Let’s not wait for Kim Kardashian to teach us about digital advertising of prescription drugs

We shouldn’t blame Kim Kardashian for the little snafu regarding her recent Instagram promotion of Diclegis, a drug that is intended to alleviate the symptoms of extreme morning sickness. After all, isn’t it a bit much to expect Kardashian to abide by the rules of the FDA regarding what an advertiser must include in any promotional material regarding prescription drugs? She made an error that the FDA did not think was minor when she posted her promotional comment for the morning sickness drug by not including the major contraindication along with the potential benefits of the drug. Oh, and she did forget to mention she was a paid spokesperson for the brand.

And, while the drug company is (and should be) being held accountable by the FDA, it’s also important to point out the rules regarding promoting prescription drugs on social media are not all that clear.

the rules regarding promoting prescription drugs on social media are not all that clear

The FDA requires that any direct to consumer drug promotion not only include the benefit of the drug, but also the risks. Balancing the two becomes, as you can quite imagine, difficult when it comes to social media, especially those that limit the length of their content, like Twitter. A promotion for a drug on Twitter would have to go something like this example taken from a draft of the FDA’s guidelines for dealing with new media:

NoFocus for mild to moderate memory loss; may cause seizures in patients with a seizure disorder www.nofocus.com/risk [117/140]

Notice in this example that in addition to naming the drug and what it may be used for, there is a risk message, as well as a website where consumers can obtain additional information. Kardashian did not include the risk message in her Instagram post. And, there was no clear indication she was a paid spokesperson for the company. Having said that, it is the drug’s manufacturer that is in hot water with the FDA. And, while Kardashian took down her post, the manufacturer’s reputation has been sullied, the long-term effects of which are unknown. But that can’t be a good thing when it comes to marketing prescription drugs: awareness may go up, but reputation goes down.

While expenditures for direct to consumer prescription drug advertising actually declined between 2005 and 2009, one category of expenditure is up significantly — digital DTCA. According to a recent study, expenditures for digital advertising of prescription drugs, or eDTCA as it is referred to, have risen 109%. It makes sense for marketers to shift their expenditures to digital media as a Pew Internet Research study determined that the majority of Americans turn to digital media to search for health information.

The main problem with eDTCA is a lack of clarity regarding what weight should be put on the benefits and the risks of a prescription drug promotion. In other words, regulation has not kept up with the growth of this form of prescription drug advertising. And, I think it is perhaps only because of Kim Kardashian’s extraordinary popularity that this particular instance caught the eye of someone at the FDA.

It is interesting to note that direct to consumer prescription drug advertising is legal in two countries: the United States and New Zealand (pop. 4.4million). As eDTCA proliferates, the implications are not only domestic, as the Internet can reach far and wide, as consumers all over the world can access health information that may not be legal in their country.

Among the problems I see is that Kardashian’s appeal is to a relatively young crowd. And, there has been a tacit agreement among drug marketers to avoid promoting prescription drugs to those under 18 years of age. There is a well-known incident where President Obama remarked while watching a Super Bowl game that he and — at the time — his young daughters were being exposed to advertisements for Viagra.

I have written on Medium about what I refer to as ad creep. Ad creep is the tendency for drug marketers to reach for younger and younger audiences. Regulators cannot wait for someone of Kim Kardashian’s notoriety to bring momentary focus to eDTCA. The ways in which consumers obtain health information continue to change. Legacy media, like TV and print, are giving way to newer digital platforms. Consumers may be driving this shift by their media habits, but it is responsibility of manufacturers to self-police what they put out over the Internet, and it is the government’s responsibility to regulate that content. Waiting for Kim Kardashian to make us aware that the issue even exists is simply unacceptable.

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