SALES AND SCIENCE: CHANGING PATTERNS OF PHARMACEUTICAL AND MEDICAL DEVICE ADVERTISING IN PEER REVIEWED UROLOGY PUBLICATIONS, 1975–2000

PURPOSE: The effects of advertising on urological practice are controversial. We studied patterns of pharmaceutical and medical device marketing in peer reviewed urological journals in 1975 and 2000. MATERIALS AND METHODS: Pharmaceutical and medical device advertising in 1 European and 2 American peer reviewed urological journals were evaluated in 4 randomly selected issues of each journal published in 1975 and 2000, respectively. Advertising quantity and the qualitative characteristics of each advertisement were analyzed. RESULTS: We analyzed 574 advertisements in 24 issues. Advertising decreased between 1975 and 2000 based on the number of pages per issue (55.3 to 31.9, p = 0.04), number of advertisements per issue (30.4 to 17.4, p = 0.0098) and the ratio of advertising-to-scientific pages (0.399 to 0.151, p = 0.0016). Mean advertisement length was stable at 1.8 pages. The top 3 advertisers in 1975 were Eaton, Roche and Warner compared with Pfizer, AstraZeneca and Merck in 2000. Advertising for antibiotics comprised 70.3% of all pharmaceutical advertisements in 1975 but only 15.2% in 2000 (p = 0.0001), while advertising for benign prostatic hyperplasia, erectile dysfunction and hormonal therapy increased sharply. Nutritional supplement marketing increased from 0.5% of all advertisements in 1975 to 4.3% in 2000 (p = 0.0026). The incidence of advertisements citing peer reviewed literature increased from 16.7% to 33% (p = 0.0001) with a greater increase in the European than in the American journals. CONCLUSIONS: Advertising in peer reviewed urological journals has decreased since 1975 and fewer companies now market more products. Few advertisements cite the scientific literature. Better understanding of pharmaceutical marketing patterns may improve awareness of these efforts to influence physician practice.