Pharma DTC spending spiked sharply during 2014, according to data compiled by Nielsen for MM&M‘s annual DTC Report.

Marketers spent $4.5 billion on DTC ads, a nearly 21% increase over the 2013 total of $3.8 billion—and the highest amount spent since 2010, when marketers poured just less than $4 billion into DTC.

Not surprisingly, most of the DTC dollars went toward television—$3.2 billion, 26% more than in 2013. Spending in magazines surged 13% to $1.2 billion, while newspaper spending predictably shrank, by 15% to $127 million. The Nielsen data excludes digital spend.

Pfizer again ranked as pharma’s top DTC spender during 2014. Its outlay of nearly $1.1 billion—up 29% from 2013—tripled second-ranked AbbVie’s DTC spend ($363 million, down 9% against the year-ago period). Of the other companies in the top 20, Johnson & Johnson ($257.8 million, up 123% versus 2013) and Sumitomo ($190 million, up 634%) grew their spending the most in 2014.

In Nielsen’s ranking of top brands by DTC spend, Eli Lilly’s Cialis ($248.7 million, up 15%) held the top spot for a second consecutive year, trailed by Bristol-Myers Squibb’s Eliquis ($219 million, up 90%) and Pfizer’s Viagra ($211 million, up 32%). Pfizer placed five brands on the list, with two Lyrica indications (for fibromyalgia and diabetes) landing in the top ten.

MM&M‘s 2015 DTC Report will be viewable online on Wednesday. One critic’s ranking of the year’s Top Ten DTC ads will debut tomorrow.