Journal of Undergraduate Research
Volume 4, Issue 8 - April 2003

Opinions of Pharmaceutical Direct-to Consumer Marketing on College Students

Lauren Cadd

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

  1. Adams, C. (2001). “FDA scrambles to police drug ads’ truthfulness.” Wall Street Journal. January 2: A24.
  2. Barry, P. (2002). “What’s fueling drug costs?” I. Vol. 43. March: 3.
  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.
  4. Lyles, A. (2002). “Direct marketing of pharmaceuticals to consumers.” Public Health Annual Review. Vol. 23. 73-91.
  5. Starkey, D. (1998). “Drug firms stepping up advertising campaigns.” Sacramento Business Journal. April 3: sacramento.bcentral.com.
  6. Teinowitz, I. (2002). “Drug ads likely to feel pressure.” Advertising Age. March 18: 4.
  7. Thomaselli, R. (2002). “DTC ads influence majority of consumers, say doctors.” Advertising Age. January 20.


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