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Executive Summary

Self-medication and self-care efforts are being hindered by OTC advertising compaigns that "infantalize" the consumer, Lowell Levin, Yale University School of Medicine, asserted in a presentation to the 8th General Assembly of the World Federation of Proprietary Medicine Manufacturers in Washington, D.C on Sept. 23. "Announcing the availability of a medication," Levin emphasized, "has some characteristics that should distinguish it from candy." Specifically, Levin, said, OTC advertising must recognize a dual responsibility -- to foster an individual's understanding of complex health issues, and to enhance the individual's sense of self-control in the area of self-diagnosis and treatment. Levin called for the elimination of the "dependency producing" aspects of advertising that appeal to "irrelevant factors" in consumer decisionmaking. These include the use of status symbols or authority figures such as health care professionals in a clinical setting. As an alternative, Levin recommended advertisers initiate campaigns that "trade up" on public sophistication regarding the more "ethical" aspects of the product. Such a program would involve the placement of product ads into a social marketing strategy "that progressively deepends the educational context and helps particularize the product for individual decisionmaking." Marketing consultant Charles Kline (Charles H. Kline & Co.) noted that the top two U.S. advertisers in the OTC industry spend more than a quarter of their non-prescription product sales revenues on traceable media expenditures: Beecham spending 27.4% of OTC revenues on traceable media and American Home Products spending 25.5%. Bayer and Warner-Lambert are not far behind at 22.4% and 18.7%, respectively. "A characteristic of all the industrial countries," Kline commented, "is extremely heavy advertising and promotion -- in my view perhaps a little too heavy. This has led parts of the OTC industry to become really more concerned with advertising and promotion than with the need for good science . . . We have an overabundance in many markets of me-too products, with relatively little differentiation, one-to-the-other." DeWitt Helm, president of the Association of National Advertisers, observed that while a growing number of physicians recognize the benefits of self-medication, "others in positions of authority too often succumb to well-intentioned concerns and erect barriers to the practice of self-medication and to effective communication between OTC manufacturers and the consumers they seek to serve." "A major barrier," Helm continued, "is the blurring of the sharp line of demarcation that must functionally exist between labeling and advertising. The function of advertising is to call the consumer's attention to the availability of a preparation, to explain the benefits and to stimulate investigation that can only occur by careful reading of the complete label." Levin declared that a second barrier to increased use of self-medication is created by government policies that fail to explore how to achieve wider public access to effective medications. "Moving active ingredients to OTC status must be seen as a desirable option and an option that is feasible in the context of public education," Levin said. "Governments must consider the negative consequences of not encouraging public access to effective self-medication projects, particularly the potential for increasing public dependency on prescribed medications."

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