A UCLA study suggests that direct to consumer television advertisements of prescription drugs may be influencing Americans to believe they are sicker than
they really are and this could lead to taking more medication than they actually need.
The study is published in the current edition of the Annals of Family Medicine.
It was funded by the National Cancer Institute's Centers of Excellence in Cancer Communication Research and the Robert Wood Johnson Foundation, and was led
by Assistant Professor of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at the University of California, Los
Angeles, Dr Dominick Frosch.
The scientists assessed the educational value of 38 direct to consumer tv ads for prescription drugs and analyzed how they tried to influence viewers. The
drugs were for treating illnesses ranging insomnia and depression to high cholesterol and high blood pressure.
Their findings suggest that the ads had virtually no educational value, failed to describe who is most at risk for which illnesses, what their symptoms might
be, and whether non-medicinal alternatives such as changes to lifestyle like exercise and diet might also be viable options.
Americans watch up to 16 hours of tv ads about prescription drugs per week. The scientists watched the ads shown during the evening news and prime time
periods. They used a coding system that takes into account a number of attributes of each ad. The attributes included the factual claims made about the
illness the drug is aimed at, the method used to attract the consumer, and also what is revealed about the behaviour and lifestyle of the people in the ad.
Although they found that over 80 per cent of the advertisements did make some factual claims and put forward rational arguments for use of the drugs, only 25
to 26 per cent of them described symptoms and causes of illnesses, the associated risk factors and how common or rare they are.
The scientists also found that many of the ads portrayed the drugs in terms of people losing (58 per cent) control over their lives and then regaining it (85
per cent) once they took the medication. 78 per cent of the ads also portrayed the medication as engendering social approval, while 58 per cent of them
implied that the drug was a medical breakthrough.
The findings also show that nearly all ads (95 per cent) used emotional appeal to influence viewers and none of them showed lifestyle and behaviour change as
viable alternatives, except for 19 per cent of them that showed this as an adjunct to taking the drug. 18 per cent of the ads suggested that changes to
lifestyle would not be enough to deal with the illness.
The conclusion of the study states that despite the claims that tv ads play an educational role, they contain limited information about causes and symptoms
of their target illnesses, their prevalence and risk factors. They also show people 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."
New Zealand and the US are the only developed countries that allow prescription drugs to be advertised direct to the consumer on tv. New Zealand is
considering stopping it.
Dr Frosch said that "We're seeing a dramatization of health problems that many people used to manage without prescription drugs," and that the "ads send the
message that you need drugs to manage these problems and that without medication your life will be less enjoyable, more painful and maybe even out of
control." He said that the US should consider banning direct to consumer tv advertising of prescription drugs too.
Last year, the major pharmaceutical companies pledged that tv ads would portray serious illnesses seriously and would describe warnings, side effects and
risks according to new guidelines. And in 2005, Paul Antony, their industry spokesman, told a Senate hearing that "direct to consumer advertising can be a
powerful tool in educating millions of people and improving health."
"Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising."
Dominick L. Frosch, PhD, Patrick M. Krueger, PhD, Robert C. Hornik, PhD, Peter F. Cronholm, MD, MSCE, and Frances K. Barg, PhD.
Annals of Family Medicine 5:6-13 (2007)
doi: 10.1370/afm.611
Click here for Abstract (no subscription required).
: Catharine Paddock
Writer: blog