, Volume 28, Issue 5, pp 429–438 | Cite as

Economic Content in Medical Journal Advertisements for Medical Devices and Prescription Drugs

  • D. Clay Ackerly
  • Seth W. Glickman
  • Kevin A. Schulman
Original Researh Article


Background: Previous studies of economic content in medical journal advertisements have not examined all types of economic content and have not included advertisements for medical devices.

Objective: To examine trends in the economic content of medical device and pharmaceutical advertisements in medical journals.

Methods: Three reviewers examined pharmaceutical and medical device advertisements in six leading medical journals from 1997 through 2006. Product characteristics, economic claims and evidence to support those claims were evaluated.

Results: Economic content appeared in 23.5%(561/2389) of pharmaceutical and device advertisements; 11.9% made market share claims and 12.7% made other economic claims. From 1997 through 2006, the percentage of medical device advertisements containing economic content declined from 26.7% to 6.7% (p = 0.02), whereas the percentage of pharmaceutical advertisements containing economic content remained stable (21.6–22.0%; p= 0.99). For pharmaceuticals, price claims declined significantly (15.7-4.2%; p< 0.01) and market share claims increased (2.8–11.5%; p= 0.09), and both consistently presented evidence (83% and 98%, respectively) while other types did not (e.g. 13.5%of formulary claims). Medical device economic claims differed from pharmaceutical economic claims; they made fewer market share claims (1.1% vs 12.8%) but more cost-effectiveness (6.5%vs 0.6%) and reimbursement (4.9% vs 0.8%) claims. Fewer than 2%of device advertisements with economic claims provided supporting evidence.

Conclusion: The prevalence and type of economic content in pharmaceutical and device advertisements changed between 1997 and 2006, which may reflect evolving market dynamics, such as changes in reimbursement systems. Furthermore, the lack of supporting evidence in medical device advertisements and pharmaceutical formulary claims are potential areas of concern that require additional scrutiny by regulators and journal editors.


Medical Device Federal Trade Commission Average Wholesale Price General Medical Journal Specialty Journal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Katina Robertson, Robert Hollowell and John Rhyner of Duke University for excellent research support and Damon Seils of Duke University for assistance with manuscript preparation.

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

Dr Schulman has made available online a detailed listing of financial disclosures (

Supplementary material

40273_2012_28050429_MOESM1_ESM.pdf (77 kb)
Supplementary material, approximately 79 KB.


  1. 1.
    The White House. Executive order: promoting quality and efficient health care in federal government administered or sponsored health care programs. 2006 Aug 22 [online]. Available from URL: [Accessed 2008 Jun 10]Google Scholar
  2. 2.
    Pham HH, Alexander GC, O’Malley AS. Physician consideration of patients out-of-pocket costs in making common clinical decisions. Arch Intern Med 2007; 167: 663–8PubMedCrossRefGoogle Scholar
  3. 3.
    Allan GM, Lexchin J, Wiebe N. Physician awareness of drug cost: a systematic review. PLo S Med 2007; 4: e283CrossRefGoogle Scholar
  4. 4.
    Neumann PJ, Zivin Bambauer K, Ramakrishnan V, et al. Economic messages in prescription drug advertisements in medical journals. Med Care 2002; 40: 840–5PubMedCrossRefGoogle Scholar
  5. 5.
    Palmer JA, Timm AR, Neumann PJ. Drug company advertising in medical journals about the health-economic advantages of their products for 2000-2006 versus 1990- 1999. J Manag Care Pharm 2008; 14: 749–55PubMedGoogle Scholar
  6. 6.
    Kaiser Family Foundation. Prescription drug trends: May 2007 [online]. Available from URL: [Accessed 2008 Jun 5]
  7. 7.
    Healthcare consumerism: trends in consumer cost-sharing [discussion document; online]. Available from URL: [Accessed 2008 Jun 16]
  8. 8.
    Pammolli F, Riccaboni M, Oglialoro C, et al. Medical devices competitiveness and impact on public health expenditure: study prepared for the Directorate Enterprise of the European Commission. July 2005 [online]. Available from URL: [Accessed 2008 Nov 8]Google Scholar
  9. 9.
    Pietzsch JB, Aquino LM, Yock PG, et al. Review of US medical device regulation. J Med Devices 2007; 1: 283–92CrossRefGoogle Scholar
  10. 10.
    US Food and Drug Administration. Frequently asked questions: reminder advertisements and labeling [online]. Available from URL: [Accessed 2008 Nov 8]
  11. 11.
    Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–74PubMedCrossRefGoogle Scholar
  12. 12.
    Thompson Healthcare. AWP policy (revised 2004 Feb 17) [online]. Available from URL: [Accessed 2008 Nov 8]
  13. 13.
    Pauly MV, Burns LR. Price transparency for medical devices. Health Aff (Millwood) 2008; 27: 1544–53CrossRefGoogle Scholar
  14. 14.
    Donawa M. US regulation of advertising and promotional materials. Med Device Technol 2006; 17: 26–8Google Scholar
  15. 15.
    Gencarelli DM. Average wholesale price for prescription drugs: is there a more appropriate pricing mechanism? National Health Policy Forum Brief 2002 Jun 7; 775 [online]. Available from URL: [Accessed 15 Nov 2009]Google Scholar
  16. 16.
    Scanlon WJ. Medicare Part B. Drugs: program payments should reflect market prices. 2001 Sep 21 [online]. Available from URL: [Accessed 2008 Nov 8]Google Scholar
  17. 17.
    Gold Standard Pricing Policies [online]. Available from URL: [Accessed 2010 Feb 6]
  18. 18.
    Lagoe R, Aspling DL, Westert GP. Current and future developments in managed care in the United States and implications for Europe. Health Res Policy Syst 2005; 3 (1): 4PubMedCrossRefGoogle Scholar
  19. 19.
    Huskamp HA, Deverka PA, Epstein AM, et al. The effect of incentive-based formularies on prescription-drug utilization and spending. N Engl J Med 2003; 349: 2224–32PubMedCrossRefGoogle Scholar
  20. 20.
    Chernew M, Cowen ME, Kirking DM, et al. Pharmaceutical cost growth under capitation: a case study. Health Aff (Millwood) 2000; 19: 266–76CrossRefGoogle Scholar
  21. 21.
    Alexander GC, Casalino LP, Meltzer DO. Patient-physician communication about out-of-pocket costs. JAMA 2003; 290: 953–8PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • D. Clay Ackerly
    • 1
  • Seth W. Glickman
    • 1
    • 2
  • Kevin A. Schulman
    • 1
    • 3
  1. 1.Center for Clinical and Genetic Economics, Duke Clinical Research InstituteDuke University School of MedicineDurhamUSA
  2. 2.Department of Emergency MedicineUniversity of North Carolina School of MedicineChapel HillUSA
  3. 3.Department of MedicineDuke University School of MedicineDurhamUSA

Personalised recommendations