Direct-to-Consumer Advertising of Pharmaceuticals: An Integrative Review - Innovation and Marketing in the Pharmaceutical Industry - page 624

illegal online drug sellers, which are pharmacies that promote sales of prescription
drugs without a prescription.

21.1.3 DTCA in Other Countries

New Zealand is the only country other than the USA in the Organization for
Economic Cooperation and Development (OECD) countries that allows DTCA of
prescription drugs. New Zealand experienced similar growth in DTCA as the USA
from its beginning circa 1995, with unsuccessful attempts to change the liberal
legislation on DTCA. In the European Union, a 5-year pilot project of allowing
DTCA for AIDS, asthma, and diabetes was proposed by the European Commission,
but rejected by the European Parliament in 2003. Despite this, pharmaceutical
companies, media industries, and the European Commission have continued to push
for watering down this strict ban on DTCA in the European Union.
Canada presents an interesting case study. Although DTCA is prohibited in Canada,
regulations permit two forms of advertising—disease-oriented or help-seeking
advertising that does not mention a specifi c brand but discusses a condition and
suggests that consumers ask their doctor about treatments, and reminder advertise-
ments that mention the brand name but no health claims or statements about the use of
the product (Mintzes 2006 ). 1 However, as many as 30 % of English-speaking Canadians
are routinely exposed to DTCA via cable and satellite television of US stations which
are governed by US regulations.
A critical concern with the growth of online advertising is that such media reach
patients in countries where DTCA is not legal. Liang and Mackey ( 2011a , b ) provide
a stark example: although GlaxoSmithKline's blog site and AstraZeneca's community
Facebook page indicate that they are intended for US residents and customers only,
non-US users have no access restrictions. This practice then amounts to an “illegal
export” that may need to be regulated.

21.2 Research Methods Appropriate for Measuring

DTCA Effects

An important area of DTCA research has been the measurement of DTCA effects.
Many different research methods have historically been used to measure advertising
effects, and we see a similar spectrum in the literature on DTCA. One important
difference, however, is that the motivation for DTCA research is typically not to test
theories of consumer information processing but instead to measure the size of

1 In a recent study Kolsarici and Vakratsas ( 2010 ) creatively use the Canadian regulatory
requirement that ads of the two kinds be clearly distinct to specify and estimate an econometric
model of effectiveness of generic vs. brand advertising.