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Health care institutions and their proprietors need to be extremely careful in developing advertising programs. Poorly conceived advertising programs will do little if any good for health care providers and indeed may do harm to the organization's marketing efforts. This paper examines ten simple rules for improving advertising programs in the health care industry.
The purpose of this inquiry was to analyze: (a) the extent to which hospitals employed senior citizens as models in their advertisements, (b) the roles of these models and their active-passive status, and (c) the degree to which the advertisements portrayed seniors in a positive or negative status. Content analysis was employed to assess these issues. Hypotheses about the portrayal of senior citizens by hospitals were tested by examining advertisements in newspapers. The analysis provided some findings which should be of value to researchers and practitioners in the health care industry.
We provide an overview of what is known about the impact of direct-to-consumer (DTC) advertising of prescription drugs. Specifically, we explore the historical trends that led to the industry's increasing use of this form of promotion. Then, using the published literature to date, we review the impact of DTC advertising on the consumer, the medical profession, and the health care system. We conclude by offering policy suggestions for how the pharmaceutical industry can promote its products more responsibly, how the Food and Drug Administration (FDA) can regulate DTC advertising more effectively, and how the medical and public health communities can educate the public about drug therapies more constructively.
Medicare beneficiaries are now facing advertising from an unprecedented number of health plans that are offering prescription drug coverage. Previous Medicare managed care efforts have been undermined by risk selection, the practice of enrolling healthier and therefore less costly patients. In this study we explore how the content of health plan advertising is related to the competitiveness of the health plan market. We find that increased competition is associated with greater use of advertising that targets healthier patients.
The paper by Joel Weissman and colleagues addresses the increasingly important topic of the effects of direct-to-consumer advertising (DTCA) by pharmaceutical companies. The authors claim that their results should be reassuring to "those concerned about potential adverse health care consequences of DTCA". However, the study and analysis of the data are marred by several flaws that diminish the importance and relevance of the findings, including weakness in design, overgenerous interpretations, and failure to address key questions. Rather than informing the debate, the study amounts to little more than an advertisement for drug advertisements.
Two papers, by Joel Weissman and colleagues and by Robert Dubois, add to our limited knowledge of the effects of direct-to-consumer (DTC) advertising of prescription drugs. Their results reinforce the largely positive findings from consumer surveys, while adding valuable new data and insights. These suggest that DTC ads probably improve patients' health outcomes and do not tend to lead to inappropriate prescribing. DTC advertising is emerging as a positive force in health care markets, consistent with what is known about the effects of advertising in many other markets.
We conducted a national telephone survey about health care experiences associated with direct-to-consumer advertising (DTCA) of prescription drugs. Among the 35 percent of our sample who had a physician visit during which DTCA was discussed, 25 percent received a new diagnosis, of which 43 percent were considered high priority according to authoritative sources. More than half also reported actions taken by their physician other than prescribing the advertised drug. Despite concerns about DTCA's negative consequences, we found no differences in health effects between patients who took advertised drugs and those who took other prescription drugs.
We surveyed a national sample of 643 physicians on events associated with visits during which patients discussed an advertised drug. Physicians perceived improved communication and education but also thought that direct-to-consumer advertising (DTCA) led patients to seek unnecessary treatments. Physicians prescribed the advertised drug in 39 percent of DTCA visits but also recommended lifestyle changes and suggested other treatments. Referring to visits when the DTCA drug was prescribed, 46 percent said that it was the most effective drug, and 48 percent said that others were equally effective. Prescribing DTCA drugs when other effective drugs are available warrants further study.
Between 1997 and 2001 spending on direct-to-consumer (DTC) drug advertising more than doubled. Opinions differ as to whether and to what extent DTC advertising benefits the doctor-patient relationship. Some analysts argue that the current regulatory regime is sufficient, others advocate a stricter enforcement, and still others promote an outright ban. An alternative may be to use the purchasing power of the federal government to require the inclusion of comparative quality data, thus creating a basis for more informed consumer choice. This approach could create incentives for the pharmaceutical industry to adjust spending on DTC advertising while avoiding "big government" interference with commercial free speech.
A videotaped indoor soccer game was shown to 125 men college students, ostensibly to evaluate the sport's televiewing appeal. Different versions of the videotape included zero, four or nine beer commercials. Refreshments, including beer, were available to the subjects. Half the subjects had immediate access to beer, and half had access delayed by one half hour. Exposure to the first few commercials increased consumption; however, continued exposure did not. Over the entire experiment, advertising had no significant effect on total beer consumption. Delayed access to beer led to compensatory beer consumption, notably in the third half hour. The results of the present study were interpreted as not supporting strong concern about television advertising's impact on immediate consumption of available alcohol. The results suggest that experiments on alcohol advertising are likely to produce negative results where drinking is measured over a substantial period (e.g., an hour or more), and positive results where drinking is measured over a brief period (e.g., half an hour or less).
Atkin and Block's study on the content and effects of alcohol advertising is discounted. The substudies involved in the research are described and their methodologies are criticized. Weaknesses are found in the following areas: coding procedures; definitions and interpretations of categories of advertising content; sampling procedures; and measures of exposure to advertising. It is felt that causal interpretations from such weak measures should not be made. The diversity of research methods used is deemed commendable. However, since all of the substudies use the same basic sample, it is of little surprise that convergent evidence results. Also, since all research methods used are felt to be inadequate, such convergence does not necessarily show external and internal validity.
OBJECTIVE: The purpose of the present study is to determine the effect that brand-level advertising has on brand-level spirits demand. METHODS: Using a panel data set consisting of 16 brands and 14 years of data, a fixed effects model of brand-level spirits demand was estimated. RESULTS: It was found that own-brand advertising, income, rival-brand price, a time trend and brand loyalty all have a significant effect on brand-level spirits demand. CONCLUSIONS: These results indicate that brand-level spirits advertising results only in brand switching and does not increase the overall size of the market.
OBJECTIVE: Two studies were conducted with the objective of analyzing the frequency and content of alcoholic beverage advertising on Brazilian television. METHOD: Study 1 presents a frequency analysis based on 84 hours of TV monitoring in which 1,640 commercials and 243 vignettes were recorded between 8:00 PM and 11:00 PM on the two main stations. Study 2 presents a content analysis of 139 alcoholic and 51 nonalcoholic beverage commercials aired in 1992-93, as evaluated by three trained judges. RESULTS: Study 1 showed the relative frequency of alcoholic beverage commercials (4.6%) to be higher than the frequency of other products such as cigarettes, nonalcoholic beverages and medicines, and lower than that of foods and various other items. Frequency of alcoholic "vignettes" (26.6%) was higher than the frequency of all the other product categories. Frequency data were closely matched by marketing investment data for the period. In Study 2, the most frequent themes and appeals present in alcohol commercials were relaxation, national symbolism, conformity, camaraderie and humor. Human models were present in most ads. Product-related themes such as information, quality or tradition were virtually absent, as were messages to drink moderately. However, 7.2% of the alcohol commercials displayed appeals promoting abusive drinking. CONCLUSIONS: The results seem to reflect the minimal regulation of alcohol advertising in Brazil, and a joint effort by health planners, educators, legislators, alcohol industries and advertising agencies is recommended as a necessary step to reduce alcoholic beverage problems in Brazilian society.
Advertising is a pervasive influence on children and adolescents. Young people view more than 40,000 ads per year on television alone and increasingly are being exposed to advertising on the Internet, in magazines, and in schools. This exposure may contribute significantly to childhood and adolescent obesity, poor nutrition, and cigarette and alcohol use. Media education has been shown to be effective in mitigating some of the negative effects of advertising on children and adolescents.
The main objective of the study was to analyze the amount and quality of food advertisement on Brazilian television in three different times of the day. The results showed that food products, when compared to other products, were the most frequently advertised, regardless of the time of the day in a given week analyzed. Television promotes food predominantly high in fat and/or sugar and salt. The large number of high fat and/or sugar and salt products advertised can contribute to changing food habits of children and teenagers, and increasing the incidence of obesity in the population.
In the 1930s and 1940s, smoking became the norm for both men and women in the United States, and a majority of physicians smoked. At the same time, there was rising public anxiety about the health risks of cigarette smoking. One strategic response of tobacco companies was to devise advertising referring directly to physicians. As ad campaigns featuring physicians developed through the early 1950s, tobacco executives used the doctor image to assure the consumer that their respective brands were safe. These advertisements also suggested that the individual physicians' clinical judgment should continue to be the arbiter of the harms of cigarette smoking even as systematic health evidence accumulated. However, by 1954, industry strategists deemed physician images in advertisements no longer credible in the face of growing public concern about the health evidence implicating cigarettes.
BACKGROUND AND OBJECTIVE: Although older adults are frequent consumers of prescription drugs and increasingly the intended audience of direct-to-consumer advertising (DTCA) marketing efforts, little is known about the effect of DTCA on older adults' prescription drug-seeking behaviour. In response, the objective of this study is to examine factors associated with requesting a prescription drug from a physician following exposure to DTCA among older adults, and whether the drug or other medical treatment was prescribed during the encounter. METHODS: A secondary data analysis of the "Public Health Impact of Direct-to-Consumer Advertising of Prescription Drugs", a data set publicly available through the Inter-university Consortium for Political and Social Research (ICPSR 3687), was conducted. For the purposes of this study, only those respondents who indicated that they had been exposed to DTCA (n = 2601) were included in the study sample. Using a two-step weighted logistic regression approach, separate models were estimated to examine first, whether a request for the advertised drug was made following exposure to DTCA and secondly, the outcomes of any patient-physician encounters that occurred following exposure to DTCA. RESULTS: Descriptive analysis of the outcome variables revealed that, among respondents exposed to DTCA, 31% (n = 801) requested a prescription drug from their physician. Approximately 5% of those who made a request were > or =75 years of age. Among respondents requesting a prescription drug, 69% (n = 556) received a prescription in response to their request, of whom, approximately 5% were > or =75 years of age. Multivariate findings suggest that although adults > or =75 years of age are less likely to request a prescription drug following exposure to DTCA (odds ratio [OR] = 0.58; p = 0.032), when they do approach their physicians, they are more likely to receive recommendations for further treatment, with ORs indicating a 250% (OR = 3.507; p = 0.002) increase in the odds of further referral among adults > or =75 years of age. CONCLUSION: Overall, results from the study suggest that DTCA influences the patient-doctor relationship and prescription drug acquisition behaviour of patients; however, the nature of the effect of DTCA on older adults is complex. Because future cohorts of older adults may be more comfortable about requesting prescription drugs and the consumer-driven approach to obtaining medical care, understanding the impact of DTCA on older consumers represents an important area for further inquiry.
We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in 1992-2002 DTC prescription drug ads both quantitatively and qualitatively. We find that the educational value as it relates to serious medical conditions decreases over time based on the media logic that the primary purpose of advertisements is to promote consumption, rather than education. We enumerate and describe the media logic tactics employed, and find a statistically significant increase in the number of such tactics per ad in 2002.