Truth in Advertising?

American television viewers see as many as 16 hours of prescription drug advertisements (ads) each year, yet no research has examined how television ads attempt to influence consumers.

This information is important, because ads may not meet their educational potential, possibly prompting consumers to request prescriptions that are clinically inappropriate or more expensive than equally effective alternatives.

We coded ads shown during evening news and prime time hours for factual claims they make about the target condition, how they attempt to appeal to consumers, and how they portray the medication and lifestyle behaviors in the lives of ad characters.

RESULTS

Most ads (82%) made some factual claims and made rational arguments (86%) for product use, but few described condition causes (26%), risk factors (26%), or prevalence (25%). Emotional appeals were almost universal (95%).

No ads mentioned lifestyle change as an alternative to products. Some ads (18%) portrayed lifestyle changes as insufficient for controlling a condition.

The ads often framed medication use in terms of losing (58%) and regaining control (85%) over some aspect of life and as engendering social approval (78%).

Products were frequently (58%) portrayed as medical breakthroughs.

CONCLUSIONS

Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters that have lost control over their social, emotional, or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes.

The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health.

THE ABOVE ARTICLE GENERATED
THE FOLLOWING EDITORIAL

Direct-to-Consumer Advertising: Is It Too Late to Manage the Risks?

KEY POINTS FROM DR. DAN MURPHY

1) American television viewers see as many as 16 hours of prescription drug advertisements (ads) each year. Notice that this does not include over-the-counter television drug advertisements.

2) Nearly all television drug ads use the “emotional appeals” approach to promote their products; the ads never mention lifestyle change as an alternative to drugs; 18% of ads portrayed lifestyle changes as insufficient for controlling a condition.

3) Despite the claims by drug companies that their television ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk and they minimize the value of health promotion through lifestyle changes.

4) Television drug ads “have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health.”

5) “The United States and New Zealand are the only developed countries that permit direct-to-consumer advertising of prescription drugs.”

6) The Food and Drug Administration relaxed direct-to-consumer advertising regulations in 1997.

7) Direct-to-consumer advertising misleads consumers and “prompts requests for products that are unneeded or more expensive than other equally effective drugs or nonpharmacologic treatment options.”

8) “Television advertising now comprises most of the consumer-directed prescription pharmaceutical marketing expenditures.”

“Television pharmaceutical ads are among the most common forms of mediated health communication in the United States.”

9) The average television drug ad length is 45 seconds.

10) Television drug ads are often “ambiguous about whether viewers might legitimately need the product.”

11) “By ambiguously defining who might need or benefit from the products, DTCA implicitly focuses on convincing people that they may be at risk for a wide array of health conditions that product consumption might ameliorate, rather than providing education about who may truly benefit from treatment.”

12) “Direct-to-consumer drug advertising contributes to the medicalization of what was previously considered part of the normal range of human experience.”

13) “Several ads for cholesterol-lowering drugs appeared to suggest that nonpharmacological approaches were almost futile.”

14) Drug ad “characters typically regained complete control over their lives after using the product, whereupon they also received social approval from friends or family.”

15) “DTCA often presents best-case scenarios that can distort and inflate consumers’ expectations about what prescription drugs can accomplish.”

16) “Pharmaceutical spending on television commercials nearly doubled from $654 million in 2001 to a staggering $1.19 billion in 2005.”

17) “Nearly all pharmaceutical ads are based on emotional appeals, not facts, and few provide necessary details about the causes of a medical condition, risk factors, or lifestyle changes that may be appropriate alternatives to pharmaceutical intervention.”

18) “Patients have always expected simple answers to complex questions, but direct-to-consumer advertising has elevated this problem to new heights, because patients in some ways now rely on Madison Avenue as a provider of health information.”

19) “Consumers who make health decisions based on what they learn from television commercials ultimately take medicines they may not need, spend money on brand medicines that may be no better than alternatives, or avoid healthy behaviors because they falsely think a medicine is all they need.”

20) “In general, the ads that consumers see do not contain the right balance of information to provide any meaningful health education. The facts gleaned from DTC ads are minimal at best.”

21) “One fact is unquestionable: DTC ads do not effectively or consistently convey important information about product risks and benefits.”

22) “Physicians, consumers, and policy makers must take further action so that the facts about medicines are not lost in the advertising fog. As Frosch, et al., correctly point out, the consequences of poor judgments are quite different for drugs than they are for soap.”