Maintaining a Fair Balance? Narrative and Non-Narrative Strategies in Televised Direct-to-Consumer Advertisements for Prescription Drugs Aired in the United States, 2003-2016.

Televised direct-to-consumer advertising for prescription drugs (hereafter DTCA) are among the most widespread forms of health communication encountered by American adults. DTCA shape public understanding of health problems and support the commercial interests of pharmaceutical companies by offering prescription drugs as a treatment option. The U.S. Food and Drug Administration (FDA) requires DTCA to present fair and balanced information regarding drug benefits versus risks. While narrative persuasion theory suggests that narratives can enhance persuasion by facilitating message processing and reducing counter-arguing, prior assessments of the balance between drug benefits versus risk information in DTCA have largely overlooked whether the ads employ narratives and/or other evidentiary strategies that may confer a persuasive advantage. This study content analyzed narrativity in DTCA aired on television between 2003 and 2016 for four different health conditions (heart disease, diabetes, depression, and osteoarthritis). Results showed that while televised DTCA spent more time discussing drug risks than drug benefits, both narratives and factual evidence were more frequently used to communicate drug benefits than drug risks. These findings raise concerns that narratives are strategically used by DTCA to highlight drug benefits rather than drug risks, which could lead to inaccurate perceptions of drug risks among viewers.