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Study: Drug Ads Rely on Emotional Appeal

Patients don't get enough to make informed choices, say researchers

THURSDAY, Oct. 11, 2001 (HealthDayNews) -- Ads that tout prescription drugs aim for the heart and not for the head, says a new study.

Drug companies spent $1.8 billion on direct consumer advertising for prescription medication in 1999. While companies could be performing a public service by focusing on important medical information, the ads make emotional appeals and rarely quantify a medication's benefits, the researchers say.

"The work we do is focused on how to improve the communication of medical information to the public," says study co-author Dr. Steven Woloshin, a professor of medicine at the Dartmouth Medical School's Department of Veterans Affairs (VA), in White River Junction, Vt. "We are particularly interested in whether these ads provide scientific information, so that people can use data to make informed decisions."

Drug companies began advertising prescription drugs in 1981, when Merck & Co. launched a print ad campaign in Reader's Digest for a new pneumonia vaccine. Concerns about freedom of speech prompted the Food and Drug Administration (FDA) to issue regulations allowing direct-to-consumer advertising as long as the ads presented true and balanced information on the drug's potential side effects.

To see what kind of message drug companies use, Woloshin and his wife, Lisa Schwartz, also a professors of medicine at the Dartmouth VA facility, surveyed ads in large-circulation women's magazines (Better Homes & Gardens, Family Circle, and Good Housekeeping), men's magazines (Sports Illustrated, Gentleman's Quarterly, and Men's Health) and general interest magazines (Time, People, and Newsweek). Seven issues of each publication were examined between July 1998 and July 1999.

Sixty-seven ads appeared a total of 211 times, the survey found. Woloshin and Schwartz analyzed their content to see if the benefit of the drug was described, whether side effects were discussed and whether the ads appealed to emotions. "We also looked at whether they encouraged self-diagnosis by providing a list of symptoms, and did the ad mention the cost of the drug?" Woloshin says.

Of the 67 ads, 45 included emotional appeals aimed at the reader's desire to avoid death or a dreaded illness and encouraged consumers to consider medical causes for symptoms, the authors say. Benefits of the medication were described in vague terms. Half the ads used data to describe side effects. Not one mentioned the cost of the drug.

The ads touted drugs to treat symptoms and to treat diseases like diabetes or to prevent illnesses like Lyme disease or breast cancer, Schwartz says. "Most of the ads have an emotional appeal and did not present the expected benefit of the drug," she says. "Nor did the ads provide the kind of medical data that would enlighten patients."

The findings appear in the Oct. 6 issue of The Lancet.

Woloshin says prescription drug ads are doing a disservice to patients.

"If the purpose of these ads is to promote doctor/patient participation in disease management, then appealing to emotion is not helping a patient make an informed decision," he says. "Our findings indicate that these advertisements rarely quantify a medication's expected benefit. This strategy probably leaves many readers with the perception that the drug's benefit is large, and that everyone who uses the drug will enjoy the benefit. The provision of complete information about the benefits would serve the interest of physicians and the public."

The drug industry defends the ads because they prompt "an important dialogue" between doctor and patient. "There's a big problem in this country with under-treatment and under-diagnosis of disease," says Meredith Art, a spokeswoman for the Pharmaceutical Research and Manufacturers of America in Washington, D.C., an umbrella group. "These advertisements bring patients into doctors' offices and allow physicians to treat patients who might not otherwise go to the doctor."

Art says the FDA regulates the ads to make sure they provide accurate information. The FDA sends warning letters to companies that step out of bounds with their ads; for instance, if it promotes a benefit that can't be backed up by research, she says.

Schwartz and Woloshin say more control may be necessary. "What we would like to see is some kind of standardized presentation of the key facts and data on the drug, created in such a way that people could easily understand the drug's benefits, the proportion of people who have been helped by the drug and the proportion that have experienced side effects," Schwartz says.

What To Do

If you're interested in a certain prescription drug, looking it up on the Internet to find out all the prescribing information and potential side effects could be helpful.

For more on the issues surrounding direct-to-consumer advertising, see the Pharmaceutical Research and Manufacturers of America or the FDA.

SOURCES: Interviews with Steven Woloshin, M.D., and Lisa Schwartz, M.D., professors of medicine, Dartmouth Medical School's Department of Veterans Affairs, White River Junction, Vt., and Meredith Art, spokeswoman, Pharmaceutical Research and Manufacturers of America, Washington, D.C.; Oct. 6, 2001, The Lancet
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