This study is designed as the building of a foundation in standardizing best practices when designing Direct-to-Consumer messaging. With this being a new and expanding field of marketing and advertising for the high visibility pharmaceutical industry, an establishment of conceptual templature, around which Direct-to-Consumer messaging campaign can be built, offers an opportunity to build a new and vibrant branch on the well-established messaging field. This is particularly important when recognizing the unique needs and requirements of both the pharmaceutical industry and its audience in learning of and about new products. This study attempted to identify current perception of Direct-to-Consumer practices by industry laypersons with in-depth interviews conducted through a phenomenological framework. Participants were interviewed on a range of relevant areas, including directly regarding their perception as well as a broader collection of their thoughts and impressions. The results of this study show clear areas of interest, identifying various tactics and strategies employed within Direct-to-Consumer messaging and pointing to areas of potential perception cultivation by those crafting the message. The study also uncovered the presence of the Third-Person Effect playing a key role in determining the response of participants on perception, and potentially opening the door for integrated methods that have been developed with Third-Person Effect in mind when building messages. This study offers a significant first-step of study into the phenomenon of Direct-to-Consumer advertising, as well as a foundation upon which future, larger scale, and more generalizable research can be done.

This study intended to examine the effects of Direct-to-Consumer prescription drug advertising (DTCA). Looking specifically for the behavioral effects that exposure to DTCA had on consumers, data was collected about respondents’ actions after seeing or hearing an advertisement for a prescription drug. Application of the Theory of Planned Behavior and the Theory of Uses and Gratifications demonstrated the potential psychological factors at play throughout consumers’ decision making process. Advertising congruence with media use was an important aspect of the study as well as grasping respondents’ perception of behavioral control with regard to requesting prescription drugs from their doctor. A small portion of this study examined how physician prescribing behavior was affected by DTCA. / text

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There are many differentiated product industries in which firms offer multiple products in the same market. In making strategic decisions regarding entry, quality and quantity to be supplied for their multiple products firms must consider the competition with rivals as well as cannibalization of their own products that are close substitutes. In this setting, understanding the relationship between the behavior of consumer demand and firms decisions' regarding product characteristics and strategic variables like advertising are fundamental issues in industrial organization. This dissertation empirically explores these fundamental issues in the pharmaceutical and airline industries. The first paper of my dissertation estimates consumer demand for different anti-cholesterol drugs using panel data on a nationally representative sample of individuals who were diagnosed with cholesterol problems in the period 1996-2002. The data provides detailed information on individuals' medical conditions, medical and drug insurance coverage, drug purchases (if any), and other demographic and medical information. Individuals choose whether to purchase an anti-cholesterol rug and, if so, which drug to buy. The model permits flexible substitution patterns among drug choices and persistence in those choices by incorporating both observed and unobserved consumer heterogeneity. The estimates suggest that lower income patients without prescription drug insurance are very price sensitive: they are less likely to use drugs and, if they do use them, they tend to purchase the less expensive drugs. I find that roughly 500 thousand individuals without drug insurance who are currently not purchasing anti-cholesterol drugs would do so in the counterfactual world in which they are given the standard co-payment plan. The second paper also looks at consumer demands for anti-cholesterol drugs. While the first paper focused on the differentiated products, this paper explores the market expansion effects of direct-to-consumer advertising (DTCA). The study combines the individual data used in the first paper with monthly expenditure data on DTCA for the period 1996-2002. The dynamic demand model estimated in this paper explores the heterogeneous effects of DTCA. Overall, I find a positive effect from DTCA with short term elasticity of 0.107. Through persistence in consumer demand this effect lasts over multiple time periods. I find that individuals not taking a cholesterol drug respond more to advertising than those on the drug. In addition, I find that less educated individuals, those that may be unaware of their health condition, and those without health insurance are most responsive to DTCA. Finally, the third paper studies the effect of product ownership and quality on entry in the airline industry. Specifically, this paper empirically examines the decision of an airline to offer high quality nonstop service between cities given that the airline may or may not be offering lower quality one-stop service. I find that airlines that offer one-stop service through a hub are less likely to enter that same market with nonstop service than those that do not. In addition, the quality of the one-stop service is another determinant of entry. Airlines are more likely to enter a market with nonstop service if their own or their rival's one-stop service in the market are of lower quality. / text

Prescription drug direct-to-consumer advertising (DTCA) has been a subject of controversy in recent years. Though government regulations require equivalent prominence of risks and benefits, there is concern about the ability of consumers with limited health literacy to fully comprehend the risks and benefits associated with drug use. Evaluating the images in DTCA is important because individuals may rely on the visual message if the wording is overly complex. Using semiotics, this study aims to evaluate whether there is functional equivalence in the presentation of risk and benefit information in prescription drug direct-to-consumer television advertising. A new analytical method is created and used to assess the consistency between the messages contained in the voice track, the primary visual images, and the superscript/ subscript text. The results indicate that risk and benefit messages in this DTCA sample lack functional equivalence. However, it is important to properly frame these findings as the study does not evaluate viewer comprehension of the various message structures.

Each year millions of people face the medical decision-making cycle that comes with a diagnosis of cancer. For patients and their families, this can be a rollercoaster of confusion and fear. Researchers have indicated that the complexity of the decision-making process is underrepresented in the current approach of informed decision-making. The purpose of this study was to add to scientifically-validated research expanding the identification of factors that influence decision-making for individuals diagnosed with cancer. Fuzzy trace theory (FTT) is the dual process memory theory used as the framework for this study. Qualitative data were collected using semistructured interviews with 10 participants. The sampling strategy included purposeful sampling and snowball or chain sampling. The audio-recorded interviews were transcribed and analyzed. Software tools were used to aid in the creation of word mapping and clusters and a naming structure emerged. A comprehensive thematic analysis was completed. Participants detailed experiences with family and social dynamics, psychological or emotional stress, external influencing factors to the decision-making process, and experiences with cancer advertising. This research can create positive social change through the advancement of scientifically-validated research to support patients during the decision-making process.

La publicité directe des médicaments d’ordonnance (PDMO), interdite au Canada, influence la relation tripartite entre l’industrie pharmaceutique, les consommateurs de médicaments d’ordonnance et les professionnels de la santé. L’industrie pharmaceutique, un secteur très lucratif, emploie diverses tactiques publicitaires dont plusieurs sont nuisibles aux consommateurs. Ces derniers sont la cible de la PDMO et interprètent de multiples façons le message publicitaire reçu. Finalement, les professionnels de la santé jouent un rôle crucial entre l’industrie et les consommateurs puisqu’une ordonnance est nécessaire pour se procurer le produit publicisé. L’encadrement normatif visant la PDMO au Canada est de sources variées. La législation mentionne clairement l’interdiction de ce type de publicité, mais Santé Canada tolère tout de même deux usages relatifs à la PDMO : les annonces de rappel de marque et les annonces de recherche d’aide. Cette situation crée de la confusion puisque l’information transmise aux consommateurs est incomplète. Les Américains ont légalisé la PDMO en favorisant son potentiel éducatif. Il est toutefois difficile de constater les effets positifs de cette légalisation sur la santé publique et l’économie américaine. Au Canada, le médicament Viagra a été l’objet de PDMO, lui conférant un succès économique et populaire. Mais cette notoriété fait que les consommateurs associent aisément le produit à la condition qu’il traite, ce qui est contraire aux usages tolérés par Santé Canada. Tous ces éléments renforcent notre position quant à l’importance de maintenir l’interdiction législative de la PDMO et de l’appliquer de manière plus rigoureuse. / Direct-to-consumer-advertising of prescription drugs (DTCAPD), forbidden in Canada, influences the three-way relationship between the pharmaceutical industry, the consumers of prescription drugs and the health care professionals. The pharmaceutical industry, a very profitable business, uses different advertising tactics that can be detrimental to the consumers. The consumers are the target of DTCAPD and interpret in many ways the advertising messages that are being sent. Finally the health care professionals are playing a crucial role between the industry and the consumers as prescriptions are necessary in order to receive the advertised drugs. The Canadian normative framework surrounding DTCAPD has different sources. The legislation is clearly forbidding these advertisements, but Health Canada is still permitting two types of messages: Reminder Ads and Help-Seeking Messages. This situation is confusing since the transmitted information is generally incomplete. The United-States legalised DTCAPD for its educational potential. It is yet difficult to observe the positive effects on the public health and the economy of this country. In Canada, the prescription drug Viagra was the target of DTCAPD and was an economical and popular success. This recognition however helps the consumers to associate the drug and the condition it is treating, which is contrary to the exception framework set up by Health Canada. All these elements strengthen our position to maintain the DTCAPD legislative interdiction and to apply it in a rigorous manner.

La publicité directe des médicaments d’ordonnance (PDMO), interdite au Canada, influence la relation tripartite entre l’industrie pharmaceutique, les consommateurs de médicaments d’ordonnance et les professionnels de la santé. L’industrie pharmaceutique, un secteur très lucratif, emploie diverses tactiques publicitaires dont plusieurs sont nuisibles aux consommateurs. Ces derniers sont la cible de la PDMO et interprètent de multiples façons le message publicitaire reçu. Finalement, les professionnels de la santé jouent un rôle crucial entre l’industrie et les consommateurs puisqu’une ordonnance est nécessaire pour se procurer le produit publicisé. L’encadrement normatif visant la PDMO au Canada est de sources variées. La législation mentionne clairement l’interdiction de ce type de publicité, mais Santé Canada tolère tout de même deux usages relatifs à la PDMO : les annonces de rappel de marque et les annonces de recherche d’aide. Cette situation crée de la confusion puisque l’information transmise aux consommateurs est incomplète. Les Américains ont légalisé la PDMO en favorisant son potentiel éducatif. Il est toutefois difficile de constater les effets positifs de cette légalisation sur la santé publique et l’économie américaine. Au Canada, le médicament Viagra a été l’objet de PDMO, lui conférant un succès économique et populaire. Mais cette notoriété fait que les consommateurs associent aisément le produit à la condition qu’il traite, ce qui est contraire aux usages tolérés par Santé Canada. Tous ces éléments renforcent notre position quant à l’importance de maintenir l’interdiction législative de la PDMO et de l’appliquer de manière plus rigoureuse. / Direct-to-consumer-advertising of prescription drugs (DTCAPD), forbidden in Canada, influences the three-way relationship between the pharmaceutical industry, the consumers of prescription drugs and the health care professionals. The pharmaceutical industry, a very profitable business, uses different advertising tactics that can be detrimental to the consumers. The consumers are the target of DTCAPD and interpret in many ways the advertising messages that are being sent. Finally the health care professionals are playing a crucial role between the industry and the consumers as prescriptions are necessary in order to receive the advertised drugs. The Canadian normative framework surrounding DTCAPD has different sources. The legislation is clearly forbidding these advertisements, but Health Canada is still permitting two types of messages: Reminder Ads and Help-Seeking Messages. This situation is confusing since the transmitted information is generally incomplete. The United-States legalised DTCAPD for its educational potential. It is yet difficult to observe the positive effects on the public health and the economy of this country. In Canada, the prescription drug Viagra was the target of DTCAPD and was an economical and popular success. This recognition however helps the consumers to associate the drug and the condition it is treating, which is contrary to the exception framework set up by Health Canada. All these elements strengthen our position to maintain the DTCAPD legislative interdiction and to apply it in a rigorous manner.

Il 40 per cento degli intervistati afferma che non ha trovato informazioni esaustive sui rischi e benefici dei farmaci trovati, mentre il 52 per cento afferma che le informazioni trovate hanno aiutato a seguire le indicazioni e i consigli del medico. Tra i rispondenti che si sono sottoposti a visita medica e che hanno discusso le informazioni trovate online con il proprio medico di fiducia, l'84 per cento ha ricevuto la prescrizione di farmaci. Di questi, solo il 17 per cento riporta che il farmaco prescritto era lo stesso trovato online, il 74 per cento è stato inviato da uno specialista e l'80 per cento ha ricevuto una prescrizione per test diagnostici. Più della metà dei rispondenti ha anche riportato azioni intraprese dal medico diverse dalla prescrizione del farmaco trovato online. Il 20 per cento degli intervistati afferma che le informazioni trovate sul farmaco da prescrizione in Internet hanno ridotto il suo / la sua fiducia nel medico, mentre il 41 per cento afferma che lo ha aiutato ad avere una comunicazione migliore con il proprio medico di fiducia. Nonostante le preoccupazioni sulle conseguenze negative della comunicazione di salute online, non abbiamo riscontrato differenze in termini di effetti sulla salute tra i pazienti che hanno assunto i farmaci “menzionati” online e coloro che hanno preso altri farmaci da prescrizione. / We conducted a national online survey about health care experiences associated with digital communication of prescription drugs. 46 percent of the sample (265 adults) found information about prescription drugs during their online search in the last 12 months. 40 percent of respondents agreed they didn’t find exhaustive information about risks and benefits while 52 percent agreed it helped in following their physician’s indications and advise. Among the respondents who had a physician visit during which health information found online was discussed, 84 percent received a drug prescription with only 17 percent being the same drug found on internet, 74 percent was sent to a specialist and 80 percent received a diagnostic test prescription. More than half also reported actions taken by their physician other than prescribing the drug brand found online. 20 percent respondents states that info found on the prescription drug in Internet reduced his/her trust in the physician while 41 percent states it helped in his/her communication with physician. Despite concerns about online health communication’s negative consequences, we found no differences in health effects between patients who took “advocated”/”mentioned” drugs and those who took other prescription drugs.