How Can We Reduce Online Pharmaceutical Mismarketing?

Theoretical Background and research questions/hypothesis: The seemingly omnipresent Internet has allowed pharmaceutical marketing to become more salient than ever before. The Internet’s power to disseminate information has helped the public in many ways. Yet this ability has simultaneously allowed for novel conflicts of interest—as when information misleads in order to promote a pharmaceutical company’s marketing efforts, and unduly influences physicians’ prescribing. These tensions are further complicated by the idiosyncrasies of the Internet as a communication medium, challenging traditional conceptions of medical ethical principles meant to safeguard the physician-patient relationship. We analyze how the Internet has influenced prescribing practices, and how its characteristics, coupled with the nature of contemporary medical practice, can leave both patients and physicians vulnerable to misinformation.

Methods and Results (informing the conceptual analysis): A literature review was conducted to determine how the Internet may influence prescribing practices, and how its characteristics, coupled with the nature of contemporary medical practice, might leave both patients and physicians vulnerable to misinformation. We found that drug marketing can mislead across both established and novel Internet domains, including search engines, company websites, e-mail lists, blogs, wikis, health information services, and mobile health software. We identify misleading Internet informational and presentational trends common among these domains and explore potential improvements.

Conclusions: Industry avowals against unduly influencing Internet users have proven insufficient. In a climate of resource-limited marketing regulation and time-strapped physicians, there is a need for third-party intervention and regulation. Such action implies finding a balance between protecting physicians' and patients' rights to unbiased health information, and respecting corporations' rights to freely promote their interests. We explore possible solutions.

Implications for research and/or practice: A means of identifying bias and veiled risk data in Internet pharmaceutical information is necessary. We suggest four ways in which access to unbiased health information can be improved online: 1) Independent evaluation systems could be implemented. The FDA and pharma-independent groups could issue, for instance, official seals of approval to unbiased online sources.  2) The FDA or other regulatory agencies could require commercial websites and advertisements to prominently feature hyperlinks to unbiased treatment algorithms. 3) Search engine architects and purveyors might consider warning users that hyperlinks to unevaluated drug marketing sites may contain misinformation. 4) Finally, a number of “red flag” heuristics could identify misleading pharmaceutical search engine results. Using these heuristics, a search engine algorithm could reorder the presentation of results to reflect weighting of biased material. This would allow unbiased information to rise to the top of a search engine results page, where users are most likely to see it. This poster conceptualizes the basic principles of such an algorithm.