279 Content analysis of psoriasis and eczema direct to consumer advertisements

Abstract

Direct to consumer (DTC) ads for prescription drugs and diseases are major sources of health communication for the general public; yet, there is substantial controversy about their utility. In dermatology, DTC ads for psoriasis and eczema are numerous. To understand age and racial differences in biologics utilization for psoriasis, we evaluated and compared DTC ads for psoriasis to those of eczema with special attention to ad placement, character representation, and factual content. We conducted a content analysis of DTC ads aired between 5 and 11pm EST on four major television networks (ABC, CBS, FOX, NBC) over 14 consecutive days in July 2018. In total, 297 DTC ads were aired: 13 (4%) for psoriasis and 27 (9%) for eczema. Psoriasis ads included 5 unique product claim ads for Cosentyx®, Humira® (2 ads), Taltz®, and Tremfya®. Eczema ads included 3 unique product claim ads for Eucrisa® and 1 non-drug ad providing information about eczema. Most ads aired on weekdays (88%) between 5 and 8pm (90%). No ads aired on FOX. Among psoriasis ads, 81 affected characters were shown, all of whom were perceived to be young adults. Perceived race of the characters was: White (93%), Black (6%), and Asian (1%). Psoriasis was shown on the skin in 85% of ads, of which 18% had subtle manifestations. Psoriasis symptoms were included in only 15% of ads. No ads discussed the epidemiology or pathophysiology of psoriasis. In contrast, among eczema ads, 80 affected characters were shown, of whom 66% were children and 34% were young adults. Perceived race of the characters was: White (54%), Black (29%), and Asian (17%). Eczema was shown on the skin in 56% of ads, and the symptoms and pathophysiology of eczema were included in 44% of ads, most, if not all, of which were non-drug ads. Our findings suggest a missed opportunity for education among psoriasis and eczema product claim ads. The DTC ads, especially those for psoriasis, may also fail to resonate with elderly and minority populations which could impact real-world treatment patterns and disease recognition.