Consumer Trust Takes More than Fair Balance


Nearly 40 years ago, advertising legend David Ogilvy observed that “the consumer isn’t a moron…she wants all the information you can give her.” Much has changed over the decades, but that advice is still right on target. More than ever, consumers want the facts, and in no place is that more apparent than direct-to-consumer advertising.

Effective DTC advertising involves more than simply meeting FDA’s fair balance requirements. Meeting those mandates only provides an accurate and fair assessment of the risks as well as the benefits. What is missing is the concept of trust.

Pharmaceutical companies now must move beyond simply meeting fair balance requirements and seek the trust of consumers reading their ads. Only then will consumers be willing to take the next step: deciding that the benefits of taking a medication outweigh the risks.

Precision wording

The patient information in a DTC ad requires precision wording at its finest. Consumers must understand how the medication can help them, how they can determine if the drug is working, and how to recognize side effects. Ad copywriters also need to select the side effects that are most important for consumers to know about and put these risks into proper perspective for them. Only then can companies begin to gain the trust of the consumer.

A look at a current DTC ad may help put this idea into perspective. The first page of the ad for the emergency contraceptive Preven reads, “Many women do not experience side effects, although serious as well as minor ones may occur. The most commonly reported side effects are nausea and vomiting. Serious risks include blood clots, strokes, and heart attacks. Please see important patient information on next page.”

On the following page under “Cardiovascular Disease,” the consumer is advised: “Use of COCs is associated with a low absolute risk of venous thromboembolism which is nonetheless 3- to 6-fold higher than that among non-users…”

First, consumers likely will question the meaning of the term COCs, which refers to but is not defined as combination oral contraceptives. Then they may wonder what is meant by low absolute risk; does this term mean that the risk is low but always occurs? They may further question the risk of venous thromboembolism–whatever that is–which is reported to be 3- to 6-fold higher than among non-users. To understand the risk associated with Preven, they must be told the risk of thromboembolism in nonusers.

Under the heading “Ocular Lesions,” consumers read, “Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision; onset of proptosis or diplopia; papilledema; or retinal vascular lesions.” Without definitions of proptosis and diplopia, however, they cannot know when to stop taking the medication.

Finally, under “Unexplained Vaginal Bleeding,” consumers confront a warning that “Women who have unexplained vaginal bleeding, suggestive of an underlying pathological condition or pregnancy, should be evaluated prior to initiation of COC use in order to avoid confusion of the pathological bleeding with COC side effects.” In this case, consumers want reassurance that the product is safe, not wording that makes it sound like the doctor could be confused–certainly a nightmare idea that will frighten every patient!

A Better Way

Is there a better way to communicate with consumers? The DTC ad for the smoking-cessation product Zyban shows it is possible. This ad discusses the possible side effects in an easy-to-understand manner. It notes, “The most common side effects include dry mouth and difficulty sleeping. These side effects are generally mild and often disappear after a few weeks. If you have difficulty sleeping, avoid taking your medicine too close to bedtime.”

Good advice! This ad goes the extra mile and tells the consumer how to manage the insomnia.

Under the precaution not to take extra doses of Zyban, the ad reads, “Do not take more tablets than your doctor prescribed. This is important so you do not increase your chance of having a seizure.” This wording explains why readers should not take an extra dose and it puts them in control rather than scaring them.

Win My Trust

The point is, What trust can consumers place in a company that prints statements that frighten them? The company may have regulatory approval for fair balance and think it is protecting itself legally–regardless of how much it scares consumers. But if a company wants consumers to ask their doctors for more information about a product, the company will have to win consumers’ trust first.

Dr. Dorothy L. Smith is a consumer education expert and president of Consumer Health Information Corporation. The full-service company specializes in patient labeling, program development, and strategic planning for DTC campaigns.

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Published in Pharmaceutical Executive, April 1999.