Study finds hardly any direct-to-consumer drug ads mention condition risks or alternative treatments

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In the study, the researchers report that they studied commercials recorded between June 30 and July 27, 2004 shown during prime time television on ABC, CBS, NBC and Fox. The total tally was 38 unique ads that were about seven of the top 10 best selling prescription pharmaceuticals of 2004. Specifically, the University of California researchers were looking "for factual claims (advertisers) make about the target condition, how they attempt to appeal to consumers, and how they portray the medication and lifestyle behaviors in the lives of ad characters."

According to the results published in the Annals of Family Medicine, 82 percent of the ads made factual claims about the product; 86 percent put forward rational argument in favor of taking the drug; 95 percent attempted to appeal to the consumer on an emotional level; 58 percent implied that the condition the drug treated can cause consumers to lose control over some aspect of their lives, while 85 percent took that approach and also implied the drug could return that control; 78 percent suggested that regaining control over the condition would help the consumer gain social approval; and 58 percent of advertisers depicted the products as medical breakthroughs.

Conversely, only 26 percent of ads informed consumers about causes and risk factors for the conditions, and 25 percent reported the prevalence of the given condition. Not one of the ads talked about making lifestyle changes instead of taking the medicine, although 19 percent referenced lifestyle changes as something that could be made alongside regimens of the product. Eighteen percent of the advertisers suggested that lifestyle changes were not enough to control the conditions their products treated. The study also noted that seven of the 38 ads captured in the study were “reminder” ads (promotions which tout the name of the drug but give no other information.) Reminder ads are the subject of a voluntary ban among major drug marketers.

"Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters 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," wrote lead author Dominick Frosch, assistant professor of medicine at the University of California, Los Angeles, and his colleagues in the study conclusion. "The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health."

Douglas Levy, one of Frosch's colleagues from the University of California, San Francisco agreed in an accompanying editorial co-written with former FDA commissioner David Kessler, stating that direct-to-consumer advertising does not "effectively or consistently convey important information about product risks and benefits."

"There is nothing wrong with pharmaceutical companies communicating directly with consumers," Kessler and Levy wrote in the article, "but they should adhere to the standards and ethics of medicine, not the standards and ethics of selling soap or some other consumer product that presents minimal risks."

The results of the study came as no surprise to Gary Ruskin, executive director of Commercial Alert. "This study confirms the obvious: The purpose of dtc ads is to sell drugs irrespective of whether the viewer needs the drug or whether there's be better safer cheaper alternative, which includes no drug at all," he said.

The non-profit Commercial Alert, hosted at www.CommercialAlert.org, was founded to oppose direct-to-consumer advertisements such as the ones studied at the University of California, and Ruskin said he hoped this study would be another "nail in the coffin" for this style of pharmaceutical marketing.

"DTC ads ought to be illegal and (Commercial Alert is) trying to make them illegal," he said. "We hope that our members of congress get up the courage to do what is right and ban it."

However, according Senior Vice President Ken Johnson of the drug industry organization Pharmaceutical Research and Manufacturers of America, the study is flawed because seven of the ads were so-called "reminder ads" -- ads that say the name of the drug but give no further information about it or the condition it treats -- which were recently voluntarily banned by the industry. Johnson also criticized the study for analyzing ads that were released a year before the PRMA established its "Guiding Principles."

"The study does not reflect any of the positive changes in DTC advertisements over the past 12 months and therefore has little relevance to the current policy discussion on direct-to-consumer advertising,” Johnson said in a statement.

Kessler and Levy's editorial addressed such efforts, saying that they may be a step in the right direction, but they added that "physicians, consumers and policymakers must take further action so that the facts about medicine are not lost in the advertising fog."

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