Many big pharma firms are running e-samples, a form of marketing which researchers say capitalizes on patients seeking health information and may affect prescribers' preference for brands over generics. As a growing area, they may also require more attention from stakeholders working to create uniform standards for online ads.
Online samples—defined here as DTC offers for free and discounted drugs—are fairly prevalent. Among the 50 most prescribed medications in 2007, most (60%) have such vouchers on a manufacturer-supported website, observed a group of physicians from the Washington VA.
Of those sites carrying a monetary incentive, they noted in the November 23 edition of Archives of Internal Medicine
, most were for drugs without generic alternatives, and risk information in these offers tended to be less prominent compared to the promotional information.
Researchers did not look at the extent to which the incentives were redeemed.
Why do they find e-sampling insidious? Looking for information on a diagnosis or chronic condition, consumers are often directed by search engines to such offers, which “co-opt consumer health-information search patterns in a potentially powerful manner,” the physicians wrote.
E-samples, they pointed out, combine DTC advertising with drug sampling, and research shows that the availability of samples may influence provider decision-making.
The practice may also “circumvent efforts to prevent provision of samples in certain clinics or organizations that are seeking to curtail influence from sample provision,” they speculated.
What the physicians also found troubling was the inconspicuous positioning of risk info—typically appearing after links to offers, and sometimes several screens down the page, a sequence that “may distract or even divert patients from reviewing” the fair balance.
As such, they said study findings seemed to agree with FDA regulators, who sent 14 letters this past April to drug manufacturers, citing inadequate representation of risk and vague presentation of indication in brief internet search ads.
Last month the FDA convened hearings to solicit input on display, sponsored search, video and other forms of DTC Web ads; e-sampling was not on the agenda. Agencies, publishers, manufacturers and industry groups are now working to suggest formats for various online ad platforms.
The FDA's 2009 draft guidelines on DTC advertising, which would require more balanced presentation of risks, do not cover use of offers for discounts or free samples, researchers wrote.