OBJECTIVES: This study was designed to investigate how African American patients respond to DTCA of prescription drug Lipitor® and the relationships between potential influencing variables and patients' responses. METHODS: Face-to-face interview was employed for this study, and a convenience sample consisting of 160 African American patients were interviewed at a general medicine clinic in a public hospital. Short-Test of Functional Health Literacy in Adults (S-TOFHLA) was administered to all study participants. Then the participants were asked to view a TV advertisement of Lipitor®, followed by DTCA-related interviews. Patients' demographic and socioeconomic information was also collected during the interviews. Bivariate analyses and logistic regressions were used to assess the relationships between potential influencing variables and patients' responses to DTCA. RESULTS: After watching the TV advertisement of Lipitor®, 89.3% of study participants agreed that they would talk to their physicians about their cholesterol, 88.7% agreed that they would ask their physicians to test their cholesterol levels, and 47.3% agreed that they would ask their doctors to write them a prescription for Lipitor®. The study also found that 26.0% of study participants had inadequate functional health literacy, 17.3% had marginal functional health literacy, and 56.7% had adequate health literacy. Participants who rated the advertisement as helpful responded more favorably to it. Older patients were more likely to agree to talk to doctors about cholesterol. Those who had a history of high cholesterol were more likely to agree to ask doctors to test their cholesterol levels. CONCLUSIONS: African American patients in this study responded more favorably to DTCA. DTCA may be an effective marketing tool for pharmaceutical companies. However, the net public health and economic effects of DTCA remain to be determined.