Concerns over the subtle nature of online pharmaceutical ads has prompted health community members to consider imposing new standards. Researchers from the University of Pennsylvania School of Medicine and the Leonard Davis Institute of Health Economics jointly published an article in The New England Journal of Medicine (NEJM) earlier this month discussing the issue.
Their main point of contention lies in customized ads targeting doctors with the use of data from electronic health records, social media and health-related apps. They are worried that these ads are not transparent enough to inform the doctor that they are sponsored content. Being unaware of the ad-based nature of the content could lead to doctors’ decisions being improperly influenced, the article alleges.
The Changing Face of Pharmaceutical Marketing
Traditionally, direct marketing from the pharmaceutical industry consists of meetings, luncheons and sponsored lectures by opinion leaders. In other cases, physicians are offered promotional materials, gifts or research grants as a way to smooth relations between the two groups.
While these methods still persist, the percentage of marketing spending has begun to shift towards digital mediums. The NEJM article states that currently 25 percent of pharmaceutical marketing budgets are dedicated to digital technologies.
What they found most disconcerting in this trend is the exposure to the advertisements has shifted closer to the point of care. Many of the ad locations occur directly in conjunction with sources that a physician would consult for care advice.
Electronic Health Records
Marketing companies have begun to use anonymized data from electronic health records to determine patterns within treatments of certain conditions. While most EHR products are not in the business of selling data to outside parties, some have their structured their entire business model around it.
Software like Practice Fusion is available for free to physicians, with the contingency that anonymized versions of records will be sold to third parties to generate revenue. Marketing firms eagerly purchase this information to offer insight on how physicians choose particular treatments.
Social Media and Apps
Physicians using social media also offer an opportunity for targeted advertising. Banner ads and games have been by marketing firms on social media sites to attract the attention of physicians and encourage the use of their products.
Smartphone and browser apps have also been used to gather data and create marketing pitches to physicians. Apps like Epocrates are used to look up information on aspects like recommended dosages, medication compatibilities and insurance coverage percentages.
Users’ searches are monitored in order to determine common queries and pathways of treatment. This data is later used to create finely-tuned ads for physicians, often taking the guise of professional advice. These ads can be displayed directly in conjunction with information aiding treatment decisions.
A Call for Change
Because the paper claims that pervasive marketing has been “associated with over-diagnosis, overtreatment and overuse of brand-name medications,” the authors recommend a change in policy. Their suggested approach is three pronged:
- Greater transparency with EMR, social media sites and apps about what data is being gathered and how it is utilized
- Caution by the medical community in venues where they could be exposed to ads to prevent their decisions being inappropriately influenced
- Oversight by professional societies to prevent the intrusion of marketing tools into patient visits or moments of care decisions
With these three changes, the authors hope that medicine and marketing can both evolve into the digital age with less ethical problems.