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ABSTRACT - Article on how Madison Avenue, whose television ads have helped turn some prescription drugs into billion-dollar products, is expanding role in drug development; lastest example is pain drug Bextra, sales of which soared sixty percent in three months after American Dental Assn journal published study showing it offered relief after dental surgery; federal regulators had rejected that conclusion six months earlier, leaving Pharmacia and Pfizer hard-pressed to market drug until more positive report came out; problem is that report came from Scirex, little-known research firm owned partly by Omnicom, one of world's largest ad companies; Omnicom, Interpublic and WPP have invested tens of millions of dollars in companies that perform clinical drug trials; critics like Dr Arnold S Relman and Dr Thomas Bodenheimer say it becomes impossible to separate marketing from science, while ad executives say intention is to direct research toward potential big sellers; federal law bars promotion of drugs before FDA aproval, but published research and medical education are exempt, and doctors may prescribe drugs for any purpose; Linda Logdberg, Lenard I Lesser and other industry critics also comment; photos; graph on sharp rise in drug-promotion spending (L) Dentists leafing through The Journal of the American Dental Association last May found a study concluding that a new drug called Bextra offered relief from one of their patients' worst nightmares -- the acute pain that follows dental surgery.

Federal regulators had rejected that conclusion only six months before, leaving Bextra's marketers, Pharmacia and Pfizer, hard pressed to sell it as an advance over Celebrex, their earlier entry in a crowded market for pain drugs.