Abstract
Objectives The objective of the study was to critically assess references cited in support of claims in drug advertisements. Methods Drug advertising brochures were collected from privately practicing General Practitioners from different parts of Karachi. Three blinded reviewers then categorized each reference in the brochure according to the sources viz: journals (both Medline indexed and non-indexed), medical reference books, web addresses, personal communications or testimonials, abstracts presented at symposia/conferences, WHO and National Health Guidelines, ‘data on file’ and ‘others’ (which included a diverse set of references). Each reviewer then assessed and analyzed the references further into 2 broad categories: traceable and non-traceable. Traceable references were appraised and, depending upon the claim with which the reference was attached, were classified into justifiable, inaccurate/false, exaggerated and ambiguous. Results We collected a total of 175 different brochures. Thirty-nine (22.3%) brochures did not cite any references and were not subjected to further analysis. The remaining 136 (77.7%) contained a total of 559 references. 305 (54.6%) of these references were from Medline-indexed journals; 67 (12.0%) were from non-indexed journals; 55 (9.8%) references quoted medical reference books; 27 (4.8%) references cited web addresses; 12 (2.1%) references were personal communications/testimonials; 11 (2.0%) references referred to abstracts presented at symposia/conferences; 12 (2.1%) references were from WHO and National Health Guidelines; 8 (1.4%) references were listed as ‘data on file’, while the remainder that could not be defined were classified as ‘others’ (13.1%). Out of a total of 559 references, 249 (44.5%) could not be traced. After critically analyzing the 310 traceable references, 197 (63.5%) were adjudged justifiable, 30 (9.7%) inaccurate/false, 79 (25.5%) exaggerated and 15 (4.8%) ambiguous. Conclusion Results of this study show for the first time that the claims substantiated with references in the pharmaceutical advertisements in Pakistan are highly unreliable.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Rohra DK, Gilani AH, Memon IK, et al. Critical evaluation of the claims made by pharmaceutical companies in drug promotional material in Pakistan. J Pharm Pharm Sci 2006;9:50–9.
Silverman M, Lee PR, Lydecker M. The drugging of the Third World. Int J Health Serv 1982;12:585–96.
Lee PR, Lurie P, Silverman MM, Lydecker M. Drug promotion and labeling in developing countries: an update. J Clin Epidemiol 1991;44 Suppl 2:S49–55.
Rohra DK, Jawaid A, Rehman T, Sukkurwala AQ, Palanpurwala AS, Gangwani R. Prescription of new drugs by general practitioners in Pakistan: an exploration into information sources, prescription influences and general attitudes. Pak J Med Res 2007;46:5–10.
Levy R. The role and value of pharmaceutical marketing. Arch Fam Med 1994;3:327–32.
http://www.dcomoh.gov.pk/. Accessed on July 10, 2007.
http://www.a257.g.akamaitech.net/7/257/2422/04nov20031500/edocket.access.gpo.gov/cfr_2001/aprqtr/21cfr202.1.htm/. Accessed on July 10, 2007.
http://www.mhra.gov.uk/home/idcplg?IdcService = SS_GET_PAGE&nodeId = 165/. Accessed on July 10, 2007.
Gutknecht DR. Evidence-based advertising? A survey of four major journals. J Am Board Fam Pract 2001;14:197–200.
Bero LA, Galbraith A, Rennie D. The publication of sponsors symposiums in medical journals. N Engl J Med 1992; 327:1135–40.
Wilkes MS, Doblin BH, Shapiro MF. Pharmaceutical advertisements in leading medical journals: experts’ assessments. Ann Intern Med 1992;116:912–9.
Gonul F. Promotion of prescription drugs and its impact on the physician’s choice behaviour. J Market 2001;216:79–90.
Jones MI, Greenfield SM, Bradley CP. Prescribing new drugs: qualitative study of influences on consultants and general practitioners. Br Med J 2001;323:378–81.
Health IMS. Total US promotional spend by type, 2004, 2005. [http://www.imhealth.com/ims/portal/front/articleC/0,2777,6599_49695992_75406357,00,htm]. Accessed on July 30, 2006).
Herxheimer A, Stalsby Lundborg C, Westerholm B. Advertisements for medicines in medical journals; a collaborative international study. Report for director-general of World Health Organisation, Sweden: WHO,1992.
Acknowledgement
The authors wish to thank the Department of Biological and Biomedical sciences, Aga Khan University, Karachi for bearing the costs of this study and publication.
Funding
No funding received.
Conflicts of Interest
None declared.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rohra, D.K., Bashir, M.U., Khwaja, U.A. et al. Critical appraisal of apparently evidence-based written advertising in Pakistan. Pharm World Sci 30, 216–221 (2008). https://doi.org/10.1007/s11096-007-9170-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-007-9170-7