The effects of advertising skepticism in consumer prescription drug advertising

A scoping review of empirical research on prescription drug promotion

BACKGROUND

Pharmaceutical spending on prescription drug promotion is considerable, and exposure to advertising can influence demand and behavior. The U.S. Food and Drug Administration (FDA) provides industry guidance to help ensure that communications to consumers and health care providers about prescription drug promotion are truthful, balanced, and accurately communicated. As empirical research has accelerated on this topic in the past decade, an understanding of the current landscape of the science will help inform future research.

OBJECTIVES

Using systematic methods, this rigorous scoping review of the literature over the past decade (2012-2021) (1) examined the extent to which prescription drug promotion has been empirically investigated with consumers, patients, and health care providers; (2) examined the extent to which content and features of prescription drug promotion have been empirically investigated; and (3) identified themes across the literature to better understand the current landscape of prescription drug promotion.

METHODS

Databases searched include PubMed, Web of Science, CINAHL, APA PsycInfo, Business Source Corporate, Communication Source, Cochrane Library, and ClinicalTrials.gov for original research published in English from January 1, 2012, through November 10, 2021, using terms related to direct-to-consumer advertising, prescription drugs, and outcomes of interest (e.g., attitudes, perceptions, intentions, behaviors).

RESULTS

Of 804 screened references, 151 studies addressed the first research question, and 40 studies addressed the second. The most common theme across the body of evidence focused on testing of features and content in prescription drug promotional materials (84), followed by studies examining attitudes, perceptions, and behaviors toward prescription drug promotion more generally (43). Some (27) studies focused on targeted populations, such as patients, the elderly, non-English speaking people or individuals of a non-white race/ethnicity. Twenty-four studies assessed influence of exposure to prescription drug promotion on actual clinical outcomes, while 11 studies examined emerging technologies around prescription drug promotion. Seven studies evaluated the extent to which prescription drug promotion complied with existing guidelines and requirements.

CONCLUSIONS

Findings from this scoping review suggest there has been an increase in the number of empirical studies conducted on prescription drug promotion over the past decade. Potential areas that warrant further study include examination of emerging technologies, an expanded focus on targeted populations, and construct measurement.

Consumer's Regulatory Knowledge of Prescription Drug Advertising and Health Risk Awareness: The Moderating Role of Risk Information Prominence

Borrowing insights from the consumer knowledge and the direct-to-consumer prescription drug advertising (DTCA) risk communication literature, the current study examined how consumers' regulatory knowledge regarding DTCA affects attention to and awareness of risk information in DTCA. The moderating role of risk information prominence and the mediating mechanism of attention were also explored. Taking an experimental design approach using a sample of US consumers (N = 264), risk information prominence was manipulated using various message attributes (e.g., font, color, size, box line, thickness, proximity). The study found that consumers' higher regulatory knowledge led to greater attention to risk information when the health risks of the advertised drug were presented less prominently, compared with when the risks were salient. The regulatory knowledge enhanced consumer recall and recognition of the drug's health risks through attention, but the indirect effects were dependent on the disclosure prominence level, such that the effects were more apparent when the prominence was low. This study manifests the value of consumers' regulatory literacy of DTCA to make informed prescription medication decisions and advises pharmaceutical marketers to present noticeable health risk information to encourage consumers to consider important health risks of promoted drugs in their decision making.