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Frosch et al's Creating Demand for Prescription Drugs-A Content Analysis of Television Direct-to-Con

Frosch et al's Creating Demand for Prescription Drugs-A Content Analysis of Television Direct-to-Con

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ANNALS OF FAMILY MEDICINE WWW.ANNFAMMED.ORG VOL. 5, NO. 1 JANUARY/FEBRUARY 2007 6 Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising ABSTRACT PURPOSE American television viewers see as many as 16 hours of prescription drug advertisements (ads) each year, yet no research has examined how televi- sion ads attempt to influence consumers. This information is important, because ads may not meet their educational potential, possibly prompting consumers to request prescriptions that are clinically inappropriate or more expensive than equally effective alternatives. METHODS We coded ads shown during evening news and prime time hours for factual claims they 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. RESULTS Most ads (82%) made some factual claims and made rational argu- ments (86%) for product use, but few described condition causes (26%), risk factors (26%), or prevalence (25%). Emotional appeals were almost universal (95%). No ads mentioned lifestyle change as an alternative to products, though some (19%) portrayed it as an adjunct to medication. Some ads (18%) portrayed lifestyle changes as insufficient for controlling a condition. The ads often framed medication use in terms of losing (58%) and regaining control (85%) over some aspect of life and as engendering social approval (78%). Products were fre- quently (58%) portrayed as a medical breakthrough. CONCLUSIONS 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. The ads have limited educational value and may oversell the benefits of drugs in ways that might confl ict with promoting population health. Ann Fam Med 2007:5:6-13. DOI: 10.1370/afm.611. INTRODUCTION T he United States and New Zealand are the only developed coun- tries that permit direct-to-consumer advertising (DTCA) of pre- scription drugs. Average American television viewers see as many as 16 hours of prescription drug advertisements (ads) per year, far exceed- ing the average time spent with a primary care physician. 1 Since the Food and Drug Administration (FDA) relaxed DTCA regulations in 1997, a polarized debate around the practice has ensued. Opponents argue that ads mislead consumers and prompt requests for products that are unneeded or more expensive than other equally effective drugs or nonpharmacologic treatment options. 2-4 Proponents counter that DTCA educates people about health conditions and available treatments and empowers them to become more active participants in their own care, thereby strengthening the health care system.
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