Prevalence and Global Health Implications of Social Media in Direct-to-Consumer Drug Advertising

Abstract

BackgroundDirect-to-consumer advertising (DTCA), linked to inappropriate medication use and higher health care expenditures, is the fastest growing form of pharmaceutical marketing. DTCA is legal only in the United States and New Zealand. However, the advent of online interactive social media “Web 2.0” technologies—that is, eDTCA 2.0—may circumvent DTCA legal proscriptions.ObjectiveThe purpose of this study was to assess the prevalence of DTCA of leading pharmaceutical company presence and drug product marketing in online interactive social media technologies (eDTCA 2.0).MethodsWe conducted a descriptive study of the prevalence of eDTCA 2.0 marketing in the top 10 global pharmaceutical corporations and 10 highest grossing drugs of 2009.ResultsAll pharmaceutical companies reviewed (10/10, 100%) have a presence in eDTCA 2.0 on Facebook, Twitter/Friendster, sponsored blogs, and really simple syndication (RSS) feeds. In addition, 80% (8/10) have dedicated YouTube channels, and 80% (8/10) developed health care communication-related mobile applications. For reviewed drugs, 90% (9/10) have dedicated websites, 70% (7/10) have dedicated Facebook pages, 90% (9/10) have health communications-related Twitter and Friendster traffic, and 80% (8/10) have DTCA television advertisements on YouTube. We also found 90% (9/10) of these drugs had a non-corporate eDTCA 2.0 marketing presence by illegal online drug sellers.ConclusionPharmaceutical companies use eDTCA 2.0 to market themselves and their top-selling drugs. eDTCA 2.0 is also used by illicit online drug sellers. Regulators worldwide must take into account the current eDTCA 2.0 presence when attempting to reach policy and safety goals.

Digital Direct-to-Consumer Advertising: A Perfect Storm of Rapid Evolution and Stagnant Regulation Comment on "Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters"

“…39 Despite eDTCA's rapid growth and maturation, regulatory responses seem to be several steps behind industry activities, who can no longer afford to wait for FDA to give them sufficient guidance on how to engage with their patients online. 15,16 This includes revised 2015 FDA draft guidance that calls for the use of a "Drug Facts" box or Q&A to better communicate risk information to consumers. 40 Specifically, revised draft guidance appears to continue FDA's antiquated trend of overemphasizing traditional media in DTCA regulatory efforts and may lack flexibility in addressing the dynamic challenges faced by eDTCA.…”

“…1 This result seems peculiar especially given the high-degree of popularity of social media in health communications, prior studies that have reported near universal use of these platforms (including Facebook, Twitter, and YouTube) by large pharmaceutical firms, and another study that found a majority of eDTCA drug product claims emphasized benefits over risks. 7,15,16 Further, study findings that violations occurred simultaneous across several different industry digital assets (including sponsored search links, online videos, and on company websites) emphasizes the need to assess how the entire online environment is collectively being used to influence the consumer through exposure to different marketing channels, multimedia, and targeted messaging. Other minor findings in Kim's study making up a smaller percentage of NOV/warning letter content characteristics should also raise alarms.…”

Future Challenges and Opportunities in Online Prescription Drug Promotion Research Comment on "Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters"

“…However, unlike traditional print and broadcast ads, online DTC activities have the ability to cross international borders and be accessed by consumers in countries where DTC advertising is not legal. 4 In fact, adults in Europe and Asia frequently seek medication information online, often accessing branded drug sites. [26][27][28] This raises questions not only about the ability of FDA, the European Medicines Agency (EMA), and other agencies to regulate drug promotion online, but also about how adults around the world react to these activities.…”

“…2,3 At the same time, pharmaceutical companies are increasingly using online promotional tools, such as branded drug websites, online videos (eg, YouTube), and social media (eg, Facebook, Twitter, online forums, and chat rooms), to provide information about prescription drugs. [4][5][6][7][8] Yet these online tools-as demonstrated by Kim and others [9][10][11] -often fail to present balanced information about prescription drug benefits and risks. Despite the availability of online promotional tools, however, the evidence on online prescription drug promotion is far from conclusive.…”

Waking Up to the Risks of Online Direct-to-Consumer Advertising of Sleep Apnea Screening Tests

“…With spending on DTC rapidly increasing and the U.S. Food and Drug Administration still years away from adequately regulating online and social media forms of DTC, it is likely that these questionable HSTs will continue to proliferate. 10 This places progress towards effective and clinically based screening, detection, and treatment of sleep apnea at risk. Health care professionals and policy makers need to be alert and address the inherent dangers of online DTC of HSTs and work to promote patient use of evidence-based screening tools in consultation with sleep health care professionals.…”