Contemporary drug advertising in leading US medical journals

Abstract

Medical journal editors have promoted transparency and elimination of conflict of interest in published research, but whether the same standards are applied to journal pharmaceutical advertisements is unknown. We evaluated claims of efficacy, reporting of adverse events, access to (and quality of) supporting references, conflict of interest, and drug price in print advertisements for prescription drugs in three leading US medical journals (The New England Journal of Medicine, Journal of the American Medical Association, and Annals of Internal Medicine) from May 2016 to October 2016. Forty-two unique advertisements for 39 distinct drugs were identified among 190 total advertisements. The wholesaler acquisition cost of 19 (49%) drugs was >$1,000 for 1 month of treatment, and 5 (13%) cost ≥$120,000 per year. Supporting references from peer reviewed medical literature were cited in only 52% of advertisements, and 48% listed only prescribing information, a package insert, and/or data on file. Requests for data on file were unsuccessful in 9 of 13 cases. Of the studies referenced, 89% were co-authored by individuals who had financial ties to the drug manufacturer, and 69% were also sponsored by the company. We conclude that prescription drug advertisements do not provide sufficient information for physicians to critically review claims made and do not meet the ethical and quality standards that the journals apply to articles they publish. New journal advertisement guidelines are needed.