The Tip of the Iceberg of Misleading Online Advertising; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”
Kim’s overview of Food and Drug Administration (FDA) regulatory actions from 2005 to 2014 is a comprehensive analysis of the US regulatory experience with online direct-to-consumer advertising (DTCA) of prescription medicines. This experience is of relevance internationally as online DTCA reaches the English-speaking public globally, despite the illegality of DTCA in most countries. The most common violations were omissions or minimizations of risk information, overstatements of efficacy, unsubstantiated claims, and promotion of unapproved (“off-label”) use. Nearly one fourth of violations involved cancer drugs, raising additional concerns about patient vulnerability, limited treatment advance, and high costs. Based on content analyses of online DTCA, these cases likely reflect a small proportion of unbalanced and misleading promotional information available on the web. The FDA is only able to review a small proportion of promotional materials submitted to them, due to limited staffing, and the delay between first posting and regulatory action means that many people may be exposed to messages that are found to be inaccurate and misleading. The sheer volume of online DTCA, combined with the ability for content to shift continually, poses unique regulatory challenges.
Mintzes B. Advertising of prescription-only medicines to the public: does evidence of benefit counterbalance harm? Annu Rev Public Health. 2012;33:259-277. doi:10.1146/annurev-publhealth-031811-124540
Topol EJ. Failing the public health--rofecoxib, Merck, and the FDA. N Engl J Med. 2004;351(17):1707-1709.
Kim H. Trouble spots in online direct-to-consumer prescription drug promotion: a content analysis of FDA warning letters. Int J Health Policy Manag. 2015;4(12):813-821. doi:10.15171/ijhpm.2015.157
Hoy MG, Park JS. Principles in action: an examination of Food and Drug Administration letters involving violative internet promotions from 1997 to 2012. J Public Policy Market 2014;33(2):127-142.
Liang BA, Mackey TK. Prevalence and Global Health implications of social media in direct-to-consumer drug advertising. J Med Internet Res 2011;13(3):e64. doi:10.2196/jmir.1775
Egilman D, Druar NM. Spin your science into gold: direct to consumer marketing within social media platforms. Work. 2012;41:4494-4502. doi:10.3233/WOR-2012-0751-4494
Light DW, Lexchin J. Why do cancer drugs get such an easy ride? Rushed approvals result in a poor deal both for patients and cancer research. BMJ. 2015;350:h2068.
FDA News Release. FDA Adds Boxed Warning for Heart-related Risks to Anti-Diabetes Drug Avandia. Agency says drug to remain on market, while safety assessment continues. FDA News Release. November 14, 2007. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm109026.htm.Accessed December 20, 2015.
Cohen D. Rosiglitazone: what went wrong? BMJ. 2010;341:c4848. doi:10.1136/bmj.c4848
Ventola CL. Direct-to-consumer advertising: therapeutic or toxic? P T. 2011;36(10):669-684.
Law MR, Mintzes B, Morgan SG. The sources and popularity of online drug information: an analysis of top search engine results and web page views. Ann Pharmacother. 2011;45(3):350-356. doi:10.1345/aph.1P572
Mintzes, B. (2016). The Tip of the Iceberg of Misleading Online Advertising; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”. International Journal of Health Policy and Management, 5(5), 329-331. doi: 10.15171/ijhpm.2016.19
MLA
Barbara Mintzes. "The Tip of the Iceberg of Misleading Online Advertising; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”", International Journal of Health Policy and Management, 5, 5, 2016, 329-331. doi: 10.15171/ijhpm.2016.19
HARVARD
Mintzes, B. (2016). 'The Tip of the Iceberg of Misleading Online Advertising; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”', International Journal of Health Policy and Management, 5(5), pp. 329-331. doi: 10.15171/ijhpm.2016.19
VANCOUVER
Mintzes, B. The Tip of the Iceberg of Misleading Online Advertising; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”. International Journal of Health Policy and Management, 2016; 5(5): 329-331. doi: 10.15171/ijhpm.2016.19