Three is optimal. Four is good. Five is OK. Anything more than that, said the drug maker, and you start wandering into too-much-information territory.
"Trying to communicate more than five risks appears to negatively impact the consumer's ability to remember and comprehend the information presented," said AstraZeneca's senior director-consumer marketing, Don Apruzzese, who first presented the study in late April at the sixth annual DTC National Conference in Washington. "Beyond this point of diminishing return, consumers tended to be overwhelmed by the multiple warnings and then fail to remember the more serious side effects."
AstraZeneca's Fair Balance Communications Research was a study of 2,300 consumers to determine their comprehension of risk and reward information in DTC commercials.
The idea of limiting DTC ads to three to five mentions of risk information seems to run counter to what the rest of the industry has discussed. The Food and Drug Administration has repeatedly asked for more risk information, and in remarks earlier this year the director of its drug marketing, advertising and communications division, Thomas Abrams, noted that 82% of pharmaceutical company violations in the past year were related to inadequate presentation of risk information.
Industry trade group Pharmaceutical Research and Manufacturers of America stressed a "balanced presentation between the benefits and the risks associated with the advertised prescription medicine" in its 15-point code of conduct issued in August 2005.
Going back even further, Johnson & Johnson CEO William Weldon said in March of that year that the company would change its ads to reflect more risk information, and challenged the industry to do the same.
But former FDA associate commissioner Peter Pitts, now senior VP-global health affairs at Manning, Selvage and Lee, New York, said he has seen research similar to AstraZeneca's, and the consensus is the same.
"Low single-digit numbers are all people can retain," Mr. Pitts said. "I think the people that argue that you're hiding things don't understand that more of something you don't understand is not in the best interest of the public health. Loading up fair balance or the brief summary may make somebody feel better, and may make a politician or a consumer advocate pump up their chest, but at the end of the day it runs counterpoint to the research."
AstraZeneca said it would use the research to help dictate its own advertising, and would share results of the study with the FDA and other companies.