Does price disclosure in pharmaceutical advertising result in price transparency? Evidence from a randomized experiment.

Background: Policies that mandate list price disclosure in direct-to-consumer pharmaceutical advertising (DTCPA) cite price transparency among the benefits. The expectation is that price transparency will lead to changes in consumer behavior that will ultimately lower healthcare costs. Objective: The objective of this study was to assess the impact of price transparency on perceived level of information and consumer behaviors, specifically intentions to seek treatment and intentions to comparison shop. Methods: A nine-arm randomized experiment was conducted to expose respondents to television advertisements for prescription drugs that varied by price disclosure type (no price/control, list price only, or price plus, which disclosed the list price and typical out-of-pocket cost) and indicated condition (deep vein thrombosis/pulmonary embolism [DVT/PE], diabetes, or rheumatoid arthritis [RA]). The sample was recruited from US adult members of the nationally representative Amerispeak online panel. Results: The sample included 2138 respondents. For ads featuring prescription drugs for DVT/PE, findings provide no evidence of an impact from price disclosure on perception of sufficient information. For ads for prescription drugs for diabetes, there was no evidence of an impact from list price only, but the price plus group was more likely than the control group to report the ad provided sufficient information (OR = 2.475). For ads for RA prescription drugs, both the list price only group (OR = 3.380) and price plus group (OR = 2.720) were more likely to report sufficient information than the control. Findings provide no evidence of an impact from price disclosure on consumer behaviors (i.e., intention to seek treatment or intention to comparison shop). Conclusions: Mandatory DTCPA list price disclosure may not be the most effective tool for improving price transparency and affecting consumer behavior.

Attention to price disclosures in direct-to-consumer prescription drug advertising and the impact on drug perceptions.

BACKGROUND: Mandatory disclosure of the price of prescription drugs within direct-to-consumer pharmaceutical advertisements (DTCA) has been proposed as a potential means of curbing rising drug costs in the United States. While price transparency in DTCA has widespread public support, empirical evidence regarding the effects of such drug prices disclosures remains limited. OBJECTIVES: This study assessed the degree to which a price disclosure was noticed, the individual characteristics associated with price disclosure recognition, and the impact on perceived drug affordability, effectiveness, and safety. METHODS: A randomized experiment was conducted among 2,138 members of the Amerispeak online panel. Participants were shown a television commercial for a drug treating either type II diabetes, deep vein thrombosis/pulmonary embolism (DVT/PE), or rheumatoid arthritis (RA) that disclosed the list price, disclosed the list price plus the average out-of-pocket cost, or had no price disclosure. RESULTS: Roughly forty percent of participants noticed when a price was disclosed while 20-24% noticed information about individual costs varying (the higher of these percentages occurred when the average out-of-pocket cost was provided). Attention did not vary systematically with the cost amount. Recognition of the different elements of the price disclosure were most predicted by sociodemographic variables such as race, education, and income as well as health characteristics. Price disclosure altered perceived affordability of the advertised medication in a manner consistent with the costs provided, but such consistent significant effects were not found for perceived drug effectiveness and safety. CONCLUSIONS: Repeated exposure to price disclosure in television DTCA or supplementary sources of price information may be necessary to increase attention to drug price information, especially among those who are most vulnerable to the burden of drug costs. Price transparency appears useful for adjusting affordability perceptions, but additional research needs to examine how such perceptions factor into healthcare decision-making and drug pricing.

The Use of Narratives to Deliver Information in Direct-To-Consumer Prescription Drug Commercials: A Content Analysis.

Information communicated through a narrative format is typically processed and evaluated differently compared to non-narrative formats. Therefore, differences in the use of narratives across various information categories within direct-to-consumer prescription drug advertisements (DTCA) could have significant implications for consumers' processing of that information. Such differences could have further implications regarding the "fair balance" rule put forth by the Food and Drug Administration (FDA). This study sought to document the presence and nature of narrative and non-narrative messages in a content analysis of 61 U.S.-based broadcast DTCA airing during 2016. Specific narrative styles (classic drama, vignette, first person, second person, third person) were distinguished from non-narrative styles (lecture, directive, endorsement, graphic/demonstration) according to key characteristics of each (chronology and character, showing versus telling). Results indicated widespread use of narrative styles in DTCA overall, but the styles used differed substantially between different types of information. Narrative styles were delivered prominently to present health condition and drug benefits information while non-narrative styles primarily reinforced drug benefits and presented drug risks. These differences offer a new frame through which to view an imbalanced presentation of drug risks and benefits and provide a foundation for future research to test the effects of various narrative and non-narrative forms on patient understanding and message recall.

An Updated Analysis of Direct-to-Consumer Television Advertisements for Prescription Drugs.

PURPOSE: In 2015, the American Medical Association called for a ban of direct-to-consumer advertising (DTCA) for prescription drugs. Yet, the pharmaceutical industry spends more than ever on broadcast advertisements, with national health care costs largely driven by drug spending. An evaluation of these ads is critical, as these advertisements can impact the frequency which patients ask their doctors about medications. METHODS: A content analysis of prime-time direct-to-consumer ads was conducted across 4 major cable television networks. The ad content (n = 61) was coded for factual claims made regarding target conditions, appeals used, portrayal of medications, and lifestyle characteristics shown. RESULTS: We found a substantial decrease in the percentage of ads that conveyed information about the conditions being targeted, such as risk factors (16%) and prevalence (16%). Positive emotional appeals (94%) continued to be emphasized; yet there was decreased use of negative emotional appeals (51%), pointing to an overall more positive portrayal of a patient's experience with a medication. The lifestyles portrayed in the sample largely featured how products can enable more recreational activities (69%) and fewer ads (7%) presented alternatives to product use. CONCLUSIONS: Direct-to-consumer advertising continued to promote prescription drugs above educating the population. Improvement in the educational value of DTCA is likely to require regulatory action rather than reliance on self-regulation by the pharmaceutical industry.

Consumers young and old: segmenting the target markets for direct-to-consumer prescription drug advertising.

Direct-to-consumer pharmaceutical advertising (DTCA) studies have typically focused on older adults or a general population of adults. However, college students are viable targets for DTCA and are receiving more research attention in this area. In this article, we compare college students with two adult age segments. Our findings indicate all age groups had relatively high awareness of DTCA and similar attitudes and behavioral responses to the ads. However, there were significant differences in media use and health characteristics as well as the factors predicting DTCA ad trust, attitudes, and behavioral intentions. Implications and future research suggestions are discussed.

Representation of African Americans in direct-to-consumer pharmaceutical commercials: a content analysis with implications for health disparities.

While direct-to-consumer (DTC) pharmaceutical drug advertising has been the center of controversy, proponents argue these ads provide educational and social benefits. This study explores the potential of these ads to address one of the proposed social benefits of reducing racial health disparities, particularly for African Americans. To examine this issue, a content analysis was conducted on DTC pharmaceutical television commercials assessing the presence and role portrayal of Black models in the ads. Findings revealed that Blacks were well represented overall but appeared to serve a token role and were underrepresented in ads for some of the most serious health conditions.