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PubMedDate not supplied

Prescription drug advertising: is it a driving force on drug pricing?

It has been shown that drug companies will sell more drugs when they use DTC advertising, but it is also true that many consumers who are suffering--unaware there is help for their symptoms--will learn from these ads that help is available. Advertising to consumers, like advertising to professionals, will continue to be one of the best methods of providing information. Of course, healthcare professionals also have the sales representatives, their colleagues, medical journals, and medical conventions as additional options for needed information. The consumer may or may not use other methods, such as the Internet, the library or friends or family, but the advertising is a starting point for a dialogue. If the DTC ad provides consumers with "information," which is different from "advertising," the drug company will be providing a worthwhile service to consumers and potential patients. No doubt consumers will begin demanding higher quality information from DTC ads and will frown upon the ads that are blatantly trying just to sell a drug. It will also reap the benefits of improved consumer awareness and patient compliance. A DTC ad that is consumer-friendly, does not use fear appeal, is educational in tone, and downplays the "hard sell" and hype will go a long way in offering important information to the casual observer. Oversight by the FDA will ensure the information meets the requirements they have set down for prescription drug advertising. That is, advertising will be truthful and fairly balanced and will meet what the government, consumers and, no doubt, the medical community wants. Attempting to control drug costs, by controlling advertising, will not be an easy task. This has an implication across all product areas, not just drugs. DTC advertising has become a lightening rod for cost containment issues, but is it alone driving demand for prescription products? I don't think so.

Advertising↗
PubMed2005

Advertising and availability of 'obesogenic' foods around New Zealand secondary schools: a pilot study.

AIMS: To examine the extent and content of outdoor food advertisements and food availability from outlets in the vicinity of secondary schools. METHODS: The sample of schools (n=10) was randomly selected from a sample frame of schools in both an urban and rural region (Wellington and Wairarapa regions respectively) and at each extreme of the socioeconomic status (SES) distribution (based on school characteristics). An area of 1-km radius around the schools was examined for food and non-food product advertisements and shops/outlets. RESULTS: Out of 1408 outdoor advertisements for products, 61.5% were for food (i.e. 28 per square kilometre). The major categories were soft drinks (21.6%), frozen confectionary (16.2%), savoury snacks (11.4%), and alcohol (8.1%). Overall, 70.2% of food advertisements were for foods classified as 'unhealthy' (i.e. inconsistent with the national nutritional guidelines for adolescents). A majority of the 224 outlets sold food (i.e. 56.3%). Those that primarily sold food were (on average) closer than other outlets to the secondary schools (p=0.03). Out of those schools that sold meals, the proportion of these that advertised a salad option was significantly lower in the low SES neighbourhoods (p=0.006). Other significantly different patterns for food outlet distribution, and category of advertised food were found by SES and rurality. CONCLUSION: Although only a pilot study, the information obtained suggests that food advertising and food outlets are prevalent in the vicinity of secondary schools and that the advertising is generally not compatible with nutritional guidelines for adolescents. Larger studies into such advertising are needed as well as consideration of policy options to control aspects of the 'obesogenic environment.'

Adolescent↗
PubMed2006

[Written drug advertisements--are they reliable?].

BACKGROUND: Drug advertisements affect the practice and continuous education of physicians. We assessed whether drug advertisements in Norway were in accordance with national regulations in the field. METHODS: All drug advertisements received by three general practitioners during a period of three months were collected. One advertisement for each of the 50 pharmaceutical products most frequently advertised was reviewed, available references obtained, and the information evaluated in relation to Norwegian regulations. RESULTS: A total of 294 advertisements for 77 different products were reviewed. The 50 chosen advertisements contained 191 reference citations, of which 93% were retrieved. The originator of the advertisement in question provided 72% of the references we asked for. We identified 262 promotional claims for which the regulations require a reference citation. Of these, 135 (52%) did not comply with the regulations, including 15 (6%) that were false. CONCLUSION: Only half of the information presented in drug advertisements was correct and clinically relevant. Relatively few statements were false, but a considerable proportion of statements gave an excessively positive picture of the product; hence, in general, this kind of information has no value as a source of information.

Advertising↗
PubMedDate not supplied

[Extent of advertising of tobacco and alcoholic beverages in a sample of Spanish weeklies].

Advertising undoubtedly influences our daily habits. In this sense, the promotion of cigarettes and alcoholic beverages is no exception, being a potential stimulus for their use. For the purpose of studying different aspects of the cigarette and alcoholic beverage advertising which appeared in a sample os Spanish weeklies was taken, these being six of the weeklies having one of the largest circulations, three of which were aimed mainly at women readers, while the other three were general information magazines. The advertising of these two products represents a significant percentage of the total advertising printed in the magazines studied (11%). The promotion of alcoholic beverages widely surpasses that of cigarettes (by 7 to 1). With regard to the groups of alcoholic beverages, whisky in the leading beverage advertised. The topics to which reference is made in the advertising slogans are widely varied, are lacking in informative elements and are limited to means of persuading one to identify with said product. Marked differences are observed between the magazines of providing general information magazines and those preferably aimed at women with regard to the amount and content of the advertising of cigarettes and alcoholic beverages. The methodological differences arising on studying the advertising-use relationship are discussed. Lastly, a number of activities for contradicting the effect of the massive advertising of cigarettes ald alcoholic beverages appearing in our weeklies are proposed.

Advertising↗
PubMed1991

Does tobacco advertising target young people to start smoking? Evidence from California.

OBJECTIVE: To evaluate whether tobacco advertising encourages teenagers younger than 18 years to start smoking. DESIGN: Comparison of 1990 California telephone survey data with data from a 1986 national telephone survey (both used a random-digit dialing system); 95% confidence intervals were calculated. To test our hypothesis, we considered whether the perception of advertising was related to age, whether the pattern of market share across age and sex groups followed the pattern of perceived advertising, and whether changes in market share paralleled changes in advertising as perceived by the youngest age group. PARTICIPANTS: There were 24,296 adults and 5040 teenagers. RESULTS: The most advertised brands of cigarettes were Marlboro, according to 33.6% of adults and 41.8% of teenagers, and Camel, according to 13.7% of adults and 28.5% of teenagers--named most often by 12- to 13-year-olds (34.2%). The brands that were purchased most often were Marlboro and Camel. Together these were the brands of choice of 79.9% of males and 85% of females aged 12 through 17 years. Marlboro's market share increased in youths and young adults up to age 24 years and then decreased gradually with age; Camel's market share decreased abruptly with age: it was the brand of choice of 24.5% +/- 5.8% of males aged 12 through 17 years but was chosen by only 12.7% +/- 3.6% of males aged 18 through 24 years; for females, 21.7% +/- 13.7% aged 12 through 17 years chose Camels, while only 5.5% +/- 3.2% aged 18 through 24 years preferred this brand. Both Marlboro and Camel brands had a higher market share in California in 1990 compared with that for the United States in 1986. Of interest is that the market share for Camel increased among the younger smokers but was more evenly distributed for Marlboro. CONCLUSIONS: Perception of advertising is higher among young smokers; market-share patterns across age and sex groups follow the perceived advertising patterns; and changes in market share resulting from advertising occur mainly in younger smokers. Cigarette advertising encourages youth to smoke and should be banned.

Adolescent↗
PubMed1990

Remedies by competitors for false advertising.

Patients who are victimized as a consequence of false medical advertising are not the only ones who can sue for damages. Under section 43(a) of the Lanham Act, effective November 17, 1989, anyone "who believes that he or she is or is likely to be damaged" by deceptive advertising may bring a civil action for damages (1). Competing physicians may sue other physicians who falsely advertise that they possess unique skills and achieve better results than other physicians because they employ exclusive methods of treatment or claim that certain surgical procedures they perform in the office are absolutely safe and without risk or who advertise false professional credentials to lure patients. Voluntary informed consent excludes the use of deceit. Misrepresentation through advertising deprives a patient of the right to exercise an informed consent (2). A patient who relies on a doctor's false advertising in agreeing to a procedure that causes the patient injury may sue for malpractice even if the procedure was performed without negligence. False medical advertising also exposes the advertiser to litigation by competitors for unfair competition. This article is concerned with the remedy that may be available for instituting private litigation against physicians and other health care providers who engage in untruthful advertising.

Advertising↗
PubMed1994

Methodologic quality and relevance of references in pharmaceutical advertisements in a Canadian medical journal.

OBJECTIVE: To evaluate the methodologic quality and relevance of references in pharmaceutical advertisements in the Canadian Medical Association Journal (CMAJ). DESIGN: Analytic study. DATA SOURCE: All 114 references cited in the first 22 distinct pharmaceutical advertisements in volume 146 of CMAJ. MAIN OUTCOME MEASURES: Mean methodologic quality score (modified from the 6-point scale used to assess articles in the American College of Physicians' Journal Club) and mean relevance score (based on a new 5-point scale) for all references in each advertisement. MAIN RESULTS: Twenty of the 22 companies responded, sending 78 (90%) of the 87 references requested. The mean methodologic quality score was 58% (95% confidence limits [CL] 51% and 65%) and the mean relevance score 76% (95% CL 72% and 80%). The two mean scores were statistically lower than the acceptable score of 80% (p < 0.05), and the methodologic quality score was outside the preset clinically significant difference of 15%. The poor rating for methodologic quality was primarily because of the citation of references to low-quality review articles and "other" sources (i.e., other than reports of clinical trials). Half of the advertisements had a methodologic quality score of less than 65%, but only five had a relevance score of less than 65%. CONCLUSIONS: Although the relevance of most of the references was within minimal acceptable limits, the methodologic quality was often unacceptable. Because advertisements are an important part of pharmaceutical marketing and education, we suggest that companies develop written standards for their advertisements and monitor their advertisements for adherence to these standards. We also suggest that the Pharmaceutical Advertising Advisory Board develop more stringent guidelines for advertising and that it enforce these guidelines in a consistent, rigorous fashion.

Advertising↗
PubMedDate not supplied

Advertising health: the case for counter-ads.

Public service advertisements have been used by many in hopes of "selling" good health behaviors. But selling good behavior--even if it could be done more effectively--is not the best goal for using mass media to prevent health problems. Personal behavior is only part of what determines health status. Social conditions and the physical environment are important determinants of health that are usually ignored by health promotion advertising. Public service advertising may be doing more harm than good if it is diverting attention from more effective socially based health promotion strategies. Counter-ads are one communications strategy that could be used to promote a broader responsibility for rectifying health problems. In the tradition of advocacy advertising directly promoting policy rather than products, counter-ads promote views consistent with a public health perspective. Counter-ads set the agenda for health issues, conferring status on policy-oriented strategies for addressing health problems. The primary purpose of counter-ads is to challenge the dominant view that public health problems reflect personal health habits. They are controversial because they place health issues in a social and political context. Advertising strategies for health promotion range over a spectrum from individually oriented public service advertising to socially oriented counter-advertising. The recent anti-tobacco campaign from the California Department of Health Services represents advertisements across the spectrum. Counter-ads that focus on a politically controversial definition for health problems are an appropriate and necessary alternative to public service advertising.

Adolescent↗
PubMed1991

Do our guardians need guarding? An examination of the Australian system of self-regulation of alcohol advertising.

In this study the Australian system of self-regulation of alcoholic beverage advertising was examined. Sixteen advertisements, eight print and eight television advertisements, were subjected to public scrutiny. Respondents rated advertisements using a self-completion questionnaire based directly on the Australian Alcoholic Beverage Advertising Code. Responses were collated and where a majority of respondents had endorsed items that constituted a breach of the cose, a complaint, ostensibly from a member of the general public, was made to the Advertising Standards Council. All sixteen advertisements were regarded by the public as containing aspects which breached the code. However, the Advertising Standards Council rejected all but one of the sixteen complaints, often directly contradicting the opinions of our respondents. The social policy implications of these results are considered. It is contended that the system of self-regulation of alcohol advertising does not serve the public interest.

Journal Article↗
PubMed1999

Trends in antihypertensive drug advertising, 1985-1996.

BACKGROUND: Over the past decade, calcium channel blockers (CCBs) and ACE inhibitors have been used increasingly in the treatment of hypertension. In contrast, beta-blocker and diuretic use has decreased. It has been suggested that pharmaceutical marketing has influenced these prescribing patterns. No objective analysis of advertising for antihypertensive therapies exists, however. METHODS AND RESULTS: We reviewed the January, April, July, and October issues of the New England Journal of Medicine from 1985 to 1996 (210 issues). The intensity of drug promotion was measured as the proportion of advertising pages used to promote a given medication. Statistical analyses used the chi2 test for trend. Advertising for CCBs increased from 4.6% of advertising pages in 1985 to 26.9% in 1996, while advertising for beta-blockers (12.4% in 1985 to 0% in 1996) and diuretics (4.2% to 0%) decreased (all P<0.0001). A nonsignificant increase was observed in advertising for ACE inhibitors (3.5% to 4.3%, P=0.17). Although the total number of drug advertising pages per issue decreased from 60 pages in 1985 to 42 pages in 1996 (P<0.001), the number of pages devoted to calcium channel blocker advertisements nearly quadrupled. CONCLUSIONS: Increasing promotion of CCBs has mirrored trends in physician prescribing. An association between advertising and prescribing patterns could explain why CCBs have supplanted better-substantiated therapies for hypertension.

Adrenergic beta-Antagonists↗
PubMed2006

UV tanning advertisements in high school newspapers.

OBJECTIVE: To examine the increasing use of UV tanning parlors by adolescents, despite the World Health Organization recommendation that no one under the age of 18 years use UV tanning devices. DESIGN: We examined tanning advertisements in a sample of public high school newspapers published between 2001 and 2005 in 3 Colorado counties encompassing the Denver metropolitan area. RESULTS: Tanning advertisements appeared in newspapers from 11 (48%) of 23 schools. Newspaper issues (N = 131) contained 40 advertisements placed by 18 tanning parlors. Advertisements commonly offered discounts (19 of 40) including unlimited tanning offers (15 of 40). Thirteen advertisements featured non-UV tanning treatments, and 2 advertisements mentioned parental consent or accompaniment for UV tanning. CONCLUSIONS: UV radiation, a classified carcinogen, is commonly and specifically marketed to adolescents through high school newspaper advertising. Public health skin cancer prevention policies should include the prohibition of UV tanning advertising to minors.

Adolescent↗
PubMedDate not supplied

Advertising, patient decision making, and self-referral for computed tomographic and magnetic resonance imaging.

BACKGROUND: Self-referred imaging is one of the latest health care services to be marketed directly to consumers. Most aspects of these services are unregulated, and little is known about the messages in advertising used to attract potential consumers. We conducted a detailed analysis of print advertisements and informational brochures for self-referred imaging with respect to themes, content, accuracy, and emotional valence. METHODS: Forty print advertisements from US newspapers around the country and 20 informational brochures were analyzed by 2 independent raters according to 7 major themes: health care technology; emotion, empowerment, and assurance; incentives; limited supporting evidence; popular appeal; statistics; and images. The Fisher exact test was used to identify significant differences in information content. RESULTS: Both the advertisements and the brochures emphasized health care and technology information and provided assurances of good health and incentives to self-refer. These materials also encouraged consumers to seek further information from company resources; virtually none referred to noncomplying sources of information or to the risks of having a scan. Images of people commonly portrayed European Americans. We found statistical differences between newspaper advertisements and mailed brochures for references to "prevalence of disease" (P<.001), "death" (P<.003), and "radiation" (P<.001). Statements lacking clear scientific evidence were identified in 38% of the advertisements (n = 15) and 25% of the brochures (n = 5). CONCLUSIONS: Direct-to-consumer marketing of self-referred imaging services, in both print advertisements and informational brochures, fails to provide prospective consumers with comprehensive balanced information vital to informed autonomous decision making. Professional guidelines and oversight for advertising and promotion of these services are needed.

Advertising↗
PubMed1998

Evaluation of antismoking advertising campaigns.

CONTEXT: Active and passive smoking are the first and third leading preventable causes of death. Many states are running or initiating antitobacco media campaigns. OBJECTIVE: To review research on the effectiveness of different antismoking messages and published evidence of the effectiveness of paid antismoking advertising. DATA SOURCES: Focus group studies conducted by professional advertising agencies that contract with California, Massachusetts, and Michigan to run their antismoking advertising campaigns, the Centers for Disease Control and Prevention's Media Campaign Resource Book, and copies of the advertisements. In total, we reviewed the results of 186 focus groups involving more than 1500 children and adults dealing with 118 advertisements that had actually been aired and additional concept advertisements that were not produced. Published literature was located using MEDLINE and standard bibliographic sources on the effectiveness of large, paid antitobacco media campaigns. We also reviewed reports and studies conducted by, or for, the California and Massachusetts health departments on program effectiveness, and conducted our own comparison of California vs Massachusetts using cigarette consumption data from the Tobacco Institute. STUDY SELECTION: All available studies. DATA SYNTHESIS: Eight advertising strategies to prevent people from starting to smoke and persuading them to stop were reviewed: industry manipulation, secondhand smoke, addiction, cessation, youth access, short-term effects, long-term health effects, and romantic rejection. These focus groups identified strategies that would be expected to be effective and ineffective. Regression analysis was used to compare the cost-effectiveness of the California and Massachusetts programs. CONCLUSIONS: Focus group participants indicated that industry manipulation and secondhand smoke are the most effective strategies for denormalizing smoking and reducing cigarette consumption. Addiction and cessation can be effective when used in conjunction with the industry manipulation and secondhand smoke strategies. Youth access, short-term effects, long-term health effects, and romantic rejection are not effective strategies. More aggressive advertising strategies appear to be more effective at reducing tobacco consumption.

Adolescent↗
PubMed2005

Physician exposure to and attitudes toward advertisements for genetic tests for inherited cancer susceptibility.

Commercial marketing materials may serve as a source of information for physicians about genetic testing for inherited cancer susceptibility (GTICS) in addition to medical guidelines, continuing education, and journal articles. The primary purposes of this study were to: (1) determine the percentage of physicians who received advertisements for GTICS early in the diffusion of commercial GTICS (1999-2000); (2) assess associated characteristics; and (3) measure the perceived importance of commercial advertisements and promotions in physicians' decisions to recommend testing to patients. A nationally representative, stratified random sample of 1,251 physicians from the American Medical Association (AMA) Physician Masterfile completed a 15-20 min mixed mode questionnaire that assessed specialty, previous use of genetic tests, practice characteristics, age, and receipt of advertising materials (response rate = 71%). Overall, 27.4% (n = 426) had received advertisements. In multivariate analysis, factors associated with receipt of advertisements included: specialties in obstetrics/gynecology, oncology, or gastroenterology; past GTICS use, and age 50+. One of four felt that advertisements would be important in their decision to recommend GTICS. Study results indicate that physicians, particularly in oncology, obstetrics/gynecology, and gastroenterology, began receiving GTICS advertisements commensurate with the early diffusion of commercially available tests into clinical practice. At that time, one-quarter of the physicians considered advertisements to play an important role in their clinical decision making, suggesting attention to other sources of information and additional factors.

Advertising↗
PubMed2006

Alcohol advertising and alcohol consumption by adolescents.

This study investigates the effects of alcohol advertising on adolescent alcohol consumption. The theory of an industry response function and evidence from prior studies indicate the importance of maximizing the variance in advertising measures. Monitoring the Future (MTF) and National Longitudinal Survey of Youth 1997 (NLSY97) data are augmented with alcohol advertising, originating on the market level, for five media. The large sample of the MTF allows estimation of race and gender-specific models. The longitudinal nature of the NLSY97 allows controls for unobserved heterogeneity with state-level and individual fixed effects. Price and advertising effects are generally larger for females relative to males. Controls for individual heterogeneity yield larger advertising effects, implying that the MTF results may understate the effects of alcohol advertising. Results from the NLSY97 suggest that a 28% reduction in alcohol advertising would reduce adolescent monthly alcohol participation from 25% to between 24 and 21%. For binge participation, the reduction would be from 12% to between 11 and 8%. The past month price-participation elasticity is estimated at -0.26, consistent with prior studies. The results show that reduction of alcohol advertising can produce a modest decline in adolescent alcohol consumption, though effects may vary by race and gender.

Adolescent↗
PubMed1999

A comparison of the advertising and accessibility of cigars, cigarettes, chewing tobacco, and loose tobacco.

BACKGROUND: Tobacco products were compared in regard to their price, point-of-purchase advertising, accessibility to shoplifters, and rate of sale to minors. METHODS: An experimental design compared the rates of illegal sales to minors of cigarettes, chewing tobacco, and cigars. Observational surveys of 102 stores measured the number of advertisements for four tobacco products, the manner in which products were displayed, and their accessibility to shoplifters. RESULTS: Illegal sales rates were similar for cigarettes, chewing tobacco, and cigars. Cigars were the least expensive. Cigarettes were the most heavily advertised product, followed by chewing tobacco, cigars, and loose tobacco. Cigarettes were the most accessible to shoplifters. All types of tobacco products were displayed to permit the package to serve as advertising. CONCLUSIONS: Point-of-purchase advertising for cigars may be increasing, and their lower price makes them more affordable to youths. Food and Drug Administration regulations that limit point-of-purchase advertising for tobacco products should be expanded to include cigars. Manufacturers pay retailers for the placement of product displays that allow the package to be used as an advertisement without the appearance of the Surgeon General's warning. Generic packaging may be necessary to protect children from point-of-purchase advertising.

Adolescent↗
PubMed2001

Direct-to-consumer advertisements for prescription drugs: what are Americans being sold?

BACKGROUND: Pharmaceutical companies spent US$1.8 billion on direct-to-consumer advertisements for prescription drugs in 1999. Our aim was to establish what messages are being communicated to the public by these advertisements. METHODS: We investigated the content of advertisements, which appeared in ten magazines in the USA. We examined seven issues of each of these published between July, 1998, and July, 1999. FINDINGS: 67 advertisements appeared a total of 211 times during our study. Of these, 133 (63%) were for drugs to ameliorate symptoms, 54 (26%) to treat disease, and 23 (11%) to prevent illness. In the 67 unique advertisements, promotional techniques used included emotional appeals (45, 67%) and encouragement of consumers to consider medical causes for their experiences (26, 39%). More advertisements described the benefit of medication with vague, qualitative terms (58, 87%), than with data (9, 13%). However, half the advertisements used data to describe side-effects, typically with lists of side-effects that generally occurred infrequently. None mentioned cost. INTERPRETATION: Provision of complete information about the benefit of prescription drugs in advertisements would serve the interests of physicians and the public.

Advertising↗
PubMed1998

Outdoor tobacco advertising in six Boston neighborhoods. Evaluating youth exposure.

BACKGROUND: The Food and Drug Administration (FDA), in its 1996 regulations to restrict certain forms of cigarette advertising likely to appeal to adolescents, prohibited outdoor tobacco advertising within 1,000 feet of schools and playgrounds. No published studies have determined the density of outdoor tobacco advertising within the FDA's prescribed 1,000-foot buffer zone around schools. OBJECTIVE: To determine the prevalence, type, and proximity to public schools of all stationary, outdoor tobacco advertising in six Boston neighborhoods. DESIGN: A cross-sectional field survey conducted in six Boston neighborhoods with varying ethnic, cultural, and socioeconomic characteristics. The main outcome measure was advertising density within buffer zones around public schools. RESULTS: Youth in the six neighborhoods are heavily exposed to stationary, outdoor cigarette advertising. This exposure is intense in areas close to public schools, and more intense in neighborhoods with more children, with significant Black and Hispanic/Latino populations, and with low socioeconomic status. Advertising strategies employed by the tobacco industry are in line with accepted professional marketing practice that targets adolescents for other products. CONCLUSIONS: Given the pervasive nature of the outdoor tobacco advertising we observed in the present study, it appears that the only way to protect youth from exposure is by eliminating it from the community.

Adolescent↗