Direct-to-consumer advertising of pharmaceuticals: developed countries experiences and Turkey

While several major problems concerning drugs occur in the world, the attempts to direct-to-consumer advertising (DTCA) has gained a considerable impetus lately in both developed and developing countries. DTCA has increasingly become an appealing advertising alternative for the pharmaceutical industry as drug companies have come to wrestle with such problems as the expansion of the drug market; the decline of the medical representatives' work efficiency; drug reimbursement restrictions; and the escalating role of the Internet in the consumer market. Some of the main disadvantages of the DTCA are: increasing drug expenditures, unnecessary drug consumption and adverse effect risks. Even though the influence of pharmaceuticals on health services and the economy hold the same importance in the developed and developing countries, its negative consequences have increased by encompassing developing countries in its grip. Therefore, in this review, using Turkey as an example, the situation of direct-to-consumer advertisements in developing countries is analysed in relation with developed countries.     

某市社区门诊患者对基本药物认知和用药行为变化的短期效果评价

[目的]分析某市社区卫生服务机构开展零差率基本药物政策后对门诊患者的影响,评价政策的短期效果。[方法]采用自行设计的《社区门诊患者对零差率基本药物认知和用药行为的调查表》,分别于2010年和2012年抽取北方某特大城市部分社区卫生服务中心的门诊患者进行问卷调查,进行前后对照分析。[结果]调查结果显示,患者对基本药物的知晓率没有明显提升,仍处于较低水平;患者对零差率基本药物的价格满意度下降;对药品种类的满意度与两年前相比没有差异;但对零差率基本药物政策总体持积极态度的患者占比明显下降。[结论]患者对基本药物政策知晓度不高,应加大宣传力度,扩宽宣传渠道,重点是发挥社区医生和街道的作用;从药品生产、流通、配送和使用的全流程着手,削弱各个环节所带来的成本提高和费用增加;提高社区医疗机构的诊疗水平和服务水平,做到基本医疗和公共卫生同步发展,从而保障基本药物政策在基层的可持续发展。     

Food advertising in the age of obesity: content analysis of food advertising on general market and african american television

OBJECTIVE: To document the types of foods advertised and weight-related nutritional claims made during advertisements appearing on general market and African American television programming. DESIGN: Content analysis of 553 food advertisements appearing during 101.5 prime-time television hours. OUTCOME MEASURES: Advertisements were classified according to general category (fast-food restaurant, sit-down restaurant, packaged food), specific food type, and the presence of a weight-related nutritional claim. ANALYSIS: The type of foods advertised and nutritional claims made on general market and African American programs were compared using t and chi-squared tests. RESULTS: More food advertisements appeared during African American programs than general market programs. These advertisements were more likely to be for fast food, candy, soda, or meat and less likely to be for cereals, grains and pasta, fruits and vegetables, dessert, or alcohol. Of all of the food advertisements, 14.9% made a weight-related nutritional claim. More claims related to fat content appeared during African American programming, whereas more light and lean claims appeared in general market advertisements. CONCLUSIONS AND IMPLICATIONS: Practitioners and policy makers should be aware of the prevalence of food advertisements and their potential impact on knowledge and behavior and should consider working more closely with food manufacturers to encourage the creation and promotion of weight-friendly foods. Meanwhile, nutrition educators can help by teaching consumers critical thinking skills as may relate to food advertisements.     

基于中美日新药上市现状对比的抗肿瘤新药发展策略研究

目的:以中国、美国及日本的新药上市情况为依据,总结我国当前抗肿瘤新药的发展现状及问题,对今后我国抗肿瘤药的创新研发及审评审批政策的完善提出建议。方法:梳理中国、美国、日本对"新药"概念的界定,基于2019年各国新药上市数据,对上市新药的类别、原研企业进行比较,并对上市抗肿瘤药的适应证、原研企业、时效性等进行对比分析。结果:我国药品研发能力显著提升,但国际影响力仍有待增强;2019年我国新药上市数量超越了美国和日本,但在上市抗肿瘤药的时效性上仍有较大差距;我国对药品创新研发的扶持力度有待加强。结论:我国需要从抗肿瘤新药研发的全流程视角进行政策支持和引导,激励企业增加研发投入力度,完善药品审评审批制度,实现抗肿瘤新药的患者可及和持续创新发展。     

基本药物制度认知及利用情况分析

目的了解医患双方对基本药物制度的认知、利用,分析其影响因素。方法采用自主设计的基本药物制度问卷,随机调查医患双方对基本药物制度的认知和基本药物制度实施现状。结果医患双方对基本药物制度推行总体持正面态度,但是对基本药物制度的内涵理解存在偏差,对目前实施效果满意度不佳,对未来的信心不足,看病就医过程的利用度偏低。调查显示,目前基本药物制度本身存在缺陷,影响了基本药物制度发挥应有的作用,其中：药品种类、数量不足,疗效不够,宣传不到位是影响基本药物制度全面推广的主要原因,在决定是否使用基本药物的过程中,医务人员起关键作用。结论我国基本药物制初步建立,但存在不足,需要加强宣传、进一步完善制度。     

Dynamic effects among patients' treatment needs, beliefs, and utilization: a prospective study of adolescents in drug treatment

OBJECTIVE: To document the prospective, reciprocal relationships among substance use problems, utilization of drug treatment, and predisposing beliefs thought to increase treatment utilization. DATA SOURCE: Persistent Effects of Treatment Study-Adolescent (PETS-A), conducted by the Center on Substance Abuse Treatment. This was a longitudinal study of youths originally participating in one of two CSAT studies; one sample included 476 youths receiving residential drug treatment, and the other included 519 youths receiving outpatient treatment. STUDY DESIGN: This study uses five waves of data collected over a 12-month period to examine the temporal relationships among four variables: treatment dose, substance use problems, drug resistance self-efficacy, and perceived need for treatment (PNT). Data from this longitudinal study were analyzed using cross-lagged panel models, and structural equation modeling techniques were used to estimate the prospective, reciprocal relationships among these four variables in each of the two samples, while controlling for several covariates. PRINCIPAL FINDINGS: Both PNT and low drug resistance self-efficacy led to higher levels of subsequent treatment. However, low self-efficacy presaged increases in drug problems while PNT predicted decreases. CONCLUSIONS: Understanding the role of psychological variables in the utilization of health services is complicated for psychological disorders because beliefs that affect treatment can also influence the disorder itself. Efforts to keep adolescents in drug treatment should focus on convincing youth that treatment can help them with their problems, rather than convincing them that they cannot resist drugs on their own. While both messages increase treatment utilization, the latter belief undermines the effects of treatment.     

影视公益广告在健康教育中的应用研究

目的了解国内外影视公益广告在健康教育领域中的应用现况,为今后在健康教育中应用影视类公益广告提供参考和建议。方法利用内容分析法对中国公益广告网中全部的健康类影视公益广告进行类目编码,利用2种检验对国内外影视公益广告各类目情况进行比较。结果119则样本中所涉及的健康主题总共有34种,分为日常保健类19则（55．9％）、慢性非传染病类9则（26．5％）、传染病类6则（17．6％）。其中中国制作发行40则（33．6％）;国外制作发行79则（66．4％）。时长主要集中在30s（48则,占30．2％）。国内外在运用影视类公益广告进行健康教育的方法中,在表现主体（）（2=14．184,P=0．001）、表达方式（X。=4．854,P=0．028）、表现手法（X2=12．368,P=0．030）、情感诉求（X2=4．732,P=0．030）和感性诉求（）（2=9．446,P=0．009）方面均有显著性差异。结论影视公益广告策略在健康传播中的应用空间很大,可以借鉴国外成熟的公益广告创作模式,综合考量艺术和科学的结合,进行更加科学、生动和细致的健康传播。     

注意缺陷多动障碍儿童药物治疗观察和停药原因分析

[目的]了解注意缺陷多动障碍(attention deficit-hyperactivity disorder,ADHD)患儿的药物治疗及部分患儿自行停药的原因. [方法]采用门诊登记统计和建病历随访,于2005年7月～2006年12月期间符合DSM-Ⅳ诊断标准的全部首次就诊ADHD儿童.疗效评定主要根据临床症状描述. [结果]门诊一年半首诊ADHD患儿共613人,接受药物治疗的共280人,其中190人采用中枢兴奋剂(哌甲酯)治疗.追访在哌甲酯治疗有效者中有25.8%因担心长期用药会影响生长发育以及一些症状较轻的儿童选择停药,还有6.8%认为治愈停药,家长认为治疗效果不满意停药者仅占6.3%. [结论]中枢兴奋剂治疗对改善ADHD核心症状确有明显疗效,家长担心副作用发生以及患儿症状轻是导致停药的主要原因.     

Management of clandestine drug laboratories: need for evidence-based environmental health policies

Clandestine drug laboratories (CDLs) have been emerging and increasing as a public health problem in Australia, with methamphetamine being the dominant illegally manufactured drug. However, management and remediation of contaminated properties are still limited in terms of regulation and direction, especially in relation to public and environmental health practice. Therefore, this review provides an update on the hazards and health effects associated with CDLs, with a specific look at the management of these labs from an Australian perspective. Particularly, the paper attempts to describe the policy landscape for management of CDLs, and identifies current gaps and how further research may be utilised to advance understanding and management of CDLs and inform public health policies. The paper highlights a significant lack of evidence-based policies and guidelines to guide regulatory authority including environmental health officers in Australia. Only recently, the national Clandestine Drug Laboratory Guidelines were developed to assist relevant authority and specialists manage and carry out investigations and remediation of contaminated sites. However, only three states have developed state-based guidelines, some of which are inadequate to meet environmental health requirements. The review recommends well-needed inter-sectoral collaborations and further research to provide an evidence base for the development of robust policies and standard operating procedures for safe and effective environmental health management and remediation of CDLs.     

Attitude toward direct-to-consumer advertising and drug inquiry intention: the moderating role of perceived knowledge

This study examined how consumers' general attitude toward direct-to-consumer advertising (DTCA) influenced their drug inquiry intent, and whether the relationship between attitude toward DTCA and drug inquiry intent was moderated by their perceived knowledge of health and medicine. Results showed that those with favorable views of DTCA were more likely to inquire and request an advertised drug they saw. The effect was greater in magnitude for consumers with high perceived knowledge in health and medicine, however, than for those with low perceived knowledge.     

Advertising expenditures in the nursing home sector: evaluating the need for and purpose of advertising

Marketing and advertising activities in the nursing home sector have increased in recent years, following the example of hospitals and health systems. The reasons for this trend may be related to the growth in competition but are not clearly identified yet. Theoretically, advertising becomes necessary to gain an advantage over the competition. The purpose of this study was to identify the reasons for the variation in advertising expenditures among nursing homes in Texas. For this study, we merged 2003 data from the Texas Medicaid Nursing Facility Cost Report, the Texas Nursing Home Quality Reporting System, and the Area Resource File for Texas. Using the Herfindahl-Hirschman Index, we then examined the correlations between advertising expenses and the level of market concentration. We evaluated the association between advertising expenditures and market competition using two logistic and four linear regression models. Total advertising expenses in Texas nursing homes ranged from $0 to $165,000 per year. Higher advertising expenditures were associated with larger facilities, higher occupancy, and high Medicare census. Market competition, however, was not a significant predictor of such expenses. Advertising seems to be more resource-driven than market-driven. Therefore, some advertising expenditures may be unnecessary, may lack impact, and may even be wasteful. Reducing unnecessary advertising costs could free up resources, which may be allocated to necessary resident care activities.     

Burgers and basketball: Race and stereotypes in food and beverage advertising aimed at children in the US

The heightened risk of obesity in African American children and research linking exposure to food/beverage advertising to children's weight status led investigators to assess the race of characters featured in a sample of food/beverage commercials aimed at children. Findings show that African American characters are significantly more likely to be featured in commercials for sandwiches (hamburgers/tacos/wraps) and soft drinks than are White characters. African American characters are also significantly less likely to be shown eating at home and more likely to be shown eating in fast food restaurants. Depictions of physical activity align with conventional racial stereotypes. Implications regarding protections for vulnerable consumers against marketing seeming to target them with unhealthy products are discussed.     

Analysis of advertising in the multimedia environment of children and adolescents in Peru

I examined advertising of healthy and unhealthy food and beverage products across television, Facebook, outdoors, and bodegas. I used content analysis to describe the types of advertised food products, the persuasive techniques of the advertisements of these products, and the portrayals of eating behaviors on food advertising. Findings revealed that food promotion was more prominent in point-of-purchase advertising and less on television. The three most common advertised products were sweets, sugary drinks, and fast-food restaurants, and the persuasive techniques most commonly associated with food and beverage advertisements were appeals to the flavor/taste/smell/texture, nutritional quality, competitive/unique, and newness of the product; only one emotional appeal stood out in one medium: family bonding was frequent on television. This study is one of the few that have collectively surveyed food advertising that children and adolescents are likely to find in their multimedia environment.