Advertising of disease and prescription medicines to Australian consumers

Background Direct-to-consumer advertising (DTCA) of prescription medicines is prohibited in Australia, but pharmaceutical companies can provide information about the health condition for which they manufacture a prescription product – commonly referred to as disease awareness advertising (DAA). The pharmaceutical industry purports that DAA provides education regarding health conditions and different treatment options, and may encourage early diagnosis and treatment. However consumer and public health advocates are concerned that DAA has the potential to inflate the perceived prevalence of disease, increase consumer anxiety, and result in unnecessary visits to doctors. They believe it provides an indirect method of advertising prescription medicines to consumers, and has the potential to increase the uptake of newer medicines whose risk profiles are not fully understood. While studies overseas have demonstrated that DAA can increase consultations regarding the advertised disease, as well as prescriptions for the advertiser’s product, there has been no research conducted in Australia regarding DAA, or consumers’ attitudes toward this form of advertising. Method This research project examined recent cases of pharmaceutical industry-sponsored DAA in Australia, and undertook a content analysis of advertisements in popular women’s magazines. To determine how Australian consumers perceive DAA, and how this compared to their perceptions of DTCA, a survey was conducted using matched DAA and DTCA as stimuli. General attitudes to DAA were compared with results from a similar study conducted in New Zealand exploring attitudes to DTCA. Finally, an intercept survey explored attitudes of older Australian women towards hypothetical DAA for two health conditions. Sponsor logos and the amount of disease information were manipulated in the advertisement stimuli. Results Pharmaceutical companies use a range of persuasive techniques in DAA, and while the name of the product is not included, other branding techniques, such as spokescharacters and campaign names, may convey the identity of the product. The most common type of information found in DAA in popular Australian women’s magazines (which included advertisements sponsored by government and non-profit organisations) was treatment information, and industry advertisements more often provided information about treatment and prevalence. In the survey research, despite pharmaceutical company branding on the DAA stimuli, most participants did not attribute a direct commercial intent (to sell a treatment or product) to the advertisements. They perceived the advertisements were designed to provide information and to make them more proactive about their health. Similar to New Zealand consumers considering DTCA, Australian consumers valued DAA for the information it provides about health conditions and treatment options; however they may have been considering DAA sponsored by government and/or non-profit organisations. Participants perceived DAA to be useful in discussions with their doctor, but were ambivalent as to whether it helped them in making health decisions. Following exposure to DAA stimuli, most participants agreed that they would talk about the condition with their doctor or talk about a treatment with their doctor, and up to half expressed an intention to ask for a prescription or referral. In the intercept survey, older women exposed to advertisements with less disease information were less likely to be satisfied that adequate information was provided, but were more likely to express an intention to ask their doctor for a prescription or a referral. Discussion The results suggest that DAA, particularly advertisements with limited disease information, can stimulate demand for prescription medicines. Despite purporting an educational function, most industry DAA focus on treatment information and many utilise persuasive techniques which may convey the identity of the product. This has implications for regulators of pharmaceutical advertising in Australia, as activities which encourage patients to seek a prescription for a specific product are prohibited. The results demonstrate the commercial intent (and potential commercial success) of industry DAA. However, it is concerning that most consumers (our research indicates up to 90%) do not recognise this intent, and they may be less critical in evaluating advertisements. While consumers value the information provided in DAA, many advertisements fail to provide detailed or comprehensive disease information. The regulation of DAA requires strengthening, with specific recommendations regarding the amount and breadth of disease information to be included