EDTCA 2.0: Global regulation and public health issues associated with interactive internet media

In the era of globalization and advances in health communication technology, Direct-to-Consumer Advertising has become the fastest growing form of pharmaceutical marketing. Due to inadequate regulation in the U.S., DTCA is global through the use of the Internet and other forms of interactive media not constrained by geopolitical boundaries and may circumvent current DTCA prohibitions. This phenomenon also coincides with the increasing use by consumers of accessing health related information online and the emergence of web-based technologies promoting information sharing and social interaction known as “Web 2.0.” This form of “eDTCA 2.0” has yet to be adequately regulated by U.S. regulators and presents potential negative implications for global public health and health economics. We assess the prevalence of eDTCA 2.0 in the top grossing pharmaceutical firms and products. Upon our review we find that of pharmaceutical companies reviewed (10/10, 100%) have presence in eDTCA 2.0 sites of Facebook, Twitter/Friendster, sponsored blogs, and RSS feeds. 80% (8/10) have dedicated YouTube Channels; and 80% (8/10) developed healthcare communication-related mobile applications. For reviewed drugs, 90% (9/10) have dedicated websites, 70% (7/10) have dedicated social media pages, 90% (9/10) have health communications-related applications, and 80% (8/10) have DTCA television advertisements on web. We also found 90% (9/10) of these drugs had non-corporate eDTCA 2.0 marketing presence by illegal online drug sellers. Reform efforts need to take into account these concerns and appropriately limit eDTCA dissemination, increase transparency, and integrate safety communication to appropriately recognize and confront this growing global health concern.