Direct-to-consumer Prescription Drug Advertising Research Articles

Optimistic Bias and Consumer Prescription Drug Decisions: Influences of Direct to Consumer Advertising and Perceived Susceptibility

ABSTRACT This study examines how optimistic bias moderates the association of direct-to-consumer prescription drug advertising (DTCA) exposure with consumers’ responses to DTCA. We propose and test a model that addresses how exposure to DTCA plays a role in health risk assessment and prescription drug decision engagement. Findings from an online survey of U.S. adults (n = 628) demonstrated that exposure to DTCA is positively associated with consumers’ perceived susceptibility and negatively associated with optimistic bias about health risk. The relationship between DTCA exposure and prescription decision engagement was mediated through perceived susceptibility, and this process was moderated by optimistic bias. The study’s theoretical implications are discussed along with its consumer and public health implications.

Effects of endorser type and testimonials in direct-to-consumer prescription drug advertising (DTCA)

PurposeThis study aims to examine the effects of different types of endorsers (expert vs consumer vs celebrity) in testimonial vs non-testimonial message contexts on consumers’ responses toward direct-to-consumer advertising (DTCA).Design/methodology/approachAn online experiment was conducted with a 3 (endorser type: expert vs consumer vs celebrity) × 2 (message type: testimonial vs non-testimonial) plus control group (no endorser, no testimonial) factorial design to assess the various dependent variables.FindingsPerceived source credibility and similarity was significantly different across the endorser types, and the expert endorser (i.e. a doctor) generated the highest mean level of source credibility, while consumer endorsers generate the highest mean source similarity. The interaction of endorser type and message type significantly impacted ad believability and skepticism. Specifically, the endorser type factor had a significant impact on the dependent variables only in the testimonial ad condition, but not in the non-testimonial ad condition. The effects were mediated by source credibility.Originality/valueWhile the focused results show celebrities may not be the strongest choice to endorse when using testimonials, the overall lack of main effect of testimonials lends to the possibility of a plateauing of effects with the various appeals used in DTC ads. DTCA has now been around for over 20 years, and this study lends to the possibility consumers are becoming unaffected by the various appeals used by pharmaceutical manufactures and only respond when a multitude of personally relevant factors are in place.

Consumer’s Regulatory Knowledge of Prescription Drug Advertising and Health Risk Awareness: The Moderating Role of Risk Information Prominence

ABSTRACTBorrowing insights from the consumer knowledge and the direct-to-consumer prescription drug advertising (DTCA) risk communication literature, the current study examined how consumers’ regulatory knowledge regarding DTCA affects attention to and awareness of risk information in DTCA. The moderating role of risk information prominence and the mediating mechanism of attention were also explored. Taking an experimental design approach using a sample of US consumers (N = 264), risk information prominence was manipulated using various message attributes (e.g., font, color, size, box line, thickness, proximity). The study found that consumers’ higher regulatory knowledge led to greater attention to risk information when the health risks of the advertised drug were presented less prominently, compared with when the risks were salient. The regulatory knowledge enhanced consumer recall and recognition of the drug’s health risks through attention, but the indirect effects were dependent on the disclosure prominence level, such that the effects were more apparent when the prominence was low. This study manifests the value of consumers’ regulatory literacy of DTCA to make informed prescription medication decisions and advises pharmaceutical marketers to present noticeable health risk information to encourage consumers to consider important health risks of promoted drugs in their decision making.

Relationship Between Exposure to Direct-To-Consumer Prescription Drug Advertising (DTCA) and Patients’ Belief Accessibility and Medication Adherence

ABSTRACTOne of the most frequent and strong arguments for supporting direct-to-consumer prescription drug advertising (DTCA) as a positive influence on individuals and society is that DTCA could contribute to improving patients’ medication adherence, but systematic empirical research testing this proposed effect is scant. To address this gap and provide an answer to the unresolved question about DTCA effects, this study examined the relationship between overall DTCA exposure and patients’ medication adherence through the mechanism of media priming effect increasing medication-related belief accessibility. Results from a survey with a sample of prescription blood thinner takers revealed no significant relationships between DTCA exposure and patients’ belief accessibility regarding their medical conditions and drug benefits and risks, and no support for the hypothesized relationship between DTCA exposure and medication adherence. The findings are discussed within the context of DTCA effect research literature, and theoretical and practical implications are presented.

Caring or Compulsion? The Effects of Consumer Attributions of Risk Information Disclosure in Direct‐to‐Consumer Prescription Drug Advertising

Direct‐to‐consumer prescription drug advertising (DTCA) is mandated to provide information about drug risks in addition to promoting drug benefits. The disclosure of drug risks is intended to provide consumers with a balanced view of the advertised drugs. However, unintended consequences of the disclosure have been observed in previous DTCA research including an influence on trust toward the ad and manufacturer. To better understand this, an experiment was conducted across two health conditions (seasonal allergies and diabetes) to examine the role of the amount of side effect information and attribution of side effects disclosure in judgments of positive advertiser motives, trustworthiness, brand attitude, and behavioral intentions. Results indicated brand attitude and behavioral intentions differed by amount of side effect information mediated by advertiser trust. Attribution of side effects information to regulations provided a limited moderation of this effect. Suggested implications include more explicit identification of mandated information within the ads.

Prescription drug advertising, disease knowledge, and older adults’ optimistic bias about the future risk of alzheimer’s disease

This study aims to broaden the scope of knowledge on the role of direct-to-consumer prescription drug advertising (DTCA) in the construction of consumers’ optimistic bias regarding health issues and their intentions for coping actions. Based on an online survey of U.S. adults aged 65 years or older (N = 622), this study revealed that (a) respondents were optimistically biased in estimating their future risk of Alzheimer’s disease (AD); (b) exposure to DTCA for AD medicine related negatively to optimistic bias when respondents had a low level of knowledge about AD, while the relationship disappeared when knowledge was high; (c) optimistic bias was negatively associated with intentions to seek information about AD and professional help to discuss it; and (d) optimistic bias mediated the relationship between the DTCA exposure × AD knowledge interaction and information- and help-seeking intentions. Implications for the theory and practice of DTCA are discussed.

The Moderating Role of Age in Responses to Direct-to-Consumer Prescription Drug Advertising

Age is an important factor that can influence processing of and response to health messages. Many studies examining evaluations of and responses to direct-to-consumer prescription drug advertising (DTCA) have incorporated age as a predictor variable, moderating variable, or sample criterion. However, findings have been inconsistent. This study attempts to add clarity to this body of research by assessing age differences in the antecedent factors of various DTCA outcomes. A multigroup structural equation modeling analysis revealed several significant differences in variable relationships between older (50+) and younger (<50) adults. Overall, older adults exhibited greater complexity in their consideration of DTCA than younger adults in terms of the sheer number of significant relationships within the model. In particular, trust in mediated health information sources and trust in one's physician appeared to be more relevant predictors for older adults. Trust in DTCA was also distinguished as having an inverse relationship with behavioral intentions among older adults while showing a straightforward positive association with attention among younger adults. Further analysis indicated that health status accounted for some but not all of the age differences. It is suggested that younger adults are more open to seeking additional information following DTCA exposure, whereas older adults remain ambivalent.

Do Prescription Drug Ads Tell Consumers Enough About Benefits and Side Effects? Results From the Health Information National Trends Survey, Fourth Administration

Direct-to-consumer prescription drug advertising (DTCA) is a major source of consumer information about prescription drugs. The present study updates 2002 U.S. Food and Drug Administration phone survey questions that found that 44% and 61% of consumers thought that DTCA did not include enough information about benefits and risks, respectively. The present study was administered by mail using a nationally representative sample, and provides a more in-depth understanding of how these beliefs relate to demographic and health characteristics. Data collected from 3,959 respondents to the National Cancer Institute's 2011 Health Information National Trends Survey find results similar to the 2002 survey: 46% and 52% of respondents thought that DCTA did not include enough information about benefits and risks, respectively. Respondents fell into four groups: 23% agreed that DTCA tells enough about drug benefits and risks, 41% disagreed, 18% expressed no opinion, and 18% had discordant beliefs. DTCA attitudes were negatively associated with education, income, and whether respondents purchase prescription drugs; attitudes were positively associated with whether respondents understand prescription drug information. This study confirms that a plurality of Americans believe that DTCA does not include enough information about benefits and risks, suggesting that the educational effect of DTCA could be improved.

Communication Strategies in Direct-to-Consumer Prescription Drug Advertising (DTCA): Application of the Six Segment Message Strategy Wheel

This study addresses a void in the literature on direct-to-consumer prescription drug advertising (DTCA) with a theory-based content analysis. The findings indicate that Taylor's communication strategy wheel provides insight into what and how pharmaceutical marketers communicate with consumers by means of DTCA. Major findings are summarized as follows: (a) In most DTC ads, informational and transformational message themes and creative approaches were simultaneously used, indicating a combination strategy; (b) DTCA message themes were associated with creative strategies in alignment with Taylor's framework; and (c) message themes and creative strategies varied across therapeutic categories and DTCA categories with different levels of ad spending. Theoretical and practical implications of the findings are discussed.

Factors Influencing Consumers' Attitudinal and Behavioral Responses to Direct-To-Consumer and Over-the-Counter Drug Advertising

Using a model developed from the research literature, the authors compared consumers’ attitudinal and behavioral responses to direct-to-consumer prescription drug advertising (DCTA) and over-the-counter nonprescription drug advertising (OTCA) of drugs. Adults 18 years of age and older who had taken any prescription drugs in the past 6 months completed online survey questionnaires. Variables measured included demographics (age, gender, race, education, and income), health-related characteristics (health status, prescription and over-the-counter drug use, health consciousness, and involvement with prescription or over-the-counter drugs), perceived amount of attention and exposure to DTCA and OTCA, attitudinal outcomes (skepticism toward DTCA/OTCA and attitude toward DTCA/OTCA), and behavioral outcomes triggered by DTCA and OTCA. The findings indicate that exposure to drug advertising is one of the most significant predictors of attitudinal and behavioral outcomes. Some audience factors such as health status, involvement with drugs, health consciousness, drug use, income, and age also were differentially associated with consumer responses to drug advertising.

Causes and consequences of trust in direct-to-consumer prescription drug advertising

Direct-to-consumer prescription drug advertising (DTCA) is believed to empower consumers, but national surveys indicate declining trust in DTCA. Given the unique characteristics of this category, it is unclear what the likely consequences are of reduced trust in these ads. Furthermore, previous research is inadequate to discern the basis of trust in DTCA. To address this issue, a model of the antecedent and consequent factors connected to trust in DTCA was developed based on prior empirical findings and relevant theory. This paper presents survey findings testing the model. Results show trust is predicted by perceptions of mediated health information sources, advertising in general, pharmaceutical companies, and the perceived value and informativeness of prescription drug ads. Regarding outcomes, results were mixed for the relationship of trust with attention, attitudes, and behavioural intent. Overall, findings suggest trust plays a complex role in shaping consumer reactions to prescription drug ads.

DTC drug advertising ethics: laboratory for medical marketing

Purpose – The aim of this paper is to call for an increased focus on the ethics of direct-to-consumer (DTC) prescription drug advertising. This is important, not only to improve DTC prescription drug advertising, but also to inform DTC advertising of future medical advances. Design/methodology/approach – This conceptual paper discusses two examples of medical advances – personal genetic testing services and surgically implanted medical devices – to explain how investigating the research of DTC prescription drug advertising can set the stage for more ethical advertising of future medical advances. Findings – Specific issues related to health literacy, at-risk populations impacted by health disparities, and medicalization of issues common to aging relate to the DTC advertising of prescription drugs and other medical advances. Creative approaches to investigating these issues in the context of prescription drug advertising can enrich the debate about drug advertising, but also prepare researchers, policymakers, and consumers for future advertising of new medical developments. Originality/value – The value of this paper is its call for increased focus on the ethics of DTC prescription drug advertising, to improve the current marketing environment but also lay the foundation for other healthcare marketing in the future.

Direct-to-Consumer Antidepressant Advertising and Consumers’ Optimistic Bias about the Future Risk of Depression: The Moderating Role of Advertising Skepticism

Although exposure to direct-to-consumer prescription drug advertising (DTCA) is reported to influence the public’s beliefs about diseases, no research has investigated how DTCA may affect the extent of consumers’ optimistic bias about the future risk of diseases. Based on a survey with members of an online consumer panel (n = 699), the current study revealed that: (a) Consumers exhibited a tendency to believe they were at less risk of developing clinical depression in the future than their peers, demonstrating an optimistic bias. (b) Exposure to antidepressant DTCA acted to reduce the extent of such bias, especially when consumers were less skeptical of prescription drug advertising. When consumers were highly skeptical, DTCA exposure did not significantly relate to the extent of optimistic bias. (c) Once formed, the extent of optimistic bias negatively related to consumers’ intention to seek information about depression. Implications of the research for the theory and practice of DTCA were discussed.

Scepticism towards DTC advertising

Studies of cultural and subcultural differences among consumers are important for advancing knowledge on direct-to-consumer prescription drug advertising (DTCA). This study investigates and compares scepticism towards DTCA between Korean and Caucasian Americans and the relationship of cultural values (collectivism vs individualism) and acculturation to DTCA scepticism. The results reveal that, while the difference in DTCA scepticism between Caucasian and Korean Americans was non-significant, Korean Americans’ acculturation level influenced DTCA scepticism within this segment and collectivism was the only significant predictor of DTCA scepticism. The findings are discussed relative to previous research on DTCA scepticism, and managerial implications are offered.

Profits and perspectives: advertising, social marketing, and public health

PurposeThe purpose of this paper is to highlight the potential value that direct‐to‐consumer (DTC) prescription drug advertisements can provide to social marketers as examples of effective persuasive health communication.Design/methodology/approachModern medicine increasingly incorporates media sources such as DTC prescription drug advertising. While DTC advertising presents concerns, it also offers opportunities for studying effective message design to promote health behavior change. The DTC advertising debate is vigorous, with some critics maintaining advertisements cannot be educational – but the field of social marketing utilizes similar tactics and a consumer‐driven marketing perspective to promote preventive health behavior and health behavior change.FindingsOne of the most prominent criticisms of DTC advertising is use of emotional appeals, but a variety of national public health campaigns engage in parallel tactics – employing emotional appeals over “pure” health education. While DTC advertising engenders valid criticism, it is crucial to not let the profit motive behind these campaigns preclude social marketers from learning important lessons from DTC advertisements.Originality/valueThe paper highlights the fact that DTC drug advertising could provide useful lessons to social marketers which some academics may be slow to embrace – the profit motive driving these campaigns may obscure the benefits to be gained from studying DTC drug advertising as a model of effective persuasive health communication. It serves as a reminder that even those who might object to the policy and practice of DTC drug advertising may still learn beneficial lessons from these campaigns.

Use of Information Sources Referenced in and Attitudes about Televised DTC Prescription Drug Advertisements

Unlike most advertising, direct-to-consumer (DTC) prescription drug advertising on television frequently contains warnings. Because of the brevity of the warning message, a follow-up source with more detailed information is given. This research examined the reported likelihood of using several follow-up sources as well as their beliefs about the completeness/accuracy and ease of access of those sources. Also examined were various other beliefs and attitudes associated with DTC prescription drug television advertising. Participants reported that they would more likely to use certain follow-up sources such as the Internet more than other sources such as an advertisement in a particular magazine and believed that certain sources provide more complete/accurate and more accessible information than other sources. The results indicate that the Internet is a growing information source that people use to find out more about prescription drugs viewed in advertisements. Participants' responses indicate skepticism about the goals and content of DTC prescription drug advertising, although the responses also indicate that they believe that there are potential benefits of such advertising. Implications for research in risk communication and warnings are discussed.

Seniors' Uncertainty Management of Direct-to-Consumer Prescription Drug Advertising Usefulness

This study provides insight into seniors' perceptions of and responses to direct-to-consumer prescription drug advertising (DTCA) usefulness, examines support for DTCA regulation as a type of uncertainty management, and extends and gives empirical voice to previous survey results through methodological triangulation. In-depth interview findings revealed that, for most informants, DTCA usefulness was uncertain and this uncertainty stemmed from 4 sources. The majority had negative responses to DTCA uncertainty and relied on 2 uncertainty-management strategies: information seeking from physicians, and inferences of and support for some government regulation of DTCA. Overall, the findings demonstrate the viability of uncertainty management theory (Brashers, 2001, 2007) for mass-mediated health communication, specifically DTCA. The article concludes with practical implications and research recommendations.

The Effects of Involvement and Ad Type on Attitudes toward Direct-To-Consumer Advertising of Prescription Drugs

This article examines consumers’ attitudes toward Direct-to-Consumer (DTC) advertising of prescription drugs that are influenced by the use different types of DTC ads and product involvement. Our findings suggest that product involvement and the type of DTC ad are significant predictors of consumers’ attitudinal responses toward DTC advertising. High involvement consumers have more favorable attitudes toward the drug's price, DTC ad and brand name, and a higher intention to ask a doctor about the advertised drug than low involvement consumers. In contrast to Informational and Reminder DTC ads, Persuasive ads have more favorable effects on consumers’ reactions to DTC prescription drug advertising.

Consumer responses to direct to consumer prescription drug advertising

PurposeThe purpose of this paper is to identify the types of patients most likely to visit physicians in response to direct to consumer prescription drug advertising (DTCA).Design/methodology/approachThe study used data from a national telephone survey, “Public Health Impact of Direct‐to‐Consumer Advertising of Prescription Drugs, July 2001‐January 2002: [United States].” It included data on respondents' health status and utilization, experience with DTCA, demographic and socio‐economic information, and three types of DTCA‐prompted physician visits: visits to discuss a prescription drug, a new health condition, or a change in treatment. A conceptual model was developed to identify consumers most likely to respond to DTCA by visiting a physician.FindingsFive variables were related to all three types of visits. The most important were viewing media as the most important source, prompting one to talk with a physician and believing that DTCA improved discussion with health professionals. Believing that DTCA increased awareness of new treatments was less important, followed by having anxiety, then having arthritis. Taking medications regularly, having allergies, getting information from pamphlets in physicians' offices, and getting information from TV or radio advertisements were related to two types of visits.Research limitations/implicationsPatients having positive beliefs about DTCA, preferring media information sources, and more susceptible to diseases treatable with prescription drugs were more likely to respond to DTCA by visiting physicians.Originality/valueThe study advances the literature on DTCA by examining a range of DTCA‐prompted physician visit behaviors using a conceptual model that has not previously been applied to DTCA.

Presumed Influence of DTC Prescription Drug Advertising: Do Experts and Novices Think Differently?

Davison's original third-person-effect proposal notes that experts, because of their special knowledge, may exhibit a greater third-person effect than do nonexperts. To gather empirical evidence on this notion, this research investigates whether experts perceive a greater influence of direct-to-consumer (DTC) advertising on others than do novices. The expert-novice distinction is made in two different ways: (a) physicians versus consumers, based on objective knowledge of prescription drugs and (b) consumer experts versus consumer novices, based on familiarity with DTC advertising. Results show that consumer experts clearly exhibit greater perceived DTC advertising influence on others than do novices, and the differences between experts and novices vary by presumed DTC advertising influence dimensions. Future research is advocated on expert views in presumed media influence studies.