Journal of Undergraduate Research
Volume 4, Issue 8 - April 2003
Opinions of Pharmaceutical Direct-to Consumer Marketing
on College Students
INTRODUCTION AND LITERATURE
REVIEW
Today consumers who watch television programs and read popular magazines
are bombarded by drug advertisements which promise to cure a plethora
of illnesses, ranging from allergies to depression. Until recently,
pharmaceutical companies have been prevented from advertising directly
to consumers. However, in 1997, the Food and Drug Administration (FDA)
began to loosen its advertising restrictions, and “direct-to-consumer”
(DTC) marketing gained popularity among pharmaceutical companies (4).
In 2001 alone, $2.5 billon was spent on DTC marketing (6). Considering
the large amount of money spent on this form of marketing, the goal
of this research project is to determine the opinions of future consumers,
current college students, on DTC marketing.
While the Federal Trade Commission monitors the advertising for most
consumer products, the FDA alone must ensure that the claims given by
DTC advertisements are reinforced by science (1). However, given its
staff of only 13 drug-marketing reviewers and overall budgeting constraints,
the FDA may find that task overwhelming (1). While the FDA requires
that drug advertisements be submitted to the agency before they are
aired on television or printed in magazines, not all pharmaceutical
companies submit their advertisements.
Opponents of DTC marketing also argue that the increase in its popularity
has led to inflated drug costs. In recent years drug spending has increased
by 17% a year, in part due to rising drug prices. Currently, drug spending
in the United States is greater than in any other nation (2). Critics
argue that drug companies promote only the newest and most expensive
“blockbuster” prescriptions, when less expensive ones may
be just as effective (2).
If recent sales trends are any indication, the DTC marketing boom is
certain to continue. In fact, the amount of money the pharmaceutical
industry spends each year on DTC marketing is expected to approach $7.5
billion by 2005 (3). It is essential, therefore, to determine the opinions
of future consumers on this influential, highly successful marketing
campaign to forecast the future of DTC marketing.
MATERIALS
The first stage of research consisted of two focus groups. Fifteen students
participated in each group. The students were given two different examples
of DTC marketing found in popular media and were asked a series of questions
pertaining directly to the advertisements. The students were then asked
a second set of questions regarding their general opinions toward DTC
marketing.
From their answers I developed a series of 38 survey questions. The
survey was administrated via the Internet to 100 students. The participants
were students enrolled in businesses classes at the University of Florida.
These students received extra credit for their participation. This incentive
guaranteed a high response rate.
The 38 survey questions were reduced to six factors that measured the
opinions of the future consumers on DTC marketing.
Table 1
Factors that Measured the Opinions of the Future Consumers on DTC
Marketing |
| Factor |
Beliefs |
| Informative Value of DTC Marketing |
Consumers make better decisions about their health.
Consumers read the small print in advertisements.
Advertisements are not misleading.
Advertisements do not cause unnecessary drug use. |
| Impact on Patient-Physician Relationship |
Consumers make better decisions about their health.
Advertising makes it easier for consumers to speak with a physician.
Advertising motivates consumers to seek a physician's care. |
| Detrimental Effects |
Advertisements need stronger regulations.
Physicians feel pressured by patients. |
| Effectiveness |
Advertisements are entertaining.
Advertisements reach their intended audience.
Advertisements encourage more consumers to be more proactive about
their healthcare. |
| Social Responsibility |
Only the safest drugs are advertised.
Physicians support DTC advertising.
Advertisements offer enough nondrug alternatives.
The dependent variables were action-based and included making an appointment
with a doctor, consulting a pharmacist, calling a toll-free number,
referring to a particular magazine and checking a Web site. A dependent
variable called “action” was a composite of the previous
five variables.
Another set of dependent variables was used in measuring respondents’
assessments of the responsibility for the negative effects of DTC marketing.
The variables were regressed using the same set of six predictors. These
dependent variables included holding the physicians, pharmaceutical
companies and consumers responsible.
Finally, t-tests were created to compare subgroups of the sample. The
subgroups were composed of gender, academic major (business/advertising
vs. all other) and prescription drug usage (yes or no).
RESULTS
The means of the six predictor factors demonstrated neutral attitudes
and beliefs toward DTC marketing. A score of 1 corresponded to a strong
negative view of DTC marketing, while a score of 5 corresponded to a
strong positive view of DTC marketing, with the exception of the detrimental
factor, for which the scores were reversed.
Table 2
Means of the Six Predictor Factors |
| Factor |
Mean |
| Attitude |
3.27 |
| Informative Value of DTC Marketing |
2.76 |
| Impact on Patient-Physician Relationship |
3.23 |
| Detrimental Effects |
3.21 |
| Effectiveness |
3.16 |
| Social Responsibility |
2.68
These factors were then used to predict the actions of
the future consumers by using a regression analysis.
The regression results showed that the independent variables explained
a statistically significant (p < .10) proportion of the variance
in six of the dependent variables.
Table 3
Regression Results |
| Dependent Variable |
R |
R^2 |
Adjusted R^2 |
F |
Significance Level |
| "Action" |
.442 |
.195 |
.142 |
3.639 |
.003 |
| Make Appointment with Doctor |
.486 |
.236 |
.185 |
4.641 |
.001 |
| Consult a Pharmacist |
.339 |
.115 |
.056 |
1.953 |
.081 |
| Call Toll-Free Number |
.319 |
.102 |
.042 |
1.701 |
.130 |
| Refer to Magazine |
.398 |
.158 |
.102 |
2.820 |
.015 |
| Check Web site |
.378 |
.143 |
.085 |
2.495 |
.028 |
| Physician Responsible |
.218 |
.047 |
-.016 |
.748 |
.613 |
| Pharmaceutical Companies Responsible |
.467 |
.218 |
.166 |
4.189 |
.001 |
| Consumers Responsible |
.173 |
.030 |
-.035 |
.461 |
.836
The “action” variable was best predicted
by the consumer’s beliefs about DTC marketing’s impact on
the patient-physician relationship.
Table 4
"Action" Regression |
| Predictor |
Beta |
Significance |
| Attitude |
.216 |
.275 |
| Informative Value of DTC Marketing |
-.002 |
.987 |
| Impact on Patient-Physician Relationship |
.261 |
.036 |
| Detrimental Effects |
.086 |
.399 |
| Effectiveness |
.010 |
.918 |
| Social Responsibility |
.076 |
.431
Consumers’ decision to make an appointment with
their doctor after seeing a relevant DTC advertisement was best predicted
by their belief that DTC marketing was socially responsible but could
possibly have detrimental effects.
Table 5
Make Appointment with Doctor |
| Predictor |
Beta |
Significance |
| Attitude |
.038 |
.740 |
| Informative Value of DTC Marketing |
.182 |
.150 |
| Impact on Patient-Physician Relationship |
.144 |
.233 |
| Detrimental Effects |
.301 |
.003 |
| Effectiveness |
.155 |
.108 |
| Social Responsibility |
.167 |
.080
No belief was significant in predicting a consumer’s
decision to consult a pharmacist.
Table 6
Consult a Pharmacist |
| Predictor |
Beta |
Significance |
| Attitude |
.192 |
.126 |
| Informative Value of DTC Marketing |
-.020 |
.885 |
| Impact on Patient-Physician Relationship |
.135 |
.396 |
| Detrimental Effects |
.139 |
.196 |
| Effectiveness |
.049 |
.633 |
| Social Responsibility |
.082 |
.421
The decision to refer to a particular magazine was best
predicted by a consumer’s overall attitude toward DTC marketing
and their belief that this form of advertising was socially responsible.
Table 7
Refer to Magazine |
| Predictor |
Beta |
Significance |
| Attitude |
.296 |
.016 |
| Informative Value of DTC Marketing |
-.078 |
.554 |
| Impact on Patient-Physician Relationship |
.037 |
.766 |
| Detrimental Effects |
.073 |
.483 |
| Effectiveness |
-.048 |
.630 |
| Social Responsibility |
.252 |
.013
Consumers were most likely to check a product’s
Web site after viewing its advertisement when they believed that DTC
marketing strengthened the patient-physician relationship and had little
or no detrimental effects to society. However, these consumers also
thought DTC marketing was socially irresponsible.
Table 8
Check Web site |
| Predictor |
Beta |
Significance |
| Attitude |
.087 |
.476 |
| Informative Value of DTC Marketing |
-.089 |
.507 |
| Impact on Patient-Physician Relationship |
.312 |
.016 |
| Detrimental Effects |
-.178 |
.092 |
| Effectiveness |
-.012 |
.904 |
| Social Responsibility |
-.212 |
.036
The regression results showed that only one independent
variable was statistically significant in assigning responsibility for
the harmful effects of DTC marketing. Consumers who held the belief
that DTC advertisements were not informative felt that pharmaceutical
companies should be responsible for DTC marketing’s negative impact
on society.
Table 9
Pharmaceutical Companies Responsible |
| Predictor |
Beta |
Significance |
| Attitude |
.013 |
.908 |
| Informative Value of DTC Marketing |
-.491 |
.001 |
| Impact on Patient-Physician Relationship |
.120 |
.323 |
| Detrimental Effects |
.054 |
.588 |
| Effectiveness |
-.097 |
.317 |
| Social Responsibility |
.020 |
.830
Finally, t-tests were created to compare these factors
within subgroups of the sample. The subgroups were composed of gender,
academic major and prescription drug usage. The mean differences between
sub-groups was not statistically significant.
DISCUSSION
The most common predictor of the participants’ actions was their
belief regarding the social responsibility of DTC marketing. Participants
who believed that DTC marketing was socially responsible were more likely
to refer to a particular magazine or make an appointment with their
doctor after seeing a DTC advertisement that interested them. Unfortunately,
it is possible that this attitude may not be based on reliable information.
For example, one component of the social responsibility factor of DTC
marketing is that is has the support of physicians. However, 47% of
physicians feel somewhat pressured to prescribe drugs that patients
request according to an FDA survey (7). In addition, 28% of physicians
say that DTC advertising has caused tension between them and their patients
(7).
Another component used to establish the social responsibility of DTC
marketing was that the participants felt that only the safest drugs
can be advertised. However, there are many misleading DTC advertisements
in the popular media today. Between August 1997 and August 2002, the
FDA issued 88 letters to pharmaceutical companies for violations. Unfortunately,
many consumers believe that only the safest prescription drugs can be
advertised. In this survey 34% of the sample answered “strongly
agree” or “agree” to the question, “Only the
safest prescription drugs can be advertised on television.” This
data suggest that over a third of potential consumers do not question
the safety of the prescription drugs they see advertised. In addition,
the sample surveyed are all college students pursuing a higher education.
This statistic may be greater for less-educated consumers and the population
as whole.
The informative value of DTC marketing was the best predictor of participants
who held pharmaceutical companies responsible for the harmful effects
of DTC marketing. These participants probably viewed the drug manufacturers
as being concerned with making a profit and not always acting in the
consumer’s best interest. Opponents of DTC marketing believe that
consumers are relying on biased sources of information because drug
companies have profit as their bottom line (5). These companies are
accused of pushing drugs that have significant side effects. By suggesting
that patients “See their doctor,” pharmaceutical companies
push the responsibility of education onto the patient’s doctor
(5).
The number of advertisements each student was exposed to on a daily
basis was not gathered in the research study. This limitation was significant
in analyzing the research. A possible hypothesis for future research
is that the more advertisements a participant is exposed to, the more
active his/her response will become in seeking additional drug information.
While this research design gathered information regarding the opinions
of future consumers on DTC marketing, another suggestion for further
research would include gathering data from current consumers. College
students may be more accepting of new products and forms of marketing
than a random sample of the United States population. Most college students
have grown up in a society that has placed great emphasis on the consumer’s
role in healthcare. The time of the physician’s complete control
over their patient’s treatment and the “Doctor knows best!”
axiom predates many college students.
Clearly, DTC advertising is a highly influential form of marketing that
has created dramatic rises in pharmaceutical prescriptions. Stricter
governmental regulation may be a possible solution for preventing misleading
advertisements. Clearly, the FDA needs a faster turnaround time between
identifying deceptive advertisements and disciplining pharmaceutical
companies. In addition, the FDA may consider enforcing requirements
that pharmaceutical advertisements be approved before being allowed
to air. While DTC marketing is creating astronomical sales for pharmaceutical
companies, the importance of consumers health and well-being must be
brought to the forefront of this issue.
REFERENCES
- Adams, C. (2001). “FDA scrambles to police drug ads’
truthfulness.” Wall Street Journal. January 2: A24.
- Barry, P. (2002). “What’s fueling drug costs?”
I. Vol. 43. March: 3.
- Bell, R., R. Kravitz and M. Wilkes (2000). “Direct-to-consumer
prescription drug advertising, 1989-1998.” The Journal of
Family Practice. Vol. 49. April: 329-335.
- Lyles, A. (2002). “Direct marketing of pharmaceuticals to
consumers.” Public Health Annual Review. Vol. 23. 73-91.
- Starkey, D. (1998). “Drug firms stepping up advertising campaigns.”
Sacramento Business Journal. April 3: sacramento.bcentral.com.
- Teinowitz, I. (2002). “Drug ads likely to feel pressure.”
Advertising Age. March 18: 4.
- Thomaselli, R. (2002). “DTC ads influence majority of consumers,
say doctors.” Advertising Age. January 20.
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