Hartley Heather, Coleman Cynthia-Lou
Department of Sociology, Portland State University, Portland, OR 97207, USA.
Health (London). 2008 Jan;12(1):107-32. doi: 10.1177/1363459307083700.
Since a 1997 regulatory shift on the part of the US Food and Drug Administration (FDA), there has been an explosion of televised direct-to-consumer (DTC) pharmaceutical advertising in the United States. The introduction and growth of this form of advertising, as well as other recent evolutions in the health care arena, have altered relationships among key countervailing powers in the health care system, suggesting the need to recast countervailing powers theory so as to account for these changes. Coming from the perspective that the news media play an important role in reflecting the balance of power among the various countervailing powers, the paper advances this theoretical framework through an empirical assessment of the relative prominence of those entities in print news media coverage of the DTC advertising phenomenon. The study finds that ;corporate sellers' (pharmaceutical industry) are accorded more prominence in news coverage than are providers, consumers, corporate purchasers, or state players and that DTC critics, in particular, have minimal representation. In addition, the findings point toward two modifications for countervailing powers theory: (1) an incorporation of the role of academic/research organizations, and (2) a consideration of the universe of possibilities with respect to each of the countervailing powers.
自1997年美国食品药品监督管理局（FDA）进行监管转变以来，美国电视上直接面向消费者（DTC）的药品广告激增。这种广告形式的出现和增长，以及医疗保健领域的其他近期发展，改变了医疗保健系统中关键制衡力量之间的关系，这表明需要重塑制衡力量理论以适应这些变化。从新闻媒体在反映各种制衡力量之间的权力平衡方面发挥重要作用的角度出发，本文通过对印刷新闻媒体对DTC广告现象报道中这些实体的相对突出程度进行实证评估，推进了这一理论框架。研究发现，“企业销售方”（制药行业）在新闻报道中比医疗服务提供者、消费者、企业采购方或政府机构更受关注，特别是DTC批评者的代表性极低。此外，研究结果还指出了对制衡力量理论的两点修正：（1）纳入学术/研究组织的作用；（2）考虑每种制衡力量的各种可能性。
