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Introduction: Drug advertisements in medical journals are an important tool to inform physicians regarding drug usage. Ethical criteria for drug promotion were laid down by WHO in 1988.
Aims and Objectives: The present study was planned to assess the accuracy of drug advertisements published in Indian medical journals from different specialties.
Material and Methods: We studied 882 drug advertisements published in different indexed medical journals from various specialties during January 2008 to December 2010. Advertisements for Laboratory equipments were excluded. Advertisements were independently categorized into different groups of specialties. Information content of the drug advertisements were analysed.
Statistical analysis: In this representative survey we found more than 70 % advertisements were not mentioning drug storage instructions and warning major interactions. We also found that more than 50 % advertisements did not include information regarding side effects, precautions taken during drug usage. Regarding information to pharmacological data was found in less than 1 % advertisements.
Conclusion and Results: Our analysis indicated that the drug advertisements published in various Indian medical journals provide less information related to vital aspects about drug.
Keywords: Drug advertisements, Indian Journals, World health organization, FDA.
Key Messages: Accuracy of drug advertisements in Indian journals, ethical criteria for drug advertisements in Indian journals, Status of drug advertisements in Indian journals .
The pharmaceutical industry whose primary aim is to maximize the profit attempts to generate more prescriptions of its products by means of advertisements in various medical journals (1).Ethical criteria for drug advertisements should lay the foundation for proper behavior concerning the production of drugs consistent with the search for truthfulness and righteousness.(2) Drug advertisements have important effect in prescribing habits of physicians.(3) Is the information content in the drug advertisements published in India really ethical? The present study was planned to analyse the content information of drug advertisements in various Indian medical journals.
Our aim was to analyse the content information of drug advertisements in various medical journals in India. Our objective was to find the usefulness of these advertisements for general practioners as well as for medical students.
Material & Methods:
In this study we screened a total of 882 drug advertisements from pharmaceutical companies appearing in different specialities journals from January 2008 to December 2010. (Table no.1) Recent three years Indexed journals were selected from different specialties. Advertisements for laboratory equipment were excluded. Only new drug advertisements were included while reminder/repeat advertisements were excluded in the present study. Advertisements were categorized according to specialties.(Table.no.2 ) The information content was collected using the format of drug information sheets suggested by the WHOââ‚¬Â²s ethical criteria for medical drug promotion, (1988) Geneva.(2) The percentage of advertisements providing information content about each aspect was worked out & tabulated. (Table no.3 & 4)
Table no. 1) List of journals evaluated.
Indian journal of Tuberculosis.
Indian journal of Ophthalmology
Indian heart journal
Indian journal of cancer
Indian journal of surgery
Indian journal of practical pediatrics
Journal of Indian academy of pediatrics
Journal of anesthesiology
Journal of association of physicians of India
Indian medical gazette
Indian journal of pharmacology.
Table no. 2 ) Distribution of advertisements according to different specialties :
Specialty of drug advertisement
Total no. of advertisements
Ear ââ‚¬"Nose- Throat
Table no.3 ) Analysis of information contents :
Total advertisements which included the content.
Name of pharma. Company
Use of graphics
Use of Models
Table no. 4) Pharmacological Data :
Total advertisements included the information
Mechanism of action
We found that Brand name, Generic name, use of drug, name & contact information of related pharmaceutical companies were mentioned in more than 70% advertisements. However therapeutic uses, side effects, contraindications were not mentioned in more than 50 % advertisements. Color advertisements were found (65.75%) more in numbers than B/W advertisements (34.24 % ) .Use of graphics ( 22.67% ) as well models like females ,children etc. ( 38.54 % ) were also found in many advertisements. Regarding information about pharmacological data like pharmacological effects, mechanism of action, Pharmacokinetics, overdose with correction, additive added in drug preparation was found in less than 1 % advertisements.
Recent advances in research and clinical experiences keep on changing the drug therapy for many diseases. Therefore, scientific information on new drugs and therapeutics is undoubtedly of paramount importance. Industry drug advertisements are intended to be persuasive rather than educational and it is not meant for educating the physicians in the use of drugs.( 4 )
In this representative survey on the accuracy of drug advertisements in different Indian journals provides less content related to vital aspects of drugs like major interactions, side effects, drug storage etc. We found that majority of drug advertisements were coloured, as well as using models . Thus ruling out limitations of budget.
Study done by B.Gitanjali (5)related to BMJ Indian editions, noted almost same observations regarding status of drug advertisements.A similar research work done by A.Lal (1998),(1) found information concerning adverse effects, precautions, contraindications, warning major interactions, ingredients known to cause problems ,drug overdose, drug storage & cost indicated in less than 40% of advertisements.
Recently V.Tandon et.al (2004) (6) compared the standard of Indian journal advertisements with international journal advertisements. He found the advertisements in international journals provided more complete drug information as per the recommendation laid down by WHO in comparison to national journals. However, they were found to be deficient in providing information regarding some of the aspects like pharmacological effects (12%), mechanism of action (16%) and pharmacokinetic data (8%). whereas, the information in the advertisements of the national journals was inadequate in nearly all aspects of pharmacological data, clinical information (0%), pharmaceutical information (0-33.3%) and legal aspects (0-11.11%). The main stress in national journals appeared to be on brand names (100%), indication (92%) and address of manufacturers (88.88%).
However there are regulatory requirements different even in the various developed countries. There are agencies like the MCA (Medicine Control Agency) in the UK to ensure these regulations strictly. (6)In the United States, marketing and distribution of pharmaceuticals is regulated by the federal Prescription Drug Marketing Act of 1987. The IFPMA code is followed strictly in developed countries like the USA and UK. Recently ( Feb.3,2011) the journal of Emergency Medicine , Australasia, which publishes the latest research and unique patient cases in the field of emergency medicine, has announced it will no longer carry advertisements paid for by pharmaceutical companies.
The establishment of ethical criteria for drug promotion is based on updating and extension of the ethical and scientific criteria established in 1968 by WHO.(2)All regulatory aspects related to advertisements of drugs in India are covered under drugs & Cosmetics Act,1940 & Magic Remedies Act, 1954. (7) There has been inadequate information in drug advertisements published regularly in different journals in India.
Our analysis indicated that the drug advertisements published in various Indian medical journals provide less information regarding vital aspects about drugs.
We strongly suggest need of uniform regulation & code to be followed & effective supervision by central agencies & Government to overcome this problem.
We are very thankful to The Librarian, Central Library, Pravara Institute Of Medical Sciences, A.P.Loni Tal.Rahata, Dist. Ahmednager,Pin-413736 to permit us ,use of Journals for analysis.
We are also very thankful to Miss. Pratibha M. Karandikar, Lecturer, PREC, Loni for her extensive help and support during the preparation of this work.
WHO : World health organization
FDA : Food & Drug Administration
MCA : Medicine control agency
IFPMA : International federation of Pharmaceutical manufacturers Association