The Educational Value of Consumer-Targeted Prescription Drug Print Advertising

Information About Treatments

The Figure also displays the percentage of advertisements reporting each of the 6 types of treatment information. Most often present was information about a drug’s mechanism of action, found in 36% of the advertisements. An acknowledgement of the existence of one or more competing treatments was offered in 29% of the advertisements. Supportive behaviors such as changes in diet, physical activity, and sleeping patterns were reported in 24% of the advertisements. In our judgment, relevant supportive behaviors are often recommended by physicians for most of the conditions addressed in these advertisements. Readers were given information about time to onset of action in 20% of the advertisements and typical required treatment duration in 11%. A success rate estimate was rarely reported (9%).

Three of these treatment information codes were significantly associated with the medical conditions variable (all P values=.02). Supportive behaviors that could be used alone or to enhance the effectiveness of therapy were more likely to be found in diabetes and tobacco cessation treatments (75% and 67% of brands, respectively). Time to onset of action information was especially likely to be offered in advertisements for dermatological and urological problems (58% and 50%, respectively). Information about treatment duration was most often found in advertisements for infection and dermatological treatments (50% and 33%, respectively).

Indexes

For summative purposes we examined the condition information, treatment information, and overall education indexes for each of the 14 medical condition categories, using the drug brand as the unit of analysis. The average brand provided only 2.1 of the 5 types of information about the condition for which the drug was marketed. Only 1.2 of the 6 types of treatment information we coded was provided in the average brand-weighted advertisement. Summing across the condition and treatment information variables, the average number of educational codes present for these 101 brands was only 3.2 out of a possible score of 11 (range=1.0-7.3).

Next we categorized the brands under the medical condition category for which each was promoted Table 3. Despite weak statistical power, a significant difference across the 14 medical conditions was found for 2 of the 3 indexes, the condition information index (F [13,87]=3.05, P=.001) and the combined education index (F [13,87]=2.39, P=.008). On the basis of post hoc comparisons, both effects could be attributed to the greater provision of information in promotions for urologic brands than in HIV/AIDS brand advertisements.

Information Formats

Information about conditions and treatments was typically provided in narrative form. Tabular data or charts (eg, bar, pie, or column charts) were rarely used to provide information about the drug (2% of advertisements) or the medical condition (<1%). Diagrams and pictures were also rarely used to provide information about the effectiveness of the treatment (2% of advertisements) or the nature of the condition (7%).

Other Sources of Information

One view of DTC advertising is that it simply provides an introduction to a treatment and that more detailed patient education is best provided in other ways, such as with brochures and videotaped presentations or through the Internet. An explicit offer of printed or audiovisual information was provided in 35% of the advertisements, and a toll-free information telephone number was found in 73%. Increasingly, the Internet is being used as a means through which interested readers can obtain more information about advertised products. In 1996, 1997, and 1998, the percentages of advertisements that provided a Web site address were 14%, 33%, and 57%, respectively. Most telephone numbers were numeric (55%), but some of these and all Web addresses referenced a benefit of use (eg, 1-800-5-SHUT-EYE for a treatment of insomnia), the treated body part (eg, www.kidsears.com for a treatment of ear infections), the medical condition treated (eg, 1-800-66-ANGINA), the brand name of the drug (eg, www.atrovent.com), or the drug company’s name (eg, 1-800-GLAXO-RX).

Discussion

A time may come when DTC advertising is recommended for its educational value, but that day is not yet at hand. The advertisements that have appeared during the past decade have been superficial in their coverage of medical conditions and their treatments. Although most provide the name of the treated medical condition and its associated symptoms, the large majority do not inform potential patients about such basic matters as the risk factors for the condition or its prevalence. Likewise, these advertisements seldom educate patients about the mechanism of action by which the drug treats a particular condition, its success in doing so, alternative treatments, and behavioral changes that could augment or supplant treatment. To their credit, most of these promotions do offer the reader alternative ways of learning more about their condition and the advertised drug.