Purpose: Starting in 1997, concurrent with a growing emphasis on patient participation in medical decision-making, the US has witnessed an explosion of direct-to-consumer prescription pharmaceutical advertising (DTCA) on television. Proponents argue that ads are creating more informed consumers who can play an active role in healthcare decision-making. While prior work has examined the content of print ads, to date there are no published studies examining persuasive themes used in television ads.

Methods: Primetime television programming (7-11pm) on four network channels (ABC, CBS, Fox, NBC) was recorded for a period of one month, resulting in 38 unique prescription drug ads. Ads were coded by two independent coders for factual information about the target condition provided and narrative themes related to portrayals of medication use and non-pharmacological alternatives. Interrater reliability (Kappa) for coding categories ranged from .76 to .92.

Results: The majority of ads (73.7%) provided some basic factual information about target conditions (e.g., symptoms). Relatively few ads provided information about causes and risk factors (26.3%) or identified specific subpopulations more likely to have the condition (7.9%). Medication use was frequently portrayed using themes of control. Characters were shown having lost control (50.0%) over biological processes or their ability to function socially or vocationally prior to taking medication. In turn, advertised products were frequently shown as permitting complete regaining of control (78.9%). Many ads (76.3%) suggested that taking medications is socially approved or common. Products were often (47.4%) portrayed as representing a breakthrough in medical science. No ads explicitly mentioned non-pharmacological options as an alternative to using prescription drugs. A substantial number of ads (60.5%) suggested that taking products is what enables a lifestyle filled with healthy and recreational activities.

Conclusions: This content analysis finds that few ads explicitly define their target populations. Ads frequently suggest to consumers that taking drugs is a way to control health problems that is socially approved. Products are often portrayed as breakthroughs that enable a desirable lifestyle. A recent estimate suggests the average American television viewer sees more than 30 hours of DTCA per year. More research is needed to determine how DTCA themes influence consumer expectations of pharmaceuticals and healthcare services, more generally.