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Healthy Skepticism Library item: 18971

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Greene JA, Kesselheim AS
Pharmaceutical Marketing and the New Social Media
N Engl J Med 2010 Nov 25;


Facebook and Twitter, the largest social media Web sites, have more than 350 million users worldwide, and surveys indicate that 60% of Americans turn first to the Internet when seeking health-related information.1 It is therefore surprising that the pharmaceutical and medical-device industries have been slow to establish a social media presence. The drug industry allocated less than 4% of the more than $4 billion it spent on direct-to-consumer advertising to Internet outlets in 2008, and only a tiny fraction of that was for social networking sites.2 In the next year, however, the proportion may change substantially.
Since the Pure Food and Drug Act was passed in 1906, control by the Food and Drug Administration (FDA) over drug labels has been one of its most powerful tools for protecting the public’s health. To encourage appropriate use of prescription drugs, the FDA has sought to ensure that promotional statements make claims about approved indications only and neither overstate the benefits nor understate the risks. A major concern has been finding ways to ensure “fair balance,” with adequate attention given to information about risks as well as benefits. When this balance is not achieved, inappropriate promotional statements can contribute to misuse of drugs, with dangerous consequences.
As communications media have evolved, manufacturers have tended to wait for the FDA to establish explicit codes of acceptable marketing practices before devoting substantial resources to a new medium. Direct-to-consumer advertising in print media proceeded tentatively until the FDA issued a guidance document in 1985 establishing a standard format for providing a “brief summary” of risks.3 Prescription-drug advertising in broadcast media was similarly minimal until the FDA’s guidance revised the definition of “adequate” risk information in 1997, and again in 1999, to permit broadcast media to include references to a toll-free number or Web site where consumers could obtain more detailed descriptions of a product’s adverse effects. In the wake of these FDA actions, spending on direct-to-consumer advertising mushroomed from $579 million in 1996 to $1.3 billion in 1998 and to over $4 billion in 2008. …


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