Animation and Consumer Perceptions of DTC Pharmaceutical Advertisement

• Published date: 01 December 2019
• Author: Esta D. Shah,Lindsay R. L. Larson,Luther L. Denton
• Date: 01 December 2019
• DOI: http://doi.org/10.1111/joca.12249

1456 THE JOURNAL OF CONSUMER AFFAIRS

ESTA D. SHAH, LINDSAY R. L. LARSON, AND

LUTHER L. DENTON III

Animation and Consumer Perceptions of DTC

Pharmaceutical Advertisement

The Food and Drug Administration (FDA) has noted that anima-

tion within direct-to-consumer (DTC) pharmaceutical advertising may

impact perceptions of risk or benet, and that therehave been few if any

comprehensives studies of the impact animation may exert upon con-

sumers. This article proposes that the use of animation in pharmaceu-

tical advertising potentially disrupts the encoding process in the mind

of the consumer, impacting perceptions of prescription drug benets

and risks. Using novel stimuli employing a rotoscoping technique, it is

found that animation signicantly reduces perceptionsof perceived risk

(but not benets), and that this effect is driven by disruptions in encod-

ing (Study 1). These ndings are extended to examine deeper consumer

inferences (Study 2). Implications for the pharmaceutical industry,con-

sumer protection agencies, and consumers are considered.

Currently, the United States is one of only two countries that allows

direct-to-consumer (DTC) prescription drug advertising, a practice permit-

ted by deregulation during the late 1980s and the early 1990s (Frosch et al.

2010). Since that time, all federal attempts to restrict the practice have been

rejected in favor of arguments advocating for consumers’ right to infor-

mation about treatment options. Despite stated aims to promote consumer

welfare and better communication between consumers and physicians, the

net impact of DTC drug advertising within this market is questionable. As

pharmaceutical manufacturers have increased spending on DTC advertis-

ing signicantly over the past decade, the incidence of patients requesting

advertised drugs from their doctors has also grown (Turk 2015). While

some believe this shift empowers consumers by providing them informa-

tion that was in the past withheld by a paternalistic medical system, in

which the doctor alone held such knowledge about available prescriptions

(Rubin 2001), others fear that by shifting these decisions to the patient,

physicians may more often prescribe drugs that are potentially unnecessary

Esta D. Shah (shahed@cofc.edu) is Assistant Professor of Marketing at College of Charleston,

Lindsay R. L. Larson (lindsaylarson@georgiasouthern.edu) is Associate Professor of Marketing at

Georgia Southern University,and Luther L. Denton III (ldenton@georgiasouthern.edu) is Professor of

Marketing at Georgia Southern University.

The Journal of Consumer Affairs, Winter 2019: 1456–1477

DOI: 10.1111/joca.12249

Copyright 2019 by The American Council on Consumer Interests

WINTER 2019 VOLUME 53, NUMBER 4 1457

or inappropriate at the behest of patients (Mintzes et al. 2002). Indeed,

critics and proponents may both have valid points, and reviews of these

arguments suggest there is evidence that DTC prescription drug advertis-

ing has the potential for both benecial and detrimental impacts on public

health (Ventola 2011).

While the Food and Drug Administration (FDA) is taskedwith scrutiniz-

ing DTC pharmaceutical advertisements in order to assuage such concerns,

this regulatory scrutiny is almost exclusively focused on the “propositional

content” within an advertisement; explicit claims made by the ad, rather

than “non-propositional content” such as background music and imagery

shown within the advertisement (McCaffry 2016). For this reason, some

have argued that current regulations leave consumers open to a form of

evaluative conditioning upon their beliefs about drug efcacy and safety

(Biegler and Vargas 2013; Hoek et al. 2011), and that federal regulations

are simply inadequate for “capturing the bewildering profusion of mar-

keting techniques employed by the pharmaceutical industry” (Greene and

Herzberg 2010, 801). The issue of nonpropositional content is raised pri-

marily because of the potential for these seemingly peripheral elements to

interfere with message encoding. Prior research highlights the effects of

auditory stimuli within advertisement (such as background music, verbal

pace, and volume) on cognitive load and message comprehension (FDA

2009; Hahn and Hwang 1999; Harlow 2010) and suggests the need for

future research to explore other forms of nonpropositional content, includ-

ing visual elements. Due to similar concerns about cognitive load and

other contributing factors, the FDA recently issued a specic call for more

research on the impact of animation on accurate identication and encod-

ing of health information found in DTC advertising (Rubin 2016).

Understanding the effects of animation on information processing is

critical considering long-term studies documenting a decline in consumer

health literacy (in relation to a consumer’s ability to process health-related

information in written, spoken, or digital form) and subsequently to trans-

late that information into effective health decisions (Adams et al. 2009;

Parker, Wolf, and Kirsch 2008). Indeed, the results of a 2007 report from

the US Educational TestingService (ETS) on declining adult health literacy

sparked alarm in the medical community, as health providers discussed the

necessity of preparing for an “epidemic of limited health literacy” (Kirsch

et al. 2007; Parker, Wolf, and Kirsch 2008). Health literacy has similarly

been documented as a point of concern abroad such as in the United King-

dom and Australia (Adams et al. 2009; Kobayashi et al. 2015).

Consumer advocates worry that as health literacy decreases, consumers

will become more reliant on other cognitive heuristics, such as animation,