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The unintended consequences of argument dilution in direct-to-consumer drug advertisements

Nature Human Behaviour volume 1, pages 797–802 (2017)Cite this article

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Abstract

Direct-to-consumer (DTC) advertising of pharmaceutical drugs is often cited as the culprit for inflated patient demand for advertised drugs. Further to this economic concern, we provide an evidence-based psychological account of another concern that warrants the re-examination of the merits of DTC advertising of prescription drugs. Across six experiments and a sample of 3,059 US participants, we find reliable evidence for the argument dilution effect. Specifically, when commercials list severe side effects along with those that are most frequent (which include both serious and minor side effects), as required by the Food and Drug Administration, it dilutes consumers’ judgements of the overall severity of the side effects, compared with when only the serious side effects are listed. Furthermore, consumers’ reduced judgement of severity leads to greater attraction to those drugs. In regulating pharmaceutical advertisements, the Food and Drug Administration appear to have paradoxically dampened consumers’ judgements of overall severity and risk, and increased the marketability of these drugs.

Unique to only the United States and New Zealand, direct-to-consumer (DTC) advertising of pharmaceutical drugs is an industry worth US$4.5 billion a year1. The Food and Drug Administration (FDA), in promoting the interests of consumers (and patients), regulated and provided guidelines to pharmaceutical companies for both print and media advertising. The nexus of these guidelines stipulated a fair balance between information on benefits and risk— the space and airtime allotted to side effects by print and broadcast media, respectively, needed to sufficiently inform consumers of the various side effects and precautions, in addition to the standard marketing of the drug’s benefits. The ubiquitous 60-second television commercial, where a significant portion of the last part of the advertisement is devoted to a laundry list of side effects, owes its impetus to the FDA regulations of 1997/19992 –4. Although the medical community, the general population and the media have expressed their annoyance and ridicule for these advertisements5 , 6, we contend that there exists a meaningful concern and downstream negative consequences of these regulated advertisements. Specifically, we contend that, despite the FDA’s good intentions to inform (vulnerable) consumers of the potential risk and side effects of pharmaceutical drugs, over the years these regulated advertisements might have produced the unintended outcome of dampening one’s assessment of the side effects and in the process further promoted the benefits and attractiveness of the drugs.

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Fig. 1: The interaction effect of the two audio conditions and participants’ recall of major side effects on the perception of the drug’s overall side-effect severity (n = 804).

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Acknowledgements

The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We thank N. Ramkumar for assistance with materials for Study 2a.

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  1. Department of Organisational Behaviour, London Business School, Regent’s Park, London, NW1 4SA, UK

    Niro Sivanathan & Hemant Kakkar

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  1. Niro Sivanathan
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Contributions

N.S. developed the research idea. N.S. and H.K. designed the experiments; H.K. analysed the data; and N.S. and H.K. wrote the paper.

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Correspondence to Niro Sivanathan.

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The ethics approval for this project was provided by London Business School as per the school’s guidelines. In line with ethical guidelines, all participants provided informed consent before taking part in the studies.

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The authors declare no competing interests.

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Supplementary Methods, Supplementary Table 1.

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Sivanathan, N., Kakkar, H. The unintended consequences of argument dilution in direct-to-consumer drug advertisements. Nat Hum Behav 1, 797–802 (2017). https://doi.org/10.1038/s41562-017-0223-1

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