A Content Analysis of Dosage Form Presentations in Prescription Drug TV Ads

Mihaela Johnson, PhD1, Kevin Betts, PhD2, Amie O’Donoghue, PhD2, Kate Ferriola-Bruckenstein, BA3, Avery Tilley, BS3, Claudia Squire, MS3 and Bridget Kelly, PhD, MPH3, (1)RTI International, Marietta, GA, (2)U.S. Food and Drug Administration, (3)RTI International

Theoretical Background and research questions/hypothesis: Studies have shown that a drug’s dosage form is one drug characteristic that may influence consumers’ preferences for disease treatments. For instance, some studies have shown that patients may prefer oral medications over injectable medications. Whether prescription drug advertisers choose to highlight a certain dosage form over other forms in direct-to-consumer prescription drug TV ads is unknown.

Methods: The current study is a content analysis of dosage form presentations in prescription drug TV ads aired in the United States between 2008 and 2022. The ads were retrieved from AdPharm, an online visual database of pharmaceutical advertisements, and Numerator Ad Intel, a media monitoring service. We coded each ad for dosage form presentation characteristics (i.e., type of dosage form, dosage strength, presentation placement and prominence [defined as (1) size relative to the screen and (2) size relative to the size of the presentation of the established/generic drug name], and presentation modality [visual, auditory, or dual/both]). We also assessed whether the presentation included an image of the dosage form (e.g., an injection pen, a pill). We summarized the findings comparing injection/infusion and tablet/capsule presentations across all ads.

Results: We found 1,220 dosage form presentations across 436 ads. Most presentations were for tablets (44.5%), followed by injections (24.7%), capsules (9.3%), and infusions (3.8%). The remaining dosage forms found included creams, gels, solutions, patches, and inhalation powders. When comparing injection/infusion and tablet/capsule presentations, we found that 62.0% of injection/infusion and 56.8% of tablet/capsule presentations included the dosage strength. We found that fewer injection/infusion (9.8%) than tablet/capsule (16.1%) presentations used dual modality. In contrast, more injection/infusion (81.8%) than tablet/capsule presentations (74.4%) were shown visually only. In terms of placement during the ad, most frequently, the dosage form was presented during the first third of the ad, followed by the last frame, and during the middle third of the ad. This order was fairly consistent across the injection/infusion and tablet/capsule presentations. In terms of placement on the screen, fewer injection/infusion (53.5%) than tablet/capsule (69.7%) presentations appeared centered on the screen, and more injection/infusion (28.6%) than tablet/capsule (13.8%) presentations appeared in the superimposed text. Perhaps the largest difference was related to dosage form prominence. A little less than half of the injection/infusion presentations (47.6%) were the same size as the established name compared with about two thirds of the tablet/capsule presentations (62.1%); the remaining presentations were smaller than the size of the established name. A similar pattern occurred when examining the prominence on the screen: about a third of injection/infusion presentations (39.9%) were categorized as large compared with over half of the tablet/capsule presentations (53.6%). Finally, we found that fewer injection/infusion (11.0%) relative to tablet/capsule (21.3%) presentations included an image of the dosage form.

Conclusions: Overall, our results show some differences in how dosage form information is presented in prescription drug TV ads: in general, injections/infusions were presented less prominently than tablets/capsules.

Implications for research and/or practice: Future research should examine whether differences in dosage form presentations affect consumer drug preferences and treatment decision-making.