Nowadays more than 60% of Americans will be looking for a health-related information on the Internet according to surveys. It is hard to believe that pharmaceutical companies didn’t spend much money on social media direct-to-consumer advertising: about 350 million users have Twitter or Facebook accounts and pharmaceutical companies spent less than $150 million on social media (comparing with $4 billion spent on advertising in total).
However, the situation may be different next year and proportions will change. Since 1906, Food and Drug Administration has the control over medication labels. One of the goals of FDA is to make medications safe to the patients and decrease the misuse of medications. For these purposes, FDA requires pharmaceutical companies not only to tell about the advances of their product but also about risks. Risks and benefits should be in balance. So there is no way for the pharmaceutical company to make statements, where the risks are understated or benefits are overstated, because one way or another this may lead to some health-related consequences.
In 1985, the FDA developed a format for pharmaceutical companies to provide their customers with a brief summary of risks and revised the definition of adequate risk information in 1997. After the FDA established new standards, manufacturers had less risk when they have worked with broadcast media. Since 1997, broadcast media should provide consumers with a phone number of a web-site address, where they can get more information about medication, its adverse effects, use, dosages etc. After the “rules” were established, pharmaceutical companies spent more on direct advertising: $579 million in 1996, $1.3 billion (1998), about $4 billion were spent in the year 2008.
With the grow of social media and the Internet community, FDA had to discuss pharmaceutical promotion again in 2009. It was even more challenging to regulate the promotion in high dynamic space of social and other Internet media resources. Manufacturers used a simple rule for the websites, where a customer had to click only one time to be redirected to a page with the risks information. Still, FDA finds this method controversial, as the presentation of risks and the possibility to know more about the risks are not the same. So in spring 2009, 14 pharmaceutical companies received warning letters from FDA for using search engines to promote their medications without an obvious connection to a risk information.
But with the increase of possibilities for promotions, pharmaceutical companies have the higher risk to lose control over the content of their message. Even if they will create the website and moderate all the content, replies and information, there are a lot of website with independent comments. Another way for pharmaceutical companies to avoid FDA’s attention and warnings is to use the Internet community, different bloggers etc. This could help to decrease the negative claims about their medication or other products.
Lack of the FDA control
It’s easy to understand that FDA cannot control the promotion over the whole social media. So the FDA has two ways to resolve the new issue. The first way is to forbid pharmaceutical companies to promote their products in social media. But this approach could meet some legal issues. Another way is to create the new guideline for social media and internet marketing. In case, if the FDA will decide to implement new guidance, there are several aspects all health care providers and their patients should to consider and pay attention to. First of all, they should understand that pharmaceutical advertisement and messages will impact the health care in the whole and try to affect communication about their products in specific. In this case, they should understand if the article in the Internet or pharmaceutical company message are influencing their outcome and health care providers should be careful when they promote someone’s production without any additional risks research.
It’s hard to understand and find the financial interest of one or another company. Even if users will find an information about medication or another pharmaceutical production risks, it’s almost impossible to check if the source is credible and has no any interest. So financial disclosures should be the part of any article or any information in social media and be explicit for all of the health care professionals and their patients.
Another way to make information about pharmaceutical products credible is to make manufacturers responsible for maintaining its credibility. There were one of the suggestions for Food and Drugs Administration to implement “FDA seal of approval”. This means that FDA will review the sources and check if the information is credible and if all the risks are counted. Unfortunately, FDA simply doesn’t have resources to check all the information and pharmaceutical-related news and articles in social media.
Also, FDA could provide the link to approved information. Unlike FDA, manufacturers are in better position and have implemented mechanisms of recognition of information on the Internet, so it would be easier for them to keep the information credible. The idea of the approval seal is not unique. It was used by American Medical Association to approve medical advertisements in journals from the 1929 year. Till 1955, AMA was the strongest in filtering and regulating of medical promotions. Nowadays social media are far more complicated, but still, the responsibility for medical promotion should be on shoulders of regulators like FDA and manufacturers.