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Urging consumers to help their children
fight allergies or to question whether their memory lapses might be
Alzheimer's, most drug ads favor "vague" claims over clinical data. |
Urging consumers to help their children fight
allergies or to question whether their memory lapses might be Alzheimer's,
most drug ads favor "vague" claims over clinical data.
Looking at ads in 70 issues of 10 leading US consumer magazines, researchers
found that 87% chose "vague, qualitative terms"
to describe the medication's benefits rather than providing research
evidence.
These advertisements rarely quantify a medication's expected benefit, and
instead make an emotional appeal. This
strategy probably leaves many readers with the perception that the drug's
benefit is large and that everyone who uses the drug will enjoy the benefit.
The authors also argue that a key danger is that many of these ads may
"medicalize" run-of-the-mill problems in the public's mind. A runny nose all
of a sudden becomes allergic rhinitis.
The first direct-to-consumer advertisement for a prescription drug appeared
in Reader's Digest in 1981 in USA. Over the next few years, other such
advertisements were published, and the US Food and Drugs Administration
(FDA) became worried that little was known about the potential effect of
such advertisements on the public.
Consequently, in 1983, the FDA initiated an advertising moratorium while it
studied the issues and considered the regulatory options. Although they
concluded that "direct to the public prescription advertising was not in the
public interest," the FDA lifted the moratorium in 1985 because of concerns
about freedom of speech and a general consensus that regulations already in
place were sufficient to protect the consumer.
After the moratorium had been lifted, direct- to-consumer advertising was
permitted provided that the advertisements met certain criteria;
specifically, that they presented true and
balanced information about the side-effects of the drugs, and their
contraindications and effectiveness. The FDA monitors compliance with these
criteria. However, prior approval of drug advertisements is not required.
Opponents of direct-to-consumer advertisements are worried that
direct-to-consumer advertisements might inappropriately increase patient
demand for specific, and generally costly, agents, and that this demand
might have a negative effect on medical practice and on the
physician-patient relationship.
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Pharmaceutical companies spent $1.8
billion on direct-to-consumer advertisements for prescription drugs in
1999. |
Concurrently, many pharmaceutical companies have
reduced the amount spent on direct-to-physician advertising, which suggests
a tactical shift in their focus from physicians to patients. Last year, for
example, drug companies spent more on advertisements in newspapers and
popular magazines than they did in medical journals ($685 million vs $473
million, respectively) (www.imshealth.com
accessed on Aug 25, 1999).
Direct-to-consumer advertisements are common in popular magazines,
particularly in those aimed at women.
Furthermore, they all share a similar structure: they link the advertised
product with its target condition and invite consumers to share in their own
health management.
Although most advertisements addressed the relief of common symptoms that
many consumers would normally treat themselves with over-the-counter
remedies (eg, runny nose), a substantial number targeted more complex
treatment decisions usually made by physicians (eg, choice of antibiotic or
type of insulin).
Additionally, many of the advertisements presented quantitative data about
potential side-effects, but very few provided any such data about benefit
In a nationally representative survey, two thirds of adult Americans
recalled seeing a prescription advertised, and about 10% asked their doctor
for that prescription (of these, 73% said the prescription was made).
Direct-to-consumer advertisements for prescription drugs undoubtedly help to
educate consumers about available options. At the same time they encourage
consumers to believe that a problem might exist where they previously would
not and that a pharmacological solution is the appropriate way to deal with
it.
The Lancet October 6, 2001;358:1141-1146
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