, DTCA began to face opposition.In 2015, the American Medical Association's house of delegates voted in favor of a motion supporting the prohibition of DTCA, arguing that these marketing efforts contribute to the high cost of drugs, and "inflates demand for new and more expensive drugs, even when these drugs may not be appropriate".