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This chapter explores how direct-to-consumer advertisements (DTCA) for major depression and anxiety disorders use contemporary gender scripts to sell medications and disease definitions to consumers, and in the process reflect and reinforce those scripts for both men and women. Between 1997 and 2006, antidepressant DTCA in popular magazines overwhelmingly depicted depression as a (white) female disorder, as did anti-anxiety DTCA, although not to such an extreme extent. In addition, DTCA often alerted men to the benefits they might reap if the women in their lives sought treatment, while suggesting that women had a responsibility to seek such treatment for the sake of their loved ones. Moreover, DTCA disproportionately encouraged women to monitor their emotions while encouraging men to monitor their physical sensations. Finally, DTCA suggested that medication would yield benefits for women primarily in their close relationships and for men primarily in their work lives, thus reinforcing the binary sex divisions implicit in hegemonic masculinity and emphasized femininity. At a broader level, DTCA studied for this article suggest to both women and men that individuals should monitor themselves and others for a wide variety of common emotions, behaviors, and physical sensations, thus individualizing social problems and encouraging the expansion of medical authority over everyday life.

The purpose of the study is to investigate the influence of direct-to-consumer advertising (DTCA) on consumers’ decision-making (CDM).

Practical data were used in the empirical analysis collected from 484 consumer surveyed by means of a questionnaire. Statistical techniques such as descriptive statistics, correlation, simple and multiple regressions were employed. A Cronbach’s alpha was used to confirm the suitability of the data collection instrument.

The results of the study indicated a positive significant relationship between DTCA and CDM. The results indicated that there was significant impact of healthcare awareness on CDM, but there were no significant impacts of drug–drug interactions, medical information source and consumer economical situation on CDM.

The data are also limited to a Jordanian market; therefore, generalizing results of a Jordanian setting to other countries may be questionable. Extending the analyses to other settings represent future research opportunities.

The current research may be considered as an initiative study that highlights the effect of DTCA on CDM in Jordan and in the Arab world. The results can provide the reference for further research about the relationship between DTCA and CDM.

The purpose of this study is to examine the effects of consumers’ prescription drug advertising (DTCA) skepticism on their advertising evaluation. In addition, the study investigates the moderating role of health risk information location in DTCA and the mediating role of perceived message effectiveness to address when and how the skepticism effects are maximized or minimized.

The study used a controlled lab experiment to enhance internal validity.

This study found that when risk information was presented earlier in a more prominent manner, it appeared to reduce the DTCA skepticism effects. In contrast, the DTCA skepticism effects remained considerable when benefit information was presented earlier.

The artificial nature of the controlled lab setting suggests conducting future research in a more natural setting using various therapeutic and product categories to enhance ecological and external validity.

Pharmaceutical marketers could reduce consumers’ DTCA skepticism effects on their advertising evaluation by using situational message strategies. The prominence of health risk disclosure could be one of such strategies.

The FDA’s industry guidance for DTCA risk communication suggests that the location of risk information in the ad may play an important role in determining its prominence. However, little is known about how complying with the FDA’s risk communication guidance by presenting a more prominent risk disclosure can affect consumers’ ad evaluation by affecting the DTCA skepticism effects. The current study provides empirical evidence for the importance of the health risk disclosure prominence.

Because the FDA’s release of the DTCA risk communication guidance, little empirical research has been conducted to examine a wide range of situational message factors that may affect consumers’ response to DTCA risk communication. The current study filled the gap in the literature by addressing the interplay between consumer and message factors in the DTCA context.

The purpose of this paper is to review empirical research on direct‐to‐consumer advertising (DTCA) of prescription drugs published in journals over the period from 1997 to 2012.

A structured review of 130 published studies on direct‐to‐consumer advertising of prescription drugs was conducted.

Based on the structured review, the authors identified seven key research themes in DTCA. These are: consumers' attitudes toward direct‐to‐consumer advertising, physician‐patient interaction, content of DTC advertisements, awareness, literacy and memory, consumer information source and search, effect of DTCA expenditures on financial performance, and physicians' attitudes toward DTCA.

Avenues for future research are proposed. Future research needs to focus on more empirical studies, television DTCA, online and emerging media DTCA, new and improved measures, ethical issues and regulations, diverse countries, and nurse and pharmacist attitudes towards DTCA.

The primary contribution of this paper is a thorough understanding of the state‐of‐the‐art in research on DTCA and future research directions.

Robotic coronary artery bypass (rCABG) is a relatively novel and less invasive form of surgery. A yearlong direct-to-consumer advertising (DTCA) campaign was initiated to provide the community with information regarding rCABG, increase awareness and recruit patients. To optimize information content and ensure appropriate messaging for future campaigns, this study aims to analyze the campaign effectiveness and compared service quality perceptions and clinical outcomes, following surgery across DTCA-responder and control groups.

The institution initiated an rCABG program and one-year DTCA campaign. The authors prospectively documented all rCABG referrals prompted by these ads (DTCA-responder group) and concurrent referrals from medical providers (controls). Groups were compared according to baseline characteristics, perioperative outcomes, patient satisfaction (HCAHPS survey) and functional capacity at three weeks (Duke Activity Status Index). At six months, both groups were surveyed for patient satisfaction and unmet expectations.

There were 103 DTCA responders and 77 controls. The subset of responders that underwent rCABG (n = 54) had similar characteristics to controls, except they were younger, less likely to have lung disease or to be scheduled as an urgent case. Both groups had similar 30-day clinical outcomes, functional capacity recovery and overall satisfaction at three weeks. Follow-up interviews at six months and four years revealed that the DTCA group reported more unmet expectations regarding the “size of the skin incisions” and “recovery time” but no concern about “expertise of their surgeon”.

The DTCA campaign was effective at recruiting patients. The specific focus of the ads and narrow timeframe for decision-making about CABG lends confidence that the incremental cases seen during the campaign were prompted primarily by DTCA. However, differences in unmet expectations underscore the need to better understand the impact of message content on patients recruited via DTCA campaigns.

This is one of the first studies to provide real-world direct empirical evidence of patients’ clinical and attitudinal outcomes for DTCA campaigns. Furthermore, the findings contradict prevailing beliefs that DTCA is ineffective for prompting surgical referrals.

The purpose of this paper is to better understand the effectiveness of direct‐to‐consumer advertising (DTCA) by examining consumer perceptions of persuasive intent and informativeness associated with product‐claim and help‐seeking advertisements, respectively.

In three behavioral experiments, a total of 413 participants provided data on their behavioral intentions and attitudes towards DTCA.

Consumers perceived help‐seeking DTCA as being highly informative without persuasive intent, whereas they perceived product‐claim DTCA as having high‐persuasive intent with little informativeness. Help‐seeking (versus product‐claim) DTCA was more effective in generating stronger behavioral intention to seek treatment for the ailments advertised (i.e. clinical depression and migraine). Consumer perceptions of persuasive intent and informativeness of DTCA were the underlying mediators for this result.

The paper helps to resolve conflicting findings in the previous DTCA research by proposing and presenting evidence which suggests that the perceived persuasive intent and informativeness of the advertised message are two underlying constructs that drive DTCA effectiveness. Considering these two constructs in future research may provide a deeper understanding of how and why DTCA effectiveness varies across different types of DTCA.

The results provide useful information for pharmaceutical companies seeking to maximize DTCA effectiveness in increasing behavioral intention to seek treatment for an advertised disease. Considering the key findings, pharmaceutical companies may decide whether and to what extent to employ product‐claim or help‐seeing DTCA.

The paper is one of the first to comparatively examine consumer perceptions of the two different types of DTCA (product‐claim versus help‐seeking) in terms of their influence on behavioral intent to seek treatment for the advertised medical conditions.

The purpose of this paper is to investigate the current trend of pharmaceutical direct-to-consumer advertising (DTCA) in the USA and its effect to patients, physicians and drug utilization. The DTCA of pharmaceutical firms is defined as an attempt of pharmaceutical companies to advertise product directly to patients.

The methodology used is literature review complemented with a semi-structured interview.

Pharmaceutical DTCA showed a reduction in total spending, whereas the online channel experienced growth. DTCA affected the physician–patient relationship and patient satisfaction. Patients who received medication associated with DTCA showed higher satisfaction. DTCA of second-line drugs resulted in an increase of first-line drug utilization. Benefits of pharmaceutical DTCA include enhancing appropriate drug utilization and increasing awareness. DTCA might cause harm by interfering with physician’s decisions regarding drug choice.

Limitations include limited available information of DTCA spending from pharmaceutical companies and lack of quantitative data on the effect of pharmaceutical DTCA. In addition, DTCA is sometimes affected by research bias.

Improvement in the physician–patient relationship and patient satisfaction, as well as in the quality of care provided may be demonstrated.

Pharmaceutical firms using DTCA marketing advertisement methodologies can increase awareness of underdiagnosed conditions and affect medication costs and the utilization of appropriate drug utilization.

Review highlights current relationships between DTCA, patients, physicians and drug utilization to explore the effects DTCA on consumers.

The purpose of this paper is to identify the types of patients most likely to visit physicians in response to direct to consumer prescription drug advertising (DTCA).

The study used data from a national telephone survey, “Public Health Impact of Direct‐to‐Consumer Advertising of Prescription Drugs, July 2001‐January 2002: [United States].” It included data on respondents' health status and utilization, experience with DTCA, demographic and socio‐economic information, and three types of DTCA‐prompted physician visits: visits to discuss a prescription drug, a new health condition, or a change in treatment. A conceptual model was developed to identify consumers most likely to respond to DTCA by visiting a physician.

Five variables were related to all three types of visits. The most important were viewing media as the most important source, prompting one to talk with a physician and believing that DTCA improved discussion with health professionals. Believing that DTCA increased awareness of new treatments was less important, followed by having anxiety, then having arthritis. Taking medications regularly, having allergies, getting information from pamphlets in physicians' offices, and getting information from TV or radio advertisements were related to two types of visits.

Patients having positive beliefs about DTCA, preferring media information sources, and more susceptible to diseases treatable with prescription drugs were more likely to respond to DTCA by visiting physicians.

The study advances the literature on DTCA by examining a range of DTCA‐prompted physician visit behaviors using a conceptual model that has not previously been applied to DTCA.

In order to improve the effectiveness of product‐claim direct‐to‐consumer advertising (DTCA), the current research examines the effect of a presentational element – the number of treatable symptoms for the advertised medical condition featured in the ad – on consumers' intentions to seek treatment.

Ninety‐five participants recruited at a mall in the northeastern US provided data on behavioral and attitudinal intentions regarding a product‐claim print DTCA for an antidepressant.

Featuring a high (vs low) number of symptoms improved the effectiveness of the product‐claim DTCA. Seeing more symptoms led to heightened perceptions of informativeness, lower persuasive intent, and higher intentions to discuss the advertised ailment and the advertised drug with the doctor. Perceptions of disease prevalence mediated this influence. The perceived impact of each symptom featured in the DTCA was controlled across experimental conditions.

This research contributes to the healthcare marketing literature by demonstrating how managing a presentational element in DTCA influences consumers' metacognitive processing of the health information and consequently their intentions to engage in health‐related behaviors.

Within the regulatory boundaries, pharmaceutical marketers may wish to increase the number of treatable symptoms to feature in their product‐claim DTCA in order to improve the effectiveness.

Within the regulatory boundaries, pharmaceutical marketers may wish to increase the number of treatable symptoms to feature in their product‐claim DTCA in order to improve the effectiveness.

This research builds on the extant literature of examining consumer perceptions of DTCA, and suggests a practical and metacognitive means to improve consumer perceptions to ultimately enhance DTCA effectiveness.

This paper aims to investigate older consumers' perceptions of the effects of direct‐to‐consumer advertising (DTCA), their views on the amount and type of information that should be provided, and their understanding of information typically contained.

Participants were 97 adult members of a social/education group, aged 55 to 87, who completed a questionnaire during the group's usual weekly meeting. There were four versions of the questionnaire; two types of medication (arthritis versus diabetes) and two ad formats (short versus long).

There was little difference between the versions in the accuracy of participants' recall of key pieces of information, suggesting that providing additional information may convey little additional benefit. Participants reported limited perceived benefits of DTCA, and expressed concern that DTCA may cause people to ask their doctor for inappropriate medicines, rely more on medicines to solve their health, and become more confused.

This study suggests that there is a need to consider consumers' perceptions of benefits and costs of DTCA when deciding whether to introduce it (e.g. in Australia) or remove it (e.g. New Zealand). Further, at least for older consumers, providing large quantities of information may increase cognitive demands without producing additional benefits.

The majority of previous studies of DTCA have used either student samples (with manipulated salience of information) or general population surveys. This study utilised a sample of older adults, including 55 per cent with arthritis and 13 per cent with diabetes. Further, as this study used US ads with an Australian population, one can be confident that participants' knowledge of the medications was purely from the ads read and not from previous exposure.