Altman, Lawrence K. "Study Says Drug Ads In Medical Journals Frequently Mislead," New
York Times, 1 June 1992, pp. 1, B7.
A new study was reported today in the Annals of Internal Medicine concerning ads in medical
journals. These ads are thought to be a prime source of information for physicians and are known
to be a major source of revenue for the journals. It is reported here that researchers from UCLA
looked over 109 ads in the first 1990 issues of 10 "leading medical journals." The UCLA people
recruited 150 physicians and pharmacologists to study the 109 full-page ads. Their findings were
buttressed by an FDA examination of the same ads.
Half of the ads examined violated F.D.A. guidelines. "Many advertisements did not highlight
potentially dangerous side effects or had misleading information on the safety and effectiveness
of the drugs... The reviewers judged that 57 percent of the advertisements had little or no
educational value." (p. B7)
Articles in medical journals are peer reviewed but ads are not. Drug companies spent $351
million on ads in medical journals.
The ads selected for study were "sent to three specialists for review. Two were doctors with
expertise in a clinical area relevant to the drug. Thus, infectious-disease specialists critiqued
advertisements for antibiotics, cardiologists examined drug advertisements for angina, and
psychiatrists went through a similar process for anti-depressants. The third reviewer in each
group was a pharmacist working in a medical school." ( p. B7)
"One advertisement in four included statistics in the text. In 8 of 27 cases, or 30 percent, the
reviewers felt the statistics were derived from inconclusive, dissimilar or poorly designed
In 30 percent of the advertisements, the tables and graphs were judged to be inadequately
references and were likely to lead a reader to a misleading conclusion.
"In 23 advertisements that used graphs, the reviewers said the graphs distorted or misrepresented
the conclusions of studies regarding the drug in 9 percent.
"Headlines were judged to be misleading in 32 percent of the advertisements about a drug's
effectiveness and in 19 percent of the advertisements about the side-effects or cases in which the
drug should not be prescribed.
In 53 advertisements, or 49 percent, two or more reviewers judged that the drug was promoted as
the ‘drug of choice' for at least one condition. In 16 of the 53 advertisements, or 30 percent, two
or more reviewers disagreed with the claim." (p. B7)
In an aside, "In choosing experts, the authors said they had originally intended to exclude anyone
who had received more than $300 from the drug industry in the preceding 24 months. But the
authors dropped the exclusion because 71 percent of the doctors selected said they had received
money from the pharmaceutical industry during the preceding two years and 53 percent of them
had accepted more than $5,000." (p. B7)
"In a statement, the Pharmaceutical Manufacturers Association, a trade group in Washington,
strongly objected to the methods and conclusions of the study, which it said unfairly impugned
the reputation of an entire industry.'
"‘Prescription drug advertising is the regulated form of advertising in the United States,' the
group said, adding that the F.D.A. vigorously monitors drug advertisements and that the agency
has adequate controls to deal with those that do not meet Federal standards.
"But Dr. David A. Kessler, the Commissioner of Food and Drugs, said there was indeed a
problem. ‘The problems of misleading drug advertisements is real,' he wrote in an editorial in the
same issue of the Annals of Internal Medicine. He said the number of misleading advertisements
in the study was ‘disturbingly high.'" (pp. 1, B7)