There exists an ongoing debate regarding the effect of direct-to-consumer (DTC) advertising spending on drug prices. The two opposite views are: (a) increase in DTC advertising spending would be added to drug prices (b) DTC advertising would increase competition and thus reduce drug prices. OBJECTIVE: Explore the relationship of DTC advertising spending and drug pricing for the top twenty drugs from 1997 to 2000. METHODS: Top twenty drugs were selected on the basis of their DTC advertising spending (source: Competitive Media Reporting, NY) for 1997. For analysis, average wholesale price (AWP) per unit was used from the Blue Book AWP Unit pricing. For each of the top twenty drugs, the following trend graphs were plotted for 1997 to 2000: (a) the total DTC advertising spending and per unit price of the drug; (b) the percent changes in the DTC advertising spending and drug price. The percent change in DTC advertising spending and drug price for a year was calculated as percent change from the previous year. RESULTS: Only sildenafil (Viagra) and sibutramine (Meridia) showed an increase in the actual drug price with an increase in the DTC advertising spending. However, for these two drugs in year 2000, the percent change in DTC advertising spending decreased and the percent change in drug price increased. No trend was evident from the graphs of the other eighteen drugs. On an average DTC advertising spending for most of the drugs decreased with time while drug prices continued to increase. CONCLUSION: Results indicate a very weak relationship between DTC advertising spending and drug prices. The increase in drug price in spite of the decrease in the DTC advertising spending contradicts both rationale i.e. DTC advertising spending reduces drug price through competition or increase in drug price is due to increase in DTC advertising spending.