QL4: QUALITY OF LIFE MESSAGES IN PRESCRIPTION DRUG ADVERTISEMENTS IN LEADING MEDICAL JOURNALS, 1990-99

Abstract

OBJECTIVES: The use of health-related quality of life (HRQL) claims in drug promotions is under active discussion by the pharmaceutical industry, the FDA, and other stakeholders. However, the extent to which pharmaceutical companies have previously promoted HRQL messages in advertisements in medical journals, and the nature of those messages, has not been quantified. METHODS: We performed a content analysis of all pharmaceutical advertisements appearing in three general medical journals (AIM, JAMA, and NEJM), and three specialty journals (Circulation, Gastroenterology, and Neurology) in January, July, and October annually from 1990–1999. Two reviewers analyzed each advertisement for the presence and type of HRQL content, and for supporting evidence. We distinguished explicit HRQL claims, which used words, such as “quality of life or “patient satisfaction,” from implicit claims, which we defined broadly as pictures implying improved physical, emotional/mental, or social functioning. RESULTS: We judged that HRQL messages appeared in 520 (24.3%) of 2142 advertisements examined. Advertisements with HRQL content increased from 1990–94 to 1995–99 (19.9% vs. 29.6%, p 100%, because a single ad could contain multiple messages). CONCLUSIONS: Advertisements conveying HRQL messages are used frequently by drug manufacturers in medical journals, and are increasing over time. In the future, researchers should better define HRQL, and probe more deeply into what comprises substantiating evidence, perhaps by incorporating the concept of “patient-reported outcomes.”