Fair Balance of Prescription Drug Information on Legitimate and Illegitimate Online Pharmacy Websites
Abstract
:1. Introduction
- RQ1:
- How often do OP websites provide information on the benefits of usage?
- RQ2:
- How often do OP websites provide directions or instructions for use?
- RQ3:
- How often do OP websites exaggerate the benefits and characteristics of prescription drug offerings?
- RQ4:
- How often do OP websites provide side effects, warnings, or precautions (“risks”)?
- RQ5:
- How often do OP websites provide overdose or missed dose information?
- RQ6:
- To what extent do OP websites adhere to the intent of the FDA’s fair balance guidelines?
- RQ7:
- How does the presentation of fair balance information differ between LOPs and IOPs?
2. Materials and Methods
2.1. Selection of Online Pharmacy Websites
2.2. Coding Procedure and Instrument
3. Results
3.1. Sample Characteristics
3.2. Prescription Drug Information on Online Pharmacy Websites
3.3. Prescription Drug Information by Online Pharmacy Type
4. Discussion
5. Limitations and Future Research
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Huhmann, B.A.; Limbu, Y.B. Content and compliance of pharmaceutical social media marketing. Mark. Intell. Plan. 2016, 34, 977–999. [Google Scholar] [CrossRef]
- Senak, M. Closing the digital gap: FDA’s oversight of social media. Pharm. Exec. 2023, 43, 1. [Google Scholar]
- Babar, Z.-U.-D.; Siraj, A.M.; Curley, L. A review of DTCA techniques: Appraising their success and potential impact on medication users. Res. Soc. Adm. Pharm. 2018, 14, 218–227. [Google Scholar] [CrossRef] [PubMed]
- Bowman, C.; Family, H.; Agius-Muscat, F.; Cordina, M.; Sutton, J. Consumer internet purchasing of medicines using a population sample: A mixed methodology approach. Res. Soc. Adm. Pharm. 2020, 16, 819–827. [Google Scholar] [CrossRef] [PubMed]
- Orizio, G.; Merla, A.; Schulz, P.J.; Gelatti, U. Quality of online pharmacies and websites selling prescription drugs: A systematic review. J. Med. Internet Res. 2011, 13, e74. [Google Scholar] [CrossRef] [PubMed]
- Royne, M.B.; Myers, S.D. Recognizing consumer issues in DTC pharmaceutical advertising. J. Consum. Aff. 2008, 42, 60–80. [Google Scholar] [CrossRef]
- Armstrong, K.; Schwartz, J.S.; Asch, D.A. Direct sale of sildenafil (Viagra) to consumers over the Internet. N. Engl. J. Med. 1999, 341, 1389–1392. [Google Scholar] [CrossRef] [PubMed]
- Fittler, A.; Bősze, G.; Botz, L. Evaluating aspects of online medication safety in long-term follow-up of 136 Internet pharmacies: Illegal rogue online pharmacies flourish and are long-lived. J. Med. Internet Res. 2013, 15, e199. [Google Scholar] [CrossRef] [PubMed]
- Ghaibi, S.; Ipema, H.; Gabay, M. ASHP Guidelines on the pharmacist’s role in providing drug information. Am. J. Health-Syst. Pharm. 2015, 72, 573–577. [Google Scholar] [CrossRef]
- Petrelli, F.; Tiffi, F.; Scuri, S.; Nguyen, C.T.T.; Grappasonni, I. The pharmacist’s role in health information, vaccination and health promotion. Ann. Ig. Med. Prev. E Comunità 2019, 31, 309–315. [Google Scholar]
- Fittler, A.; Vida, R.G.; Radics, V.; Botz, L. A challenge for healthcare but just another opportunity for illegitimate online sellers: Dubious market of shortage oncology drugs. PLoS ONE 2018, 13, e0203185. [Google Scholar] [CrossRef] [PubMed]
- Limbu, Y.B.; Huhmann, B.A. Online but unlawful sales of unapproved and misbranded prescription drugs: Internet pharmacy compliance with Food and Drug Administration warning letters. J. Consum. Aff. 2023, 57, 1015–1038. [Google Scholar] [CrossRef]
- Long, C.S.; Kumaran, H.; Goh, K.W.; Bakrin, F.S.; Ming, L.C.; Rehman, I.U.; Dhaliwal, J.S.; Hadi, M.A.; Sim, Y.W.; Tan, C.S. Online pharmacies selling prescription drugs: Systematic review. Pharmacy 2022, 10, 42. [Google Scholar] [CrossRef] [PubMed]
- Van de Ven, K.; Koenraadt, R. Exploring the relationship between online buyers and sellers of image and performance enhancing drugs (IPEDs): Quality issues, trust and self-regulation. Int. J. Drug Policy 2017, 50, 48–55. [Google Scholar] [CrossRef] [PubMed]
- Ivanitskaya, L.; Brookins-Fisher, J.; O’Boyle, I.; Vibbert, D.; Erofeev, D.; Fulton, L. Dirt cheap and without prescription: How susceptible are young US consumers to purchasing drugs from rogue internet pharmacies? J. Med. Internet Res. 2010, 12, e11. [Google Scholar] [CrossRef] [PubMed]
- Kennedy, J.P.; Wilson, J.M. Clicking into harm’s way: The decision to purchase regulated goods online. Am. Behav. Sci. 2017, 61, 1358–1386. [Google Scholar] [CrossRef]
- Assi, S.; Thomas, J.; Haffar, M.; Osselton, D. Exploring consumer and patient knowledge, behavior, and attitude toward medicinal and lifestyle products purchased from the Internet: A web-based survey. JMIR Public Health Surveill. 2016, 2, e34. [Google Scholar] [CrossRef] [PubMed]
- Alwon, B.M.; Solomon, G.; Hussain, F.; Wright, D.J. A detailed analysis of online pharmacy characteristics to inform safe usage by patients. Int. J. Clin. Pharm. 2015, 37, 148–158. [Google Scholar] [CrossRef]
- Jackson, G.; Patel, S.; Khan, S. Assessing the problem of counterfeit medications in the United Kingdom. Int. J. Clin. Pract. 2012, 66, 241–250. [Google Scholar] [CrossRef]
- Limbu, Y.B.; Huhmann, B.A. Illicit online pharmacies: A scoping review. Int. J. Environ. Res. Public Health 2023, 20, 5748. [Google Scholar] [CrossRef]
- Campbell, N.; Clark, J.P.; Stecher, V.J.; Goldstein, I. Internet-ordered Viagra (sildenafil citrate) is rarely genuine. J. Sex. Med. 2012, 9, 2943–2951. [Google Scholar] [CrossRef] [PubMed]
- Monteith, S.; Glenn, T.; Bauer, R.; Conell, J.; Bauer, M. Availability of prescription drugs for bipolar disorder at online pharmacies. J. Affect. Disord. 2016, 193, 59–65. [Google Scholar] [CrossRef] [PubMed]
- Penley, B.; Minshew, L.; Chen, H.-H.; Eckel, S.; Ozawa, S. Accessibility of low-cost insulin from illegitimate Internet pharmacies: Cross-sectional study. J. Med. Internet Res. 2022, 24, e25855. [Google Scholar] [CrossRef] [PubMed]
- Bleir, A.; Harmeling, C.M.; Palmatier, R.W. Creating effective online customer experiences. J. Mark. 2019, 83, 98–119. [Google Scholar] [CrossRef]
- Eisend, M. Two-sided advertising: A meta-analysis. Int. J. Res. Mark. 2006, 23, 187–198. [Google Scholar] [CrossRef]
- Nelson, P. Advertising as information. J. Political Econ. 1974, 82, 729–754. [Google Scholar] [CrossRef]
- Franke, G.R.; Huhmann, B.A.; Mothersbaugh, D.L. Information content and consumer readership of print ads: A comparison of search and experience products. J. Acad. Mark. Sci. 2004, 32, 20–31. [Google Scholar] [CrossRef]
- Yoo, S.H.; Ozer, M.; Xu, J. Relative effects of the different bundles of web-design features on intentions to purchase experience products online. Decis. Support Syst. 2024, 179, 114171. [Google Scholar] [CrossRef]
- Alfadly, S.; Anaam, M.; Alshammari, M.; Alsahali, S.; Ahmed, E.; Mubarak, A.B.; Aldahouk, A.; Aljameeli, M. Drug information sources for patients with chronic conditions in the Qassim Region, Saudi Arabia. Pharmacy 2023, 11, 57. [Google Scholar] [CrossRef]
- Ulfvarson, J.; Bardage, C.; Wredling, R.A.-M.; von Bahr, C.; Adami, J. Adherence to drug treatment in association with how the patient perceives care and information on drugs. J. Clin. Nurs. 2007, 16, 141–148. [Google Scholar] [CrossRef]
- Bergmo, T.S.; Sandsdalen, V.; Manskow, U.S.; Småbrekke, L.; Waaseth, M. Internet use for obtaining medicine information: Cross-sectional survey. JMIR Form. Res. 2023, 2, e40466. [Google Scholar] [CrossRef] [PubMed]
- Mononen, N.; Airaksinen, M.S.A.; Hämeen-Anttila, K.; Helakorpi, S.; Pohjanoksa-Mäntylä, M. Trends in the receipt of medicines information among Finnish adults in 1999–2014: A nationwide repeated cross-sectional survey. BMJ Open 2019, 9, e026377. [Google Scholar] [CrossRef] [PubMed]
Website Type: Legitimate [ ] Illegitimate [ ] Name of pharmacy: Site URL: | ||
Variables | Description | Categories |
Drug category | Category of randomly selected drug. | (e.g., HIV or depression) |
Brand name | Brand name of the selected prescription drug. | (e.g., Viagra) |
Search | Consumers can search for specific medications on the website. | Yes [ ] No [ ] |
Usage | The website provides information on the benefits of usage. | Yes [ ] No [ ] |
Exaggeration | The site exaggerates the benefits and characteristics of its offerings. | Yes [ ] No [ ] |
Storage | The site provides storage information for the selected drug. | Yes [ ] No [ ] |
Directions | For the selected drug, the site provides directions or instructions for use. | Yes [ ] No [ ] |
Warnings | The website provides side effects, warnings, or precautions for the selected drug. | Yes [ ] No [ ] |
Overdose | The site provides overdose information for the selected drug. | Yes [ ] No [ ] |
Extent-benefits | Extent of benefit information for the selected drug | 1 = minimal, 2 = moderate, 3 = extensive |
Words-benefits | Word count of benefit information for the selected drug | |
Extent-risks | Extent of risk information for the selected drug | 1 = minimal, 2 = moderate, 3 = extensive |
Words-risks | Word count of risk information for the selected drug |
Measure of Information Extensiveness | N | Minimum | Maximum | Mean | Standard Deviation |
---|---|---|---|---|---|
Average number of words about benefits | 144 | 10 | 1193 | 84.86 | 108.913 |
Average number of words about risks | 134 | 14 | 1477 | 391.46 | 328.705 |
Average extent of benefits | 144 | 1 | 3 | 1.97 | 0.733 |
Average extent of risks | 134 | 1 | 3 | 2.11 | 0.772 |
Variables | LOP (n = 232) | IOP (n = 75) | Chi-Square (χ2) | p-Value | ||
---|---|---|---|---|---|---|
Yes n (%) | No n (%) | Yes n (%) | No n (%) | |||
Prescription drug information available on their websites. | 82 (35.3) | 150 (64.7) | 75 (100) | 0 | 94.821 | 0.000 *** |
The site provides use (benefit) information. | 71 (88.8) | 9 (11.3) | 69 (92) | 6 (8) | 0.468 | 0.494 |
The site exaggerates the benefits and characteristics of its offerings. | 8 (9.8) | 74 (90.2) | 18 (24) | 57 (76) | 5.752 | 0.016 * |
The site provides direction or instructions for use. | 69 (84.1) | 13 (15.9) | 71 (94.7) | 4 (5.3) | 4.49 | 0.034 * |
The site provides side effects, warnings, or precautions (risks). | 65 (79.3) | 17 (20.7) | 68 (90.7) | 7 (9.3) | 3.93 | 0.047 * |
The site provides overdose or missed dose information. | 21 (25.6) | 61 (74.4) | 31 (41.3) | 44 (58.7) | 4.372 | 0.037 * |
The site provides storage information provided. | 27 (32.9) | 55 (67.1) | 27 (36) | 48 (64) | 0.164 | 0.686 |
Fair balance | 37 (47.4) | 41 (52.6) | 27 (36.5) | 47 (63.5) | 1.868 | 0.172 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Huhmann, B.A.; Limbu, Y.B. Fair Balance of Prescription Drug Information on Legitimate and Illegitimate Online Pharmacy Websites. Pharmacy 2024, 12, 67. https://doi.org/10.3390/pharmacy12020067
Huhmann BA, Limbu YB. Fair Balance of Prescription Drug Information on Legitimate and Illegitimate Online Pharmacy Websites. Pharmacy. 2024; 12(2):67. https://doi.org/10.3390/pharmacy12020067
Chicago/Turabian StyleHuhmann, Bruce A., and Yam B. Limbu. 2024. "Fair Balance of Prescription Drug Information on Legitimate and Illegitimate Online Pharmacy Websites" Pharmacy 12, no. 2: 67. https://doi.org/10.3390/pharmacy12020067