200706 Patient education through pharmaceutical marketing: A pilot study of PhRMA's Office of Accountability consumer comment process

Wednesday, November 11, 2009: 8:30 AM

Ano L. Lobb, MPH , Independent public health consultant, Barre, VT
Samuel Wertheimer, MPH , RAND Health, RAND Corporation, Santa Monica, CA
Shannon Sweeney, MPH , Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH
Salma Batool-Anwar, MD , Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH
Dennis Goulet, BA , Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH
Marian Bihrle, BS , Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH
Background: The pharmaceutical industry claims that direct to consumer advertising of pharmaceuticals (DTCA) provides consumers with valuable education and information about medical conditions and treatments, claims that are disputed by many researchers. Recognizing the need to reform marketing practices, the Pharmaceutical Research and Manufacturers of America (PhRMA) has developed a 14 principle code of ethical conduct for DTCA, and in 2005 created a central Office of Accountability that provides feedback to consumer challenges of specific DTCA's adherence to these industry standards. An annual tally is published documenting the number of inquiries responded to by industry. We could not locate any studies evaluating this system. This study tested the quality of the PhRMA process, and evaluated the industry responses to consumer inquiries about DTCA.

Methods: Consumer inquiries were submitted for a convenience sample of print and television DTCAs using the process established by PhRMA. After 12 months, responses received were tallied and evaluated for timeliness, and content quality.

Results: Of 27 inquiries submitted to 14 companies for 23 distinct drugs, 14 responses were received from 7 companies for 12 distinct drugs, and 1 company did not participate in the process (response rate: 53.8%). In cases where multiple inquiries were sent to a single company, 5 responded to all inquiries, 5 provided no response, 1 responded to 50% of inquiries (1/2) and 1 responded to 66% inquiries (2/3). It took an average of 77 days for companies to respond (range 28-122 days). Company responses utilized some combination of five general strategies: Acknowledging receipt of inquiry with no additional comment, unsubstantiated statements of compliance, directing consumer to another source of information (website or phone number), stating that concern is not covered by code of conduct, or recommending a discussion of the drug with a healthcare provider. In 5 cases additional information was provided in the form of study citations (3/5), or an official drug label or brochure (2/5).

Conclusion: The industry process established to respond to consumers does little to enhance the informational and educational value of DTCA. Communications are characterized by lengthy response times and few companies provided additional information not already available in the advertising or product websites. Information that was provided was of limited value. Despite the creation of PhRMA's Office of Accountability, DTCA continues to be of little educational use to consumers.

Learning Objectives:
1. Explain arguments in support and against direct-to-consumer drug advertising 2. Describe the PhRMA established process for receiving consumer comments, its strengths and weaknesses 3. Discuss potential shortcomings PhRMA’s approach 4. List steps that industry has taken to reform DTC drug advertising

Keywords: Health Information, Health Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a Masters of Public Health, and 9 years of evidenced-based research experience related to health, healthcare, and pharmaceuticals. I have worked on pharmaceutical related projects for advocacy organizations and state regulators, and have lectured on elated material at Dartmouth Medical School. I also have published material related to pharmaceuticals and pharmaceutical policy in the peer-reviewed literature, and am a past presenter at APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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