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Healthy Skepticism Library item: 19133

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

Joshi AD, Patel DA, Holdford DA
Media coverage of off-label promotion: A content analysis of US newspapers
Res Social Adm Pharm 2010 Nov 24;


BACKGROUND: Promotion of drugs for
off-label use is newsworthy, because
it is an illegal but all too common
strategy used by pharmaceutical
companies. The print media are an
important source of information
about coverage of off-label
promotion of drugs and devices and
can influence public perceptions of
the practice.

OBJECTIVES: Print media coverage of
off-label promotion during the years
1990-2008 were described and
quantified. The primary themes and
general tones relating to off-label
promotion articles were evaluated.
General concerns associated with
off-label promotion and complaints
about specific brand name drugs were
also identified.

METHODS: Content analyses of the top
6 US newspapers were conducted over
the period of 1990-2008 to analyze
the media coverage given to
off-label promotion of drugs and
devices. Headlines and full text of
articles were analyzed for primary
themes and tones of the coverage.
Intercoder reliability tests were
performed on all the study

RESULTS: One hundred and one
articles were identified meeting the
study inclusion criteria. Coverage
varied by newspaper. The Wall Street
Journal had the most coverage on the
topic (45%), and USA Today and
Chicago Tribune had the least
coverage (5%). Overall, most of the
stories sampled were deemed to have
a negative tone in coverage (77%),
focusing mainly on lawsuits against
drug companies for promoting their
drugs for off-label uses. Pfizer’s
Neurontin(®) (Pfizer Inc., New York,
NY 10017, USA) and Johnson &
Johnson’s Retin-A(®)
(Orthoneutrogena, Los Angeles, CA
90045, USA) received the most media

CONCLUSION: The news media helps
shape public understanding of
promotional practices of
pharmaceutical companies and their
potential benefits and harms. This
study suggests that print media
coverage is generally negative about
off-label promotion, focusing on
legal actions taken against drug
companies and the negative
consequences of such promotional


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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963