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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.

The purpose of this paper is to evaluate the differential effects of help-seeking and product-claim direct-to-consumer advertising (DTCA) on consumers’ attitude toward the ad, intention to seek information and intention to see a doctor. This paper also seeks to examine the underlying mechanism of these effects and the moderating role of advertising literacy.

An online experiment was conducted with 130 adults who experienced narcolepsy symptoms and experimental stimuli promoting a fictitious drug for narcolepsy.

Help-seeking DTCA generated lower persuasion knowledge activation than product-claim DTCA, resulting in lower skepticism, more favorable attitude toward the ad and higher behavioral intentions. The effects of ad type were stronger among consumers with higher advertising literacy.

This is the first study that provides a thorough examination of the underlying mechanism of the differential effects of help-seeking vs product-claim DTCA as well as the roles of consumers’ advertising literacy on ad outcomes.

The purpose of this paper is to study two major research objectives. The first objective is to investigate the effect of direct‐to‐consumer advertising (DTCA) on market share in the pharmaceutical drugs industry by modeling advertising decision of the firm as an endogenous decision. The second objective is to examine and determine whether there is any empirical support for the argument advanced by medical insurers and providers that DTCA advertising encourages brand switching.

Data on sales, price, DTCA, direct‐to‐physician advertising (DTPA), and average cost of consumption per usage for three prescription (Rx) drugs categories was obtained for the period, January 1998 to December 1999. A simultaneous model of market share and DTCA is proposed. Market share is modeled as a function of DTCA, price, the intensity of competition as represented by the number of competitive brands, and DTPA. DTCA is modeled as a function of its lagged market share (with the optimal number of lags to be determined empirically), and the average cost per consumption usage.

This paper finds that there is a positive and significant effect of DTCA on market share when advertising decision is modeled as an endogenous decision. The empirical results suggest brand switching by consumers. There is, thus, some evidentiary support for the argument made by the insurance providers.

This paper is unique for two reasons. First, the paper estimates the effects of DTCA in a simultaneous model accounting for endogenous decision by the firm. Therefore, the estimates are unbiased and robust. Second, the paper investigates the important public policy question of the social welfare of DTCA.

Direct‐to‐consumer advertising (DTCA) is a pervasive element in society today. Consumers have responded accordingly by becoming more knowledgeable, developing specific perceptions and attitudes toward DTCA. The purpose of this article is to examine direct‐to‐consumer prescription drug advertising issues among younger adults as both consumers and caregivers to determine whether companies are, or should be, taking advantage of building brand value through DTCA.

A sample of 225 young adults answered questionnaires to measure the effects of DTCA. The questionnaire was based on a study by the National Consumers League and only the items that were most central to the current study were utilized and/or modified to measure the following key variables: age; current health status; prescription drug use; attitudes toward DTCA; interest in DTCA; DTCA recall; and inclination to seek additional information.

The findings show that demographics influence attitudes and interest in DTCA, as well as younger consumers' interest and propensity to seek additional information for themselves and family members. Details of the statistical analysis of the study are given.

The implications of the findings for pharmaceutical marketers, health care advisors, and academic researchers are discussed in the paper.

The purpose of this paper is to review the issues regarding direct‐to‐consumer advertising that have been identified in the literature from the perspective of consumers, consumer groups, physicians, the medical profession and the pharmaceutical industry.

Literature from international sources was reviewed to identify themes relating to direct‐to‐consumer advertising.

Direct‐to‐consumer advertising is expressly permitted in only two developed countries (USA and New Zealand). All other countries place various limitations on the practice. The debate surrounds whether or not the advertising provides a public health benefit.

The debate over direct‐to‐consumer advertising continues in jurisdictions around the world. This paper identifies and summarizes the issues that are being considered.

This study has four objectives. First is to investigate and compare the immediate and carryover effects of four pharmaceutical marketing tools (prescriber detailing, medical events, journal ads and direct-to-consumer advertising [DTCA]) on sales. Based on the effect comparisons, the second objective is to determine whether advertising tools that are more compatible with prescriber’s behavior have superior impact on sales. Third is to examine empirical support for the argument that advertising directly to consumers, as a market follower versus leader, has a backfiring effect. Finally, this paper aims to assess the magnitude of variance in sales as a function of each advertising tool.

Data on unit sales and spending (on DTCA, journal ads, events and detailing) ranging 84 months are obtained for six prescription-only cholesterol-reducing brands. First, linearity is checked. Second, evolution versus stationarity is tested by applying the unit-root test. Third, potential endogeneity among variables is assessed with granger causality. Fourth, vector autoregressive model (VAR) that accounts for endogeneity and dynamic interactions is specified. Intercept, seasons and market share are added into the model specification as exogenous variables. Fifth, VAR with akaike selected lags and generalized impulse response are conducted. Finally, sales variance is decomposed with forecast error variance decomposition and Cholesky ordering.

A 10% increase on detailing or journal ads spending brought an immediate (one month) negative effect on sales in a market leader, whereas that same increase is insignificant in a market follower. A 10% increase on DTCA (vs detailing) spending led to a negative (vs positive) carryover effect for the market follower, giving empirical support to the backfiring effect of DTCA and partial evidentiary support suggested about prescriber friendly advertising. However, DTCA induces a larger short term and longer carryover effect in a market leader, with seven times more effect on sales than what detailing does. In addition, it explains 50% of the variation in sales.

The model applied captures extensive dynamics; hence, findings are robust. The analysis considered comparison in terms of prescriber friendly (vs not) advertising tools and brand market status and thus can make managers rethink strategy of advertising budget allocations. This study also introduced a new look onto DTCA and hence challenges the traditional thought held on consumer advertising response.

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.

This article seeks to examine attitudes about direct‐to‐consumer advertising (DTCA) of prescription drugs to final users (referred to as consumers in this paper).

A national telephone survey was carried out of 300 consumers that had seen a doctor in the last six months.

Consumer awareness of DTCA continues at a very high level (96 percent) among the adult consumer population. However, the majority of consumers (53 percent) disagreed somewhat or strongly with the statement “I like seeing advertisements directed to consumers for prescription drugs.” The majority of consumers (69 percent) agree strongly or somewhat that DTCA does not provide adequate information on the risks and benefits of advertised products. It appears that the use of DTCA by pharmaceutical companies is not stimulating nearly the information‐gathering response reported in past studies.

Small sample size makes this survey exploratory.

This negativism may impair the usefulness of this type of advertising in the future. As television, magazine, radio, and other traditional media become less important, the internet may become an important channel for the growth of DTCA. Given the growing negativism of consumers, it is clear that significant changes in DTCA practices are necessary. Without significant changes, DTCA may become impractical or even prohibited.

The article adds to longitudinal data on consumer attitudes towards DTCA. It is hoped that this study will suggest areas for subsequent research and will elaborate on the practical consequences of DTCA and its implications for public health and welfare.

This study aims to examine the effects of different types of endorsers (expert vs consumer vs celebrity) in testimonial vs non-testimonial message contexts on consumers’ responses toward direct-to-consumer advertising (DTCA).

An online experiment was conducted with a 3 (endorser type: expert vs consumer vs celebrity) × 2 (message type: testimonial vs non-testimonial) plus control group (no endorser, no testimonial) factorial design to assess the various dependent variables.

Perceived source credibility and similarity was significantly different across the endorser types, and the expert endorser (i.e. a doctor) generated the highest mean level of source credibility, while consumer endorsers generate the highest mean source similarity. The interaction of endorser type and message type significantly impacted ad believability and skepticism. Specifically, the endorser type factor had a significant impact on the dependent variables only in the testimonial ad condition, but not in the non-testimonial ad condition. The effects were mediated by source credibility.

While the focused results show celebrities may not be the strongest choice to endorse when using testimonials, the overall lack of main effect of testimonials lends to the possibility of a plateauing of effects with the various appeals used in DTC ads. DTCA has now been around for over 20 years, and this study lends to the possibility consumers are becoming unaffected by the various appeals used by pharmaceutical manufactures and only respond when a multitude of personally relevant factors are in place.

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.