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White C, Basham N, Floyd S, Morrow L, Dean RS, Brennan ML. Cross-sectional survey of sources of information accompanying veterinary product advertisements in two professional print publications. Vet Rec 2024; 194:e3902. [PMID: 38409799 DOI: 10.1002/vetr.3902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/14/2024] [Accepted: 01/19/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Veterinarians should be able to easily access scientific evidence about medical products and devices to incorporate into their clinical decision making. While the characteristics and quality of supporting information accompanying device and pharmaceutical advertisements have been studied in human medicine, little is known about this topic in veterinary medicine. The aim of this study was to characterise the supporting information provided by manufacturers of prescribed products, tests or devices in promotional material found in two commonly read UK-based veterinary publications. METHODS Advertisements contained in issues of two veterinary periodicals published between July 2017 and July 2018 were analysed for advertisement and product characteristics and for items of accompanying information. Literature searches were conducted to assess the availability of peer-reviewed sources of information on advertised products. RESULTS A minority (16%) of the 451 analysed advertisements were accompanied by references to peer-reviewed literature, despite the availability of scientific literature for many of the products advertised. LIMITATION This study sampled two professional publications over a narrow time period. CONCLUSIONS There may be insufficient evidence being provided to veterinary professionals via marketing features; this may limit the accessibility of scientific information for clinical decision making around advertised products.
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Affiliation(s)
- Constance White
- Oregon State University Carlson College of Veterinary Medicine, Corvallis, Oregon, USA
| | - Natasha Basham
- Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | | | - Lisa Morrow
- Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | | | - Marnie L Brennan
- Centre for Evidence-Based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
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Gupta R, Friedman AB, McCoy MS. Medical journals and advertiser tracking-Consequences for patients, clinicians, and editors. Digit Health 2023; 9:20552076231176654. [PMID: 37559829 PMCID: PMC10408310 DOI: 10.1177/20552076231176654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/02/2023] [Indexed: 08/11/2023] Open
Abstract
Medical journal websites frequently contain tracking code that transfers data about journal readers to third parties. These data give drug, device, and other medical product companies a potentially powerful resource for targeting advertisements and other marketing materials to journal readers based on unique attributes and medical interests that can be inferred from the articles they read. Thus, while editors may strictly regulate the content of advertisements that such companies place in their journals' pages, they simultaneously provide those companies with the means to target readers in other forums, possibly in ways that subvert editorial guidelines. We examine the implications of third-party tracking on medical journal webpages, and recommend actions that publishers, editors, and academic societies can take to curb it.
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Affiliation(s)
- Ravi Gupta
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ari B Friedman
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew S McCoy
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Guo XM, Barber EL. The Invisible Hand of Industry. Clin Obstet Gynecol 2022; 65:260-267. [PMID: 35476619 PMCID: PMC9060382 DOI: 10.1097/grf.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Over the last decades, federal funding for medical research has decreased, while industry funding has increased. The majority of clinical trials are now industry funded. Involvement of industry raises documented concerns of reporting and publication bias, data suppression, and conclusions that may more favorably align with funder motivations rather than study results. However, industry involvement may also lead to scientific innovation, efficiency, and a more rapid timeline to bring new developments to patients. Through a careful review of a manuscript, the reader can understand the nature of industry involvement and interpret the results in this context.
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Affiliation(s)
- X Mona Guo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California
| | - Emma L Barber
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
- Robert H Lurie Comprehensive Cancer Center, Northwestern University
- Surgical Outcomes and Quality Improvement Center, Institute for Public Health in Medicine, Chicago, Illinois
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Yousefi N, Sharif Z, Chahian F, Mombeini T, Peiravian F. An investigation into the pharmaceutical advertising in Iranian medical journals. J Pharm Policy Pract 2022; 15:18. [PMID: 35255995 PMCID: PMC8900423 DOI: 10.1186/s40545-022-00415-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pharmaceutical advertising is not only considered a key factor in the successful launch of pharmaceutical products, but is also an important source of public health information with a significant impact on consumer choice and behavior. Nowadays, advertising has become the broadest dissemination channel for various products, including medicines, which may ultimately lead to the generalization of self-treatment or mistreatment. Improper drug promotion can exacerbate unhealthy outcomes by making false or misleading claims, using inferior references, and failing to meet international standards. This study aimed to examine the requirements for pharmaceutical advertising from regulatory perspective and the compliance of Iranian pharmaceutical advertisements to related standards and guidelines. It is limited to print advertisements in Iranian national medical journals and magazines. Method The present study is a descriptive–analytical study using bibliometric methods. As a first step, a comprehensive review of the national and international regulations on drug advertising was conducted and a comparison of different regulations was provided. In the second step, a checklist was created to evaluate the compliance of drug advertising with the extracted regulations. Result The results of the present study show that the claims made in Iranian drug advertisements are 29.10% valid, 27.67% exaggerated, 23.10% controversial, 12.62% misleading, and 6.8% invalid. In general, we found that most medical advertisements in Iranian journals and magazines comply with national laws and regulations. However, many international requirements are not met in these advertisements. Conclusions Although we found that printed medical advertisements in Iran are roughly compliant with national regulations, there is still a long way to achieve full compliance. Monitoring processes should be improved and clearly defined penalties should be set to avoid misleading claims and their likely health consequences. It is very important in Iran to update the existing rules and regulations for medical advertisements according to international guidelines. More careful monitoring of the content of advertising and the accuracy of claims are also needed.
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Kirubarajan A, Lam A, Yu A, Taheri C, Khan S, Sethuram C, Mehta V, Olivieri N. Knowledge, Information Sources, and Institutional Trust of Patients Regarding Medication Use in Pregnancy: A Systematic Review. J Family Reprod Health 2021; 15:160-171. [PMID: 34721607 PMCID: PMC8536826 DOI: 10.18502/jfrh.v15i3.7133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The objective of our study is to characterize the knowledge, information sources, and institutional trust of patients regarding medication use in pregnancy. Materials and methods: We conducted a review of three databases: MEDLINE, EMBASE, and CINAHL. We included observational studies and knowledge assessments that examined the knowledge, attitudes, beliefs or information sources of pregnant patients related to medication use during pregnancy. Extraction was completed by two independent reviewers, outcomes were summarized descriptively, and appraisal was conducted. Results: Of the 1359 search results, 34 studies met inclusion criteria. Thus, our systematic review encompasses the beliefs of 11,757 pregnant participants. In most studies, participants described apprehension regarding potential risks to the fetus and the inadequacy of safety information. Across the 23 knowledge assessments, the majority of studies reported patient misconceptions about prescription medication in pregnancy. The most preferred information source was a healthcare provider. However, many participants expressed frustration, mistrust, and skepticism regarding physician knowledge. A common source of mistrust was due to perceived physician self-interest as well as a lack of education tailored to pregnancy. Consequently, informal sources of information were also popular. Conclusion: There is a need to improve the health literacy and trust among pregnant patients regarding drug prescribing. There are modifiable risk factors for mistrust that require further attention.
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Affiliation(s)
- Abirami Kirubarajan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Lam
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amy Yu
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Cameron Taheri
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shawn Khan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Claire Sethuram
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vikita Mehta
- Arts and Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nancy Olivieri
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Boesen K, Simonsen AL, Jørgensen KJ, Gøtzsche PC. Cross-sectional study of medical advertisements in a national general medical journal: evidence, cost, and safe use of advertised versus comparative drugs. Res Integr Peer Rev 2021; 6:8. [PMID: 33971984 PMCID: PMC8108346 DOI: 10.1186/s41073-021-00111-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 04/11/2021] [Indexed: 01/15/2023] Open
Abstract
Background Healthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity. Methods We conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or more were compared with older comparators: (1) comparative evidence of added benefit; (2) Defined Daily Dose cost; (3) regulatory safety announcements; and (4) completed and ongoing post-marketing studies 3 years after advertising. Results We found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue (range 0 to 11). Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: (1) ‘no added benefit’ in 4 (29%) of 14 comparisons, ‘uncertain benefits’ in 7 (50%), and ‘no evidence’ in 3 (21%) comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; (2) advertised drugs were 2 to 196 times (median 6) more expensive per Defined Daily Dose; (3) 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; (4) 20 post-marketing studies (7 completed, 13 ongoing) were requested for the advertised drugs versus 10 studies (4 completed, 6 ongoing) for the comparator drugs, and 7 studies (2 completed, 5 ongoing) assessed both an advertised and a comparator drug at 3 year follow-up. Conclusions and relevance In this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements. Supplementary Information The online version contains supplementary material available at 10.1186/s41073-021-00111-9.
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Affiliation(s)
- Kim Boesen
- Nordic Cochrane Centre, Rigshospitalet Dept. 7811, 2100 Copenhagen, Denmark. .,Current address: Meta Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Charité Universitätsmedizin, QUEST Center for Transforming Biomedical Research, Berlin, Germany.
| | | | - Karsten Juhl Jørgensen
- Nordic Cochrane Centre, Rigshospitalet Dept. 7811, 2100 Copenhagen, Denmark.,Centre for Evidence-Based Medicine (CEBMO) and Cochrane Denmark, Dept. Clinical Research, University of Southern Denmark, Odense, Denmark.,Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
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AlShammari M, Assiri G, bin Buraykan M, Almogbel Y, Arafah A, Bashatah A, AlRuthia Y. The Impact of Direct-to-Consumer Pharmaceutical Advertising on Public Knowledge of Gastroesophageal Reflux Disease: A Study on Over-the-Counter Proton Pump Inhibitors. Patient Prefer Adherence 2020; 14:635-642. [PMID: 32256054 PMCID: PMC7093092 DOI: 10.2147/ppa.s245391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/04/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of direct-to-consumer advertising (DTCA) to promote sales of over-the-counter (OTC) pharmaceuticals used to manage common medical conditions, such as gastroesophageal reflux disease (GERD), is increasing. However, the educational value of these advertisements as well as the public perceptions of this type of advertising remain largely unknown among non-English speaking populations. OBJECTIVE The aim of this study was to explore the public perceptions and educational value of a short motion graphic video documenting the lifestyle of person with GERD and presenting a brief introduction to the role of proton pump Inhibitors (PPIs) in relieving the symptoms. METHODS This was a prospective quasi-experimental study in which a short mock advertising motion graphic video was shown to a sample of adult individuals in malls and shopping centers in different cities across Saudi Arabia. Participants were required to express their levels of agreement with six statements concerning their perceptions of DTCA of OTC drugs, and answer a quiz consisting of three questions and enquiries about their knowledge of GERD and the OTC drugs used in its treatment. RESULTS Two hundred and ninety-five participants were involved in this study, the majority of whom were female (55.30%). After watching the video, the percentages of participants who strongly agreed or agreed that DTCA is a credible source of information and encourages them to purchase the marketed drug have increased significantly (P<0.05). With regard to the quiz, the percentages of participants with correct answers regarding the definition of GERD, knowledge of OTC drugs for GERD, and awareness of the common side effects of PPIs increased from 81.69% to 95.93%, 69.83% to 96.27%, and 46.44% to 91.53%, respectively (P<0.0001). CONCLUSION DTCA of OTC drugs for GERD, particularly if the content complies with the regulatory requirements, can promote the public knowledge of the disease and treatment options.
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Affiliation(s)
- Maram AlShammari
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ghadah Assiri
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed bin Buraykan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yasser Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Saudi Arabia
| | - Azher Arafah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
| | - Adel Bashatah
- Department of Nursing Education and Administration, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Yazed AlRuthia Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaTel +996 114677483Fax +966 114677480 Email
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Abstract
BACKGROUND Developers of medicines-related apps collect a variety of technical, health-related, and identifying user information to improve and tailor services. User data may also be used for promotional purposes. Apps, for example, may be used to skirt regulation of direct-to-consumer advertising of medicines. Researchers have documented routine and extensive sharing of user data with third parties for commercial purposes, but little is known about the ways that app developers or "first" parties employ user data. OBJECTIVE We aimed to investigate the nature of user data collection and commercialization by developers of medicines-related apps. APPROACH We conducted a content analysis of apps' store descriptions, linked websites, policies, and sponsorship prospectuses for prominent medicines-related apps found in the USA, Canada, Australia, and UK Google Play stores in late 2017. Apps were included if they pertained to the prescribing, administration, or use of medicines, and were interactive. Two independent coders extracted data from documents using a structured, open-ended instrument. We performed open, inductive coding to identify the range of promotional strategies involving user data for commercial purposes and wrote descriptive memos to refine and detail these codes. KEY RESULTS Ten of 24 apps primarily provided medication adherence services; 14 primarily provided medicines information. The majority (71%, 17/24) outlined at least one promotional strategy involving users' data for commercial purposes which included personalized marketing of the developer's related products and services, highly tailored advertising, third-party sponsorship of targeted content or messaging, and sale of aggregated customer insights to stakeholders. CONCLUSIONS App developers may employ users' data in a feedback loop to deliver highly targeted promotional messages from developers, and commercial sponsors, including the pharmaceutical industry. These practices call into question developers' claims about the trustworthiness and independence of purportedly evidenced-based medicines information and may create a risk for mis- or overtreatment.
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Leonardo Alves T, Lexchin J, Mintzes B. Medicines Information and the Regulation of the Promotion of Pharmaceuticals. SCIENCE AND ENGINEERING ETHICS 2019; 25:1167-1192. [PMID: 29721844 PMCID: PMC6647516 DOI: 10.1007/s11948-018-0041-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/06/2018] [Indexed: 06/03/2023]
Abstract
Many factors contribute to the inappropriate use of medicines, including not only a lack of information but also inaccurate and misleading promotional information. This review examines how the promotion of pharmaceuticals directly affects the prescribing and use of medicines. We define promotion broadly as all actions taken directly by pharmaceutical companies with the aim of enhancing product sales. We look in greater detail at promotion techniques aimed at prescribers, such as sales representatives, pharmaceutical advertisements in medical journals and use of key opinion leaders, along with the quality of information provided and the effects thereof. We also discuss promotion to the public, through direct-to-consumer advertising, and its effects. Finally, we consider initiatives to regulate promotion that come from industry, government and nongovernmental organizations.
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Affiliation(s)
- Teresa Leonardo Alves
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, WHO Collaborating Centre for Pharmaceutical Policy and Regulation, PO Box 80 082, 3508 TB, Utrecht, The Netherlands.
| | - Joel Lexchin
- Faculty of Health, York University, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Barbara Mintzes
- Faculty of Pharmacy and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Abstract
IMPORTANCE Manufacturers, companies, and health care professionals and organizations use an array of promotional activities to sell and increase market share of their products and services. These activities seek to shape public and clinician beliefs about laboratory testing, the benefits and harms of prescription drugs, and some disease definitions. OBJECTIVE To review the marketing of prescription drugs, disease awareness campaigns, health services, and laboratory tests and the related consequences and regulation in the United States over a 20-year period (1997-2016). EVIDENCE Analysis (1997-2016) of consumer advertising (Kantar Media data for spending and number of ads); professional marketing (IQVIA Institute for Human Data Science, Open Payments Data [Centers for Medicare & Medicaid Services]); regulations and legal actions of the US Food and Drug Administration (FDA), Federal Trade Commission (FTC), state attorneys general, and US Department of Justice; and searches (1975-2018) of peer-reviewed medical literature (PubMed), business journals (Business Source Ultimate), and news media (Lexis Nexis) for articles about expenditures, content, and consequences and regulation of consumer and professional medical marketing. Spending is reported in 2016 dollars. FINDINGS From 1997 through 2016, spending on medical marketing of drugs, disease awareness campaigns, health services, and laboratory testing increased from $17.7 to $29.9 billion. The most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9%) of total spending in 1997 to $9.6 billion (32.0%) of total spending in 2016. DTC prescription drug advertising increased from $1.3 billion (79 000 ads) to $6 billion (4.6 million ads [including 663 000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies. Pharmaceutical companies increased DTC marketing about diseases treated by their drugs with increases in disease awareness campaigns from 44 to 401 and in spending from $177 million to $430 million. DTC advertising for health services increased from $542 million to $2.9 billion, with the largest spending increases by hospitals, dental centers, cancer centers, mental health and addiction clinics, and medical services (eg, home health). DTC spending on advertising for laboratory tests (such as genetic testing) increased from $75.4 million to $82.6 million, although the number of ads increased more substantially (from 14 100 to 255 300), reflecting an increase in less expensive electronic media advertising. Marketing to health care professionals by pharmaceutical companies accounted for most promotional spending and increased from $15.6 billion to $20.3 billion, including $5.6 billion for prescriber detailing, $13.5 billion for free samples, $979 million for direct physician payments (eg, speaking fees, meals) related to specific drugs, and $59 million for disease education. Manufacturers of FDA-approved laboratory tests paid $12.9 million to professionals in 2016. From 1997 through 2016, the number of consumer and professional drug promotional materials that companies submitted for FDA review increased from 34 182 to 97 252, while FDA violation letters for misleading drug marketing decreased from 156 to 11. Since 1997, 103 financial settlements between drug companies and federal and state governments resulted in more than $11 billion in fines for off-label or deceptive marketing practices. The FTC has acted against misleading marketing by a single for-profit cancer center. CONCLUSIONS AND RELEVANCE Medical marketing increased substantially from 1997 through 2016, especially DTC advertising for prescription drugs and health services. Pharmaceutical marketing to health professionals accounted for most spending and remains high even with new policies to limit industry influence. Despite the increase in marketing over 20 years, regulatory oversight remains limited.
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Affiliation(s)
- Lisa M Schwartz
- The Center for Medicine in the Media, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
| | - Steven Woloshin
- The Center for Medicine in the Media, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
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Off the Market: The Percentage of Products Available After Ten Years. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2018; 2:e076. [PMID: 30211376 PMCID: PMC6132318 DOI: 10.5435/jaaosglobal-d-17-00076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: We observed that medical devices advertised in journals are often no longer available 5 to 10 years after first being advertised. In this study, we quantified the percentage of products advertised from 2003 to 2008 in the Journal of Bone and Joint Surgery, American, which were still available 5 to 10 years after first being advertised. Methods: We created a database of 427 unique orthopaedic products advertised in the Journal of Bone and Joint Surgery. In 2013, we classified products into categories: available in advertised form, available in modified form, available under a different manufacturer, and available but temporarily recalled, discontinued voluntarily, or discontinued by forced recall. Results: A total of 13.8% of products were discontinued 5 to 10 years after being advertised. Three percent were discontinued through forced recall, and 10.8% were discontinued voluntarily. Of the products still available, 60.2% were in current form, 12.9% were modified, 11.9% were available under a different company, and 1.2% were available but were temporarily recalled. Conclusion: Five to 10 years after the initial advertisement, nearly 40% of products were not available in their original advertised form.
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Klara K, Kim J, Ross JS. Direct-to-Consumer Broadcast Advertisements for Pharmaceuticals: Off-Label Promotion and Adherence to FDA Guidelines. J Gen Intern Med 2018; 33:651-658. [PMID: 29484575 PMCID: PMC5910340 DOI: 10.1007/s11606-017-4274-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/28/2017] [Accepted: 12/06/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND Direct-to-consumer (DTC) advertisements for prescription drugs in the United States are regulated by the Food and Drug Administration (FDA). Off-label promotion, or the advertisement of a drug for an indication not approved by the FDA, is prohibited. Our objective was to examine the presence of off-label promotion in broadcast DTC ads and to assess their adherence to FDA guidelines mandating fair balance in presentation of risks and benefits and prohibiting misleading advertisement claims. METHODS All English-language broadcast DTC ads for prescription drugs that aired in the United States from January 2015 to July 2016 were obtained from AdPharm, an online collection of healthcare advertisements. Ad length was measured and adherence to FDA guidelines was assessed for several categories: key regulatory items, indicators of false or misleading ads, and indicators of fair balance in presentation of risks and benefits. RESULTS Our sample included 97 unique DTC ads, representing 60 unique drugs and 67 unique drug-indication combinations. No ads described drug risks quantitatively, whereas drug efficacy was presented quantitatively in 25 (26%) ads. Thirteen (13%) ads, all for diabetes medications, suggested off-label uses for weight loss and blood pressure reduction. The most commonly advertised drugs were indicated for the treatment of inflammatory conditions (n = 12; 18%), diabetes or diabetic neuropathy (n = 11; 16%), bowel or bladder dysfunction (n = 6; 9%), and infections or allergic reaction (n = 6; 9%). More than three-quarters (n = 51; 76%) advertised drugs to treat chronic conditions. CONCLUSIONS Few broadcast DTC ads were fully compliant with FDA guidelines. The overall quality of information provided in ads was low, and suggestions of off-label promotion were common for diabetes medications. The impact of current DTC ads and off-label marketing on patient and prescriber decisions merits further scrutiny.
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Affiliation(s)
| | - Jeanie Kim
- Yale Law School, New Haven, CT, USA
- Collaboration for Research Integrity and Transparency (CRIT) at Yale University, New Haven, CT, USA
| | - Joseph S Ross
- Collaboration for Research Integrity and Transparency (CRIT) at Yale University, New Haven, CT, USA.
- Section of General Internal Medicine and the National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA.
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.
- Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT, USA.
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Sullivan HW, Aikin KJ, Squiers LB. Quantitative Information on Oncology Prescription Drug Websites. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:371-374. [PMID: 27589969 PMCID: PMC5334459 DOI: 10.1007/s13187-016-1107-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Our objective was to determine whether and how quantitative information about drug benefits and risks is presented to consumers and healthcare professionals on cancer-related prescription drug websites. We analyzed the content of 65 active cancer-related prescription drug websites. We assessed the inclusion and presentation of quantitative information for two audiences (consumers and healthcare professionals) and two types of information (drug benefits and risks). Websites were equally likely to present quantitative information for benefits (96.9 %) and risks (95.4 %). However, the amount of the information differed significantly: Both consumer-directed and healthcare-professional-directed webpages were more likely to have quantitative information for every benefit (consumer 38.5 %; healthcare professional 86.1 %) compared with every risk (consumer 3.1 %; healthcare professional 6.2 %). The numeric and graphic presentations also differed by audience and information type. Consumers have access to quantitative information about oncology drugs and, in particular, about the benefits of these drugs. Research has shown that using quantitative information to communicate treatment benefits and risks can increase patients' and physicians' understanding and can aid in treatment decision-making, although some numeric and graphic formats are more useful than others.
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Affiliation(s)
- Helen W Sullivan
- U.S. Food and Drug Administration, 10903 New Hampshire Ave, Bldg 51, Silver Spring, MD, 20993-0002, USA.
| | - Kathryn J Aikin
- U.S. Food and Drug Administration, 10903 New Hampshire Ave, Bldg 51, Silver Spring, MD, 20993-0002, USA
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Pharmaceutical Advertising in Medical Journals: Revisiting a Long-Standing Relationship. Chest 2018; 153:9-11. [PMID: 29307432 DOI: 10.1016/j.chest.2017.09.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 11/23/2022] Open
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Moore AE, Straus SE, Kasperavicius D, Bell NR, Dickinson JA, Grad R, Singh H, Thériault G, Thombs BD, Colquhoun H. Knowledge translation tools in preventive health care. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:853-858. [PMID: 29138155 PMCID: PMC5685446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Ainsley Elizabeth Moore
- Associate Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont
| | - Sharon E Straus
- Director of the Knowledge Translation Program at St Michael's Hospital in Toronto, Ont, and Professor in the Department of Medicine and Division Director of Geriatric Medicine at the University of Toronto
| | | | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montreal, Que, and Senior Investigator at the Lady Davis Institute in Montreal
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and in the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | | | - Brett D Thombs
- Professor and William Dawson Scholar in the Faculty of Medicine at McGill University and Chair of the Canadian Task Force on Preventive Health Care
| | - Heather Colquhoun
- Assistant Professor in the Occupational Science and Occupational Therapy Department at the University of Toronto
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Moore AE, Straus SE, Kasperavicius D, Bell NR, Dickinson JA, Grad R, Singh H, Thériault G, Thombs BD, Colquhoun H. [Not Available]. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e466-e472. [PMID: 29138169 PMCID: PMC5685460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Ainsley Elizabeth Moore
- Professeure agrégée au Département de médecine familiale de l'Université McMaster à Hamilton, en Ontario
| | - Sharon E Straus
- Directrice du Programme d'application des connaissances à l'Hôpital St Michael's à Toronto, et professeure au Département de médecine et directrice de la Division de médecine gériatrique à l'Université de Toronto, en Ontario
| | - Danielle Kasperavicius
- Coordonnatrice de la recherche au Programme d'application des connaissances à l'Hôpital St Michael's.
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary en Alberta
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill à Montréal et chercheur principal à l'Institut Lady Davis à Montréal, au Québec
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg et au Département d'hématologie et d'oncologie pour CancerCare Manitoba
| | | | - Brett D Thombs
- Professeur et chercheur-boursier William Dawson à la Faculté de médecine de l'Université McGill et président du Groupe d'étude canadien sur les soins de santé préventifs
| | - Heather Colquhoun
- Professeure adjointe au Département des sciences occupationnelles et d'ergothérapie de l'Université de Toronto
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Boudewyns V, Williams PA. Content analysis of comparative claims in drug advertisements. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2016. [DOI: 10.1108/ijphm-09-2014-0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to describe the trends and practices of comparative prescription drug advertising by examining the types of comparative claims made in direct-to-consumer (DTC) and direct-to-physician (DTP) print advertisements.
Design/methodology/approach
The authors conducted a content analysis of 54 DTC and DTP print prescription drug advertisements (published between 1997 and 2014) with comparative claims.
Findings
Efficacy-based comparisons appeared in 64 per cent of advertisements, and attribute-based comparisons appeared in 37 per cent of advertisements. Most advertisements made direct (vs indirect) references to competitors (85 per cent), compared the advertised drug to a single (vs multiple) competitor (78 per cent), focused exclusively on one type of comparison claim (i.e. efficacy-, risk- or attribute-based) (70 per cent) and did not contain data-driven visual aids (82 per cent). Some differences between DTC and DTP advertisements emerged. More DTP than DTC advertisements included data-driven visual aids (82 per cent vs 0 per cent, respectively), included numerical data (88 per cent vs 53 per cent) and conveyed statistical significance (52 per cent vs 12 per cent).
Research limitations/implications
The study used a convenience sample rather than a random sample of advertisements; thus, the findings might not be generalizable to all pharmaceutical DTC and DTP advertisements. Examining the tactics that advertisers use to educate and influence consumers and physicians sets the foundation for future studies that examine the effects of their exposure to comparative claims. Suggestions for future research are discussed.
Originality/value
This study is the first to examine and statistically compare the comparative advertising tactics used in both consumer and physician prescription drug advertisements.
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Affiliation(s)
- Deborah Korenstein
- Corresponding author: Deborah Korenstein, MD, FACP, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065,
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Zetterqvist AV, Merlo J, Mulinari S. Complaints, complainants, and rulings regarding drug promotion in the United Kingdom and Sweden 2004-2012: a quantitative and qualitative study of pharmaceutical industry self-regulation. PLoS Med 2015; 12:e1001785. [PMID: 25689460 PMCID: PMC4331559 DOI: 10.1371/journal.pmed.1001785] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 12/29/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In many European countries, medicines promotion is governed by voluntary codes of practice administered by the pharmaceutical industry under its own system of self-regulation. Involvement of industry organizations in policing promotion has been proposed to deter illicit conduct, but few detailed studies on self-regulation have been carried out to date. The objective of this study was to examine the evidence for promotion and self-regulation in the UK and Sweden, two countries frequently cited as examples of effective self-regulation. METHODS AND FINDINGS We performed a qualitative content analysis of documents outlining the constitutions and procedures of these two systems. We also gathered data from self-regulatory bodies on complaints, complainants, and rulings for the period 2004-2012. The qualitative analysis revealed similarities and differences between the countries. For example, self-regulatory bodies in both countries are required to actively monitor promotional items and impose sanctions on violating companies, but the range of sanctions is greater in the UK where companies may, for instance, be audited or publicly reprimanded. In total, Swedish and UK bodies ruled that 536 and 597 cases, respectively, were in breach, equating to an average of more than one case/week for each country. In Sweden, 430 (47%) complaints resulted from active monitoring, compared with only two complaints (0.2%) in the UK. In both countries, a majority of violations concerned misleading promotion. Charges incurred on companies averaged €447,000 and €765,000 per year in Sweden and the UK, respectively, equivalent to about 0.014% and 0.0051% of annual sales revenues, respectively. One hundred cases in the UK (17% of total cases in breach) and 101 (19%) in Sweden were highlighted as particularly serious. A total of 46 companies were ruled in breach of code for a serious offence at least once in the two countries combined (n = 36 in the UK; n = 27 in Sweden); seven companies were in serious violation more than ten times each. A qualitative content analysis of serious violations pertaining to diabetes drugs (UK, n = 15; Sweden, n = 6; 10% of serious violations) and urologics (UK, n = 6; Sweden, n = 13; 9%) revealed various types of violations: misleading claims (n = 23; 58%); failure to comply with undertakings (n = 9; 23%); pre-licensing (n = 7; 18%) or off-label promotion (n = 2; 5%); and promotion of prescription drugs to the public (n = 6; 15%). Violations that go undetected or unpunished by self-regulatory bodies are the main limitation of this study, since they are likely to lead to an underestimate of industry misconduct. CONCLUSIONS The prevalence and severity of breaches testifies to a discrepancy between the ethical standard codified in industry Codes of Conduct and the actual conduct of the industry. We discuss regulatory reforms that may improve the quality of medicines information, such as pre-vetting and intensified active monitoring of promotion, along with larger fines, and giving greater publicity to rulings. But despite the importance of improving regulatory arrangements in an attempt to ensure unbiased medicines information, such efforts alone are insufficient because simply improving oversight and increasing penalties fail to address additional layers of industry bias.
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Affiliation(s)
- Anna V. Zetterqvist
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Juan Merlo
- Department of Clinical Sciences, Unit of Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Shai Mulinari
- Department of Clinical Sciences, Unit of Social Epidemiology, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Sociology, Faculty of Social Sciences, Lund University, Lund, Sweden
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Gladsø KH, Garberg HR, Spigset O, Slørdal L. Skriftlig legemiddelreklame – fremdeles ikke til å stole på? TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2014; 134:1563-8. [DOI: 10.4045/tidsskr.13.1571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Faerber AE, Kreling DH. Content analysis of false and misleading claims in television advertising for prescription and nonprescription drugs. J Gen Intern Med 2014; 29:110-8. [PMID: 24030427 PMCID: PMC3889958 DOI: 10.1007/s11606-013-2604-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND False and misleading advertising for drugs can harm consumers and the healthcare system, and previous research has demonstrated that physician-targeted drug advertisements may be misleading. However, there is a dearth of research comparing consumer-targeted drug advertising to evidence to evaluate whether misleading or false information is being presented in these ads. OBJECTIVE To compare claims in consumer-targeted television drug advertising to evidence, in order to evaluate the frequency of false or misleading television drug advertising targeted to consumers. DESIGN A content analysis of a cross-section of television advertisements for prescription and nonprescription drugs aired from 2008 through 2010. We analyzed commercial segments containing prescription and nonprescription drug advertisements randomly selected from the Vanderbilt Television News Archive, a census of national news broadcasts. MAIN MEASURES For each advertisement, the most-emphasized claim in each ad was identified based on claim iteration, mode of communication, duration and placement. This claim was then compared to evidence by trained coders, and categorized as being objectively true, potentially misleading, or false. Potentially misleading claims omitted important information, exaggerated information, made lifestyle associations, or expressed opinions. False claims were factually false or unsubstantiated. KEY RESULTS Of the most emphasized claims in prescription (n = 84) and nonprescription (n = 84) drug advertisements, 33 % were objectively true, 57 % were potentially misleading and 10 % were false. In prescription drug ads, there were more objectively true claims (43 %) and fewer false claims (2 %) than in nonprescription drug ads (23 % objectively true, 7 % false). There were similar numbers of potentially misleading claims in prescription (55 %) and nonprescription (61 %) drug ads. CONCLUSIONS Potentially misleading claims are prevalent throughout consumer-targeted prescription and nonprescription drug advertising on television. These results are in conflict with proponents who argue the social value of drug advertising is found in informing consumers about drugs.
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Affiliation(s)
- Adrienne E Faerber
- Center for Medicine and the Media, The Dartmouth Institute for Health Policy and Clinical Practice, 35 Centerra Pl, Lebanon, NH, 03766, USA,
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Al-Aqeel SA, Al-Sabhan JF, Sultan NY. Analysis of written advertising material distributed through community pharmacies in Riyadh, Saudi Arabia. Pharm Pract (Granada) 2013; 11:138-43. [PMID: 24223078 PMCID: PMC3809137 DOI: 10.4321/s1886-36552013000300003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 09/13/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Advertising is a crucial component of pharmaceutical industry promotion. Research indicates that information on advertisement materials might be inadequate, inaccurate, biased, and misleading. OBJECTIVE To analyse and critically assess the information presented in print pharmaceutical advertisements in Saudi Arabia. METHODS Pharmaceutical advertisements were collected from 280 community pharmacies in Riyadh city, Saudi Arabia. The advertisements were evaluated using criteria derived from the Saudi Food and Drug Authority (SFDA) regulation, the World Health Organization (WHO) ethical medicinal drug promotion criteria, and other principles reported in similar studies. The data were extracted independently by two of the researchers using a standardized assessment form. RESULTS One hundred eighty five printed advertisements were included in the final sample. Approximately half of the advertisements (n = 94, 51%) were for over-the-counter (OTC) medications, and 71 (38%) were for prescription-only medication. Information such as the name of active ingredients was available in 168 (90.8%) advertisements, therapeutic uses were mentioned in 156 (98.7%) of analysed advertisements. Safety information related to side effects, precautions, and major interactions were stated in 53 (28.5%), 58 (31%), and 33 (16.5%) advertisements, respectively. Only 119 advertisements (64%) provided references for information presented. CONCLUSIONS Our findings suggest that print advertisements do not convey all the information necessary for safe prescribing. These results have implications for the regulation of drug advertising and the continuing education of pharmacists.
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Nilsen P, Ståhl C, Roback K, Cairney P. Never the twain shall meet?--a comparison of implementation science and policy implementation research. Implement Sci 2013; 8:63. [PMID: 23758952 PMCID: PMC3686664 DOI: 10.1186/1748-5908-8-63] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 05/29/2013] [Indexed: 11/17/2022] Open
Abstract
Background Many of society’s health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science. Discussion Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature. Summary There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research.
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Affiliation(s)
- Per Nilsen
- Division of Healthcare Analysis, Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden.
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Zetterqvist AV, Mulinari S. Misleading advertising for antidepressants in Sweden: a failure of pharmaceutical industry self-regulation. PLoS One 2013; 8:e62609. [PMID: 23650519 PMCID: PMC3641086 DOI: 10.1371/journal.pone.0062609] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 03/26/2013] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The alleged efficacy of pharmaceutical industry self-regulation has been used to repudiate increased government oversight over promotional activity. European politicians and industry have cited Sweden as an excellent example of self-regulation based on an ethical code. This paper considers antidepressant advertising in Sweden to uncover the strengths and weaknesses of self-regulation. METHODOLOGY We analyzed all antidepressant advertisements in the Swedish Medical Journal, 1994-2003. The regulation of these advertisements was analyzed using case reports from self-regulatory bodies. The authors independently reviewed this material to investigate: (1) extent of violative advertising; (2) pattern of code breaches; (3) rate at which the system reacted to violative advertising; (4) prevalence of and oversight over claims regarding antidepressant efficacy and disease causality, and (5) costs for manufactures associated with violative advertising. PRINCIPAL FINDINGS Self-regulatory bodies identified numerous code breaches. Nonetheless, they failed to protect doctors from unreliable information on antidepressants, since as many as 247 of 722 (34%) advertisements breached the industry code. Self-regulatory bodies repeatedly failed to challenge inflated claims of antidepressant efficacy, lending evidence of lax oversight. On average, 15 weeks elapsed between printing and censure of a wrongful claim, and in 25% of cases 47 weeks or more elapsed. Industry paid roughly €108000 in fines for violative advertising, adding an estimated additional average cost of 11% to each purchased violative advertisement, or amounting to as little as 0.009% of total antidepressant sales of around €1.2 billion. CONCLUSIONS Lax oversight, combined with lags in the system and low fines for violations, may explain the Swedish system's failure to pressure companies into providing reliable antidepressants information. If these shortcomings prove to be consistent across self-regulatory settings, and if appropriate measures are not taken to amend shortcomings, many countries may want to reconsider the current balance between self-regulation, and legislative control with government oversight.
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Affiliation(s)
| | - Shai Mulinari
- Department of Gender Studies, Lund University, Lund, Sweden
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Kornfield R, Donohue J, Berndt ER, Alexander GC. Promotion of prescription drugs to consumers and providers, 2001-2010. PLoS One 2013; 8:e55504. [PMID: 23469165 PMCID: PMC3587616 DOI: 10.1371/journal.pone.0055504] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 12/23/2012] [Indexed: 12/02/2022] Open
Abstract
Background Pharmaceutical firms heavily promote their products and may have changed marketing strategies in response to reductions in new product approvals, restrictions on some forms of promotion, and the expanding role of biologic therapies. Methods We used descriptive analyses of annual cross-sectional data from 2001 through 2010 to examine direct-to-consumer advertising (DTCA) (Kantar Media) and provider-targeted promotion (IMS Health and SDI), including: (1) inflation-adjusted total promotion spending ($ and percent of sales); (2) distribution by channel (consumer v. provider); and (3) provider specialty both for the industry as a whole and for top-selling biologic and small molecule therapies. Results Total promotion peaked in 2004 at US$36.1 billion (13.4% of sales). By 2010 it had declined to $27.7B (9.0% of sales). Between 2006 and 2010, similar declines were seen for promotion to providers and DTCA (both by 25%). DTCA’s share of total promotion increased from 12% in 2002 to 18% in 2006, but then declined to 16% and remains highly concentrated. Number of products promoted to providers peaked in 2004 at over 3000, and then declined 20% by 2010. In contrast to top-selling small molecule therapies having an average of $370 million (8.8% of sales) spent on promotion, top biologics were promoted less, with only $33 million (1.4% of sales) spent per product. Little change occurred in the composition of promotion between primary care physicians and specialists from 2001–2010. Conclusions These findings suggest that pharmaceutical companies have reduced promotion following changes in the pharmaceutical pipeline and patent expiry for several blockbuster drugs. Promotional strategies for biologic drugs differ substantially from small molecule therapies.
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Affiliation(s)
- Rachel Kornfield
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Julie Donohue
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Ernst R. Berndt
- Alfred P. Sloan School of Management, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- National Bureau of Economic Research, Cambridge, Massachusetts, United States of America
| | - G. Caleb Alexander
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland, United States of America
- Department of Pharmacy Practice, University of Illinois at Chicago School of Pharmacy, Chicago, Illinois, United States of America
- * E-mail:
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Yonemori K, Hirakawa A, Ando M, Hirata T, Yunokawa M, Shimizu C, Tamura K, Fujiwara Y. Content analysis of oncology-related pharmaceutical advertising in a peer-reviewed medical journal. PLoS One 2012; 7:e44393. [PMID: 22952970 PMCID: PMC3432119 DOI: 10.1371/journal.pone.0044393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 08/03/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The oncology market represents one of the largest pharmaceutical markets in any medical field, and printed advertising in medical journals is an important channel by which pharmaceutical companies communicate with healthcare professionals. The aim of the present study was to analyze the volume and content of and trends and changes in oncology-related advertising intended for healthcare professionals in a peer-reviewed medical journal. Information that could be included in advertisements to promote drug development and improve treatment strategies for cancer patients is discussed on the basis of the results of the analysis. METHODS/PRINCIPAL FINDINGS Overall, 6,720 advertisements covering 13,039 pages in a leading oncology medical journal published (by the American Society of Clinical Oncology) between January 2005 and December 2009 were analyzed. The advertisements targeting pharmaceuticals and clinical trials, in particular, were reviewed. A total of 6,720 advertisements covering 13,039 pages were included in the analysis. For the years 2005-2009, the percentages of total journal pages dedicated to advertising were 24.0%, 45.7%, 49.8%, 46.8%, and 49.8%, respectively. Package insert information and efficacy and safety explanations appeared in more than 80% of advertisements intended for pharmaceutical promotion. From 2005 to 2009, the overall quantity of drug advertisements decreased by approximately 13%, whereas advertisements calling for the enrollment of patients into registration trials increased by approximately 11%. CONCLUSION/SIGNIFICANCE Throughout the study period, oncology-related pharmaceutical advertisements occupied a considerable number of pages relative to other journal content. The proportion of advertisements on ongoing clinical trials increased progressively throughout the study period.
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Affiliation(s)
- Kan Yonemori
- Breast and Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
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Stein KF. Advertisements in medical and health-related journals. J Am Psychiatr Nurses Assoc 2012; 18:211-3. [PMID: 23029670 DOI: 10.1177/1078390312455058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Karen Farchaus Stein
- Karen Farchaus Stein, PhD, RN, FAAN, University of Rochester, School of Nursing, Rochester, NY, USA
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