The medical community should exert pressure on the drug industry to incorporate more information about conditions and treatments in its advertising. It is in the industry’s best interest to do so. Advertising that incorporates quality health and drug information will have greater credibility, and deservedly so. Also, consumers are less likely to be influenced by messages that appear to be more promotional than informational.31 Thus, providing complete and accurate information is the right thing to do and may even enhance the effectiveness of DTC advertising. If such information is not provided voluntarily by the industry in future advertising, the medical establishment should lobby for regulation.
These results also highlight an important opportunity for professional organizations to contribute to consumer education on prescription drugs. According to the National Institute for Health Care Management, the most successfully promoted drugs fall into 5 categories: antidepressants, cholesterol-lowering agents, gastric acid reducers, oral antihistamines, and antihypertensives.32 Organizations such as the American Academy of Family Physicians and the American College of Physicians already produce patient informational materials, but these efforts could be intensified so physicians would have a ready source of “counter-detailing.” Patients requesting drugs for which the indications are questionable could be given a handout and told, “This is what my professional society has to say about _________. This information is produced by the best experts in the field and provides a more balanced view than what you will find in profit-motivated advertisements. Look it over, and let’s talk about this at our next visit.”
If the industry were to be prodded into taking a more educational stance in its consumer-targeted prescription drug advertising, the impact of this shift on physician-patient interactions would need to be investigated. A more educated patient may take less time to treat and counsel, might show greater adherence to treatment regimens, and could assume greater responsibility for his or her health. On the other hand, educational promotions may lead to requests from more determined patients for drugs that are not medically indicated, requiring time-consuming re-education by their physicians.
Limitations
Our study has limitations. We have evaluated the educational qualities of these advertisements by imposing a common set of standards for each promotion. A stronger approach would have been to convene a panel of experts for each of the many conditions treated by the promoted drugs to identify the specific details that consumers need to know about the condition and its treatment. Resource constraints prevented us from developing expert-based educational standards for each condition or disease. However, it is reasonable to expect the drug industry to provide to consumers basic information about the treatments being promoted and the conditions these drugs address. We acknowledge that particular content analytic codes may have been irrelevant to certain conditions. For instance, precursor information does not need to be provided when the causes of the condition are obvious (eg, advertisements for contraceptive drugs); mention of supportive lifestyle changes should not be demanded when helpful behavioral changes do not exist (eg, advertisements for hair loss treatments); and references to the presence of competing treatments should not be expected in the rare event that such treatments are nonexistent. Such exceptions aside, we believe that the 11 codes assessed are both fundamental and relevant to the vast majority of the conditions covered by these advertisements.
Also, with this preliminary investigation we sought only to assess the extent to which the industry is making an effort to provide information about medical conditions and treatments for those conditions. We did not examine the educational quality of these efforts, including the completeness and accuracy of information provided about conditions and treatments. Such assessments will require input from medical and pharmaceutical experts selected for their specialized knowledge.
Conclusions
We acknowledge that instances of informative advertising can readily be found in our sample of advertisements. Thus, although DTC advertising in general is not serving the information needs of consumers, there are companies and individuals within the industry who are motivated to treat their advertising as vehicles for effective health promotion through quality education. Billions of dollars will be spent in the next few years on consumer-targeted prescription drug promotions.4 Consumers will be very receptive to those advertisements that address their personal health needs and concerns33; many will talk to their primary care physicians as a result of these promotions.34 The drug industry thus has a tremendous opportunity to silence its critics and improve the public’s health by providing objective medical and drug information.35
Acknowledgments
We wish to acknowledge the contributions made by Ronald Emerick, Robert LaGreca, Love Lord, and Sarah Shaw in the collection and coding of advertisements and by 2 anonymous peer reviewers for their thoughtful evaluations.