Look, Puppies! A Visual Content Analysis of Required Risk Statements Embedded in Direct-to-Consumer Pharmaceutical Advertising

Abstract

Direct-to-consumer advertising (DTCA) on television is a prominent source of information about medical conditions and their potential treatments. In the United States, the Food and Drug Administration (FDA) requires that DTCA include a major statement presenting the medication’s most important risk information in a fair and balanced manner. However, there is growing concern about the visual content that accompanies this risk information within DTCA major statements. Specifically, the FDA has failed to provide guidance on how to measure DTCA’s adherence to the fair and balanced provision. This research introduces eight metrics organized into three categories to perform a visual content analysis of 230 existing DTCAs. Using these metrics, the authors test for differences in visual content between the major risk statement and the remaining portions of an ad. Our results indicate that the major risk statements of DTCAs feature more positive imagery, visually complex imagery, and motion than other portions of the ads. The authors discuss the implications of these findings for public policy makers, consumers, and marketers.

A “Clear and Conspicuous” Distraction: Coping with Incongruent Audiovisual Content in Direct-to-Consumer Advertisements

“…Figure 1 indicates a divergence between the visual-only condition and other two conditions in risk perceptions following the initiation of the major statement, and a relative convergence of all three groups at its conclusion. This finding is consistent with previous research (Avery, Eisenberg, and Simon 2012; Kaphingst et al 2004; King, Koppenhafer, and Madrigal 2021; Macias, Pashupati, and Lewis 2007) indicating that visual content delivered during the major statement is incongruent with auditory content.…”

“…For example, Kaphingst et al (2004) found that 91% of the DTCA included in their study featured positive or neutral visual imagery during the major risk statement (see also Avery, Eisenberg, and Simon 2012). Using a larger set of advertisements, King, Koppenhafer, and Madrigal (2021) recently reported that DTCA major statements feature significantly more positive imagery, complex imagery, and on-screen motion than non–major statement portions of the same ad.…”

“…be presented in "a clear, conspicuous, and neutral manner … without distraction from the content" (FDA 2010, p. 15382). Unfortunately, a common tactic used by pharmaceutical advertisers during the major statement is to present visual imagery (e.g., bucolic scenes, smiling faces) that is incongruent with the negative auditory risk information (Kaphingst et al 2004;King, Koppenhafer, and Madrigal 2021). 1 Incongruent audiovisual information violates a principle of effective communication because it creates a competition for processing resources (Basil 1994), thereby distracting consumers from what the message is attempting to convey (Russell et al 2017;Sullivan et al 2017).…”

“…The major statement must be presented in “a clear, conspicuous, and neutral manner … without distraction from the content” (FDA 2010, p. 15382). Unfortunately, a common tactic used by pharmaceutical advertisers during the major statement is to present visual imagery (e.g., bucolic scenes, smiling faces) that is incongruent with the negative auditory risk information (Kaphingst et al 2004; King, Koppenhafer, and Madrigal 2021). 1…”

Measuring the motivation to avoid duping: scale development and validation

“…Although deception may include instances in which a seller is taken advantage of by a buyer, our focus is on situations where the seller profits at the expense of the buyer. Duping examples are varied and include instances in which buyers fall prey to advertising created to mislead (Darke and Ritchie, 2007;Hastak and Mazis, 2011) or distract (King et al, 2021). Other contexts include the victimization of buyers by sellers of counterfeit goods (Mavlanova et al, 2008) and the use of online appeals disguised to fool consumers (Campbell and Grimm, 2019).…”