Pharmaceutical Advertising as a Source of Consumer Self-Empowerment: Evidence from Four Countries

393 Pages·2016·12.96 MB·English

by  Isabell Koinig (auth.)

Forschungsgruppe Konsum und Verhalten
Isabell Koinig
Pharmaceutical Advertising
as a Source of Consumer
Self-Empowerment
Evidence from Four Countries
Forschungsgruppe
Konsum und Verhalten
Herausgegeben von
S. Bekmeier-Feuerhahn, Lüneburg, Deutschland
Y. Boztug˘, Göttingen, Deutschland
S. Diehl, Klagenfurt, Österreich
F.-R. Esch, Oestrich-Winkel, Deutschland
C. Ch. Germelmann, Bayreuth, Deutschland
A. Gröppel-Klein, Saarbrücken, Deutschland
L. Hildebrandt, Berlin, Deutschland
J. Königstorfer, München, Deutschland
T. Langner, Wuppertal, Deutschland
B. Neibecker, Karlsruhe, Deutschland
M. Neumaier, Köln, Deutschland
T. Posselt, Leipzig, Deutschland
D. Radic, Leipzig, Deutschland
C. Schade, Berlin, Deutschland
M. Steul-Fischer, Erlangen-Nürnberg, Deutschland
D. Temme, Wuppertal, Deutschland
R. Terlutter, Klagenfurt, Österreich
V. Trommsdorff, Berlin, Deutschland
Die Forschungsgruppe „Konsum und Verhalten“, die von Professor Dr. Werner
Kroeber-Riel begründet wurde, veröffentlicht ausgewählte Ergebnisse ihrer Arbei-
ten seit 1997 in dieser Reihe. Im Mittelpunkt steht das Entscheidungsverhalten von
Abnehmern materieller und immaterieller Güter bzw. Dienstleistungen.
Ziel dieser Schriftenreihe ist es, Entwicklungen in Theorie und Praxis aufzuzeigen
und im internationalen Wettbewerb zur Diskussion zu stellen. Das Marketing wird
damit zu einer Schnittstelle interdisziplinärer Forschung.
Herausgegeben von
Prof. Dr. Sigrid Bekmeier-Feuerhahn Prof. Dr. Bruno Neibecker
Lüneburg, Deutschland Karlsruhe, Deutschland
Prof. Dr. Yasemin Boztug˘ Prof. Dr. Maria Neumaier
Göttingen, Deutschland Köln, Deutschland
Prof. Dr. Sandra Diehl Prof. Dr. Thorsten Posselt
Klagenfurt, Österreich Leipzig, Deutschland
Prof. Dr. Franz-Rudolf Esch Prof. Dr. habil. Dubravko Radic
Oestrich-Winkel, Deutschland Leipzig, Deutschland
Prof. Dr. Claas Christian Germelmann Prof. Dr. Christian Schade
Bayreuth, Deutschland Berlin, Deutschland
Prof. Dr. Andrea Gröppel-Klein Prof. Dr. Martina Steul-Fischer
Saarbrücken, Deutschland Erlangen-Nürnberg, Deutschland
Prof. Dr. Lutz Hildebrandt Prof. Dr. Dirk Temme
Berlin, Deutschland Wuppertal, Deutschland
Prof. Dr. Jörg Königstorfer Prof. Dr. Ralf Terlutter
München, Deutschland Klagenfurt, Österreich
Prof. Dr. Tobias Langner Prof. Dr. Volker Trommsdorff
Wuppertal, Deutschland Berlin, Deutschland
Isabell Koinig
Pharmaceutical
Advertising as a
Source of Consumer
Self-Empowerment
Evidence from Four Countries
Foreword by Prof. Dr. Sandra Diehl
Isabell Koinig
Klagenfurt, Austria
Dissertation Alpen-Adria-Universität Klagenfurt, Austria, 2015
Veröffentlichung mit Unterstützung des Forschungsrats der Alpen-Adria- Universität
Klagenfurt aus den Fördermitteln der Privatstiftung Kärntner Sparkasse und des
Instituts für Medien- und Kommunikationswissenschaften
OnlinePlus material to this book can be available on
http://www.springer-gabler.de/978-3-658-13134-0
Forschungsgruppe Konsum und Verhalten
ISBN 978-3-658-13133-3 ISBN 978-3-658-13134-0 (eBook)
DOI 10.1007/978-3-658-13134-0
Library of Congress Control Number: 2016933236
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Foreword
The topic of health communication has taken center stage in the 21st century, which
has been labeled the “health communication renaissance”. Health communication is a
broad research field and can take a variety of forms.
The primary focus of Dr. Isabell Koinig’ s dissertation is on pharmaceutical advertis-
ing as one form of health communication, and in particular she deals with the question
of whether pharmaceutical advertising can serve as a source of consumer empower-
ment. The thesis can, therefore, be classified as belonging to a research agenda, which
has been growing in significance in recent years. Pharmaceutical advertising encom-
passes all promotion activities related to medications, as well as medical products and
services, with the goal of informing and influencing the target group. Due to current
trends, such as an aging population, switches in the status of drugs from prescription to
non-prescription drugs (OTC – Over the Counter drugs), and the predicted shortage of
physicians, the OTC drug sector is steadily gaining in importance. Compared to the
effects of prescription drug advertising, the effects of OTC advertising have received
significantly less attention. Dr. Isabell Koinig narrows her focus to non-prescription
pharmaceuticals (OTC drugs) and to the role pharmaceutical advertising plays in self-
medication and consumer self-empowerment. Her dissertation makes a highly valuable
contribution to this research discipline.
Dr. Isabell Koinig develops a theoretically sound model that explains the effects of
pharmaceutical advertising in relationship to the construct of self-empowerment. She
analyzes her model in four countries and on three continents, utilizing four standard-
ized ads with different appeal types. She was able to confirm her model in large part.
With regard to the quantitative study, it should be emphasized that the investigation
was based on a large non-student sample (967 subjects). In addition to important OTC
markets such as the US, Germany and Austria, the emerging Brazilian pharmaceutical
market, which is expected to become an increasingly important market in the future,
was included as well. With this dissertation, the author contributes to the empirical
intercultural advertising research field and also to the long-standing debate on stand-
VI Foreword
ardization vs. differentiation of advertising. The study results show that a mixed adver-
tising appeal is the most promising approach for a standardized international advertis-
ing campaign promoting non-prescription pharmaceuticals. Dr. Isabell Koinig intro-
duces the concept of self-empowerment, a well-established concept in cultural studies
and media education, to the field of international marketing communication. Due to
the extensive availability of pharmaceuticals and health-related products, patients are
increasingly becoming “prosumers.” No longer passive and dependent, their role has
been redefined. They are becoming active consumers, who demand a stronger say and
wish to be integrated in their health-related decisions. In this context, ads play a criti-
cal role, as they have the potential to strengthen consumers’ competencies and to help
them make better-qualified decisions. The empowerment gained via advertising is in-
fluenced by the appeal incorporated in an ad, and mixed appeals were found to be par-
ticularly suitable for reinforcing consumer empowerment.
In summary, Dr. Isabell Koinig’s dissertation addresses a very relevant topic and con-
tributes to research development in the fields of pharmaceutical advertising, self-
empowerment and health communication. The implications of the current thesis are
highly relevant for researchers as well as for practitioners interested in the areas of
pharmaceutical advertising, self-empowerment and health communication.
ao. Univ.-Prof. Dr. Sandra Diehl
Department of Media and Communications
Alpen-Adria-Universität Klagenfurt, Austria
Preface
According to the IMS Institute for Health, the global pharmaceutical market is current-
ly worth almost USD 1 trillion a year – a figure that is expected to increase to USD 1.2
trillion by 2017. North America is responsible for the largest portion, generating more
than 40 % of these revenues. The world’s ten largest drug companies control over one
third of this market, six of which are based in the United States, while the other four
are located in Europe. The pharmaceutical industry is, hence, of immense importance
as a global sector. Currently, pharmaceutical companies spend one third of their total
sales revenues on marketing their drugs; by comparison, they spend only half of that
sum on research and development. With regard to their promotional efforts, academic
research has so far focused on direct-to-consumer prescription drug advertising, which
is solely permitted in the U.S. and New Zealand. Significantly less research has been
conducted in the area of non-prescription drug advertising – also known as over-the-
counter (OTC) advertising. While these pharmaceutical ads are clearly persuasive in
nature, such advertisements can also provide useful information that empowers con-
sumers to arrive at qualified decisions regarding their health and well-being. Apart
from a very small number of investigations, neither consumer evaluations of OTC
drug ads, nor the topic of consumer empowerment gained from such messages, have
been explored. The primary goal of the investigation at hand is to shed light on the
contribution of pharmaceutical promotions to individual self-empowerment and to un-
derstand whether manifestations of cultural dimensions affect the evaluation of such
commercial messages. This study examines how standardized promotional messages
for a fictitious OTC pain medication are perceived by consumers in four countries
(Austria, Germany, the U.S. and Brazil), and the degree to which advertisements in-
corporating varying appeal types (informative, emotional, mixed and corporate social
responsibility) contribute to consumers’ sense of self-empowerment. The relations
amongst the different variables are conceptualized as a model, which will be put to the
test. Study limitations are addressed and implications for further research are provided.
Numerous people have been part of this journey and I would take the opportunity to
express my gratitude to them. First and foremost, I would like to thank my supervisor
VIII Preface
Sandra Diehl, who did not only encourage me to pursue a PhD in the first place, but
also provided me with advice, guidance and constructive criticism along the way. Al-
ready during my Master’s degree, Sandra kindled my interest in pharmaceutical ad-
vertising and her mentoring encouraged me to take my research to the next level. To
her, I owe being introduced to Barbara Mueller, who I would like to mention at this
point as well: I am grateful to her for supporting my research (especially in the United
States) and her kind, encouraging words. I would also like to mention Ralf Terlutter at
this point, who patiently answered my statistical questions.
A special thank you goes out to Matthias Karmasin, who continuously expressed his
trust in my competencies and made me try even harder. Moreover, I am deeply grateful
to my colleagues and friends (you know who you are!) for their help and words of
comfort. The largest thank you is reserved for my family and Jonathan, without whom
I would have been lost on the way. If it were not for them, I would not have taken
much-needed breaks, experienced reassurance and found some distraction.
I highly appreciate the confidence and trust everyone has put in me. Your continuous
reassurance, love, and endless support were what made me strive for more and helped
me get to the place I wanted to be. Now the journey is over, I have conquered the
mountain called PhD. It is time to start looking again, to find the next peak to climb. I
cannot wait for whatever is out there.
Isabell Koinig
Table of Contents
1 Introduction ............................................................................................................... 1
1.1 General Introduction ................................................................................................. 1
1.2 Fundamentals of the Present Investigation ................................................................ 6
2 Conceptual Foundations ............................................................................................ 9
2.1 Health | Disease | Illness ............................................................................................ 9
2.2 Health Communication ........................................................................................... 10
2.3 Advertising .............................................................................................................. 11
2.4 Pharmaceutical Advertising ..................................................................................... 12
2.5 Culture ..................................................................................................................... 14
2.6 Standardization vs. Localization ............................................................................. 15
2.7 Health-Conscious Consumers | Empowerment ....................................................... 16
3 Perceptions of Health and Illness and Their Bodily Relevance .............................. 18
3.1 The Relevance of Health to Individuals’ Self-Identity ............................................ 18
3.2 Healthy Bodies As ‘Social’ Bodies ......................................................................... 20
3.2.1 Bodies and Social Capital: Expectations of Conformity ......................................... 20
3.2.2 Foucault: Enforcing Bodily Politics Through the Gaze .......................................... 22
3.3 Medicine and Its Regulatory Power ........................................................................ 24
3.4 Empowerment: From Passivity to Active Involvement .......................................... 26
3.4.1 The Emergence of the (Active) Health-Conscious Consumer ................................ 27
3.4.2 Health(-Conscious) Consumers and the Enterprise of the Self ............................... 28
4 Effects of Health Communication and Pharmaceutical Advertising ....................... 32
4.1 Health Communication in the 21st Century ............................................................. 33
4.1.1 Communicating about Health .................................................................................. 34
4.1.2 Approaches to Health: Focus on Health or Disease? .............................................. 35
4.1.3 Goal-Directed Health Campaigns: Pushing Information to the Public ................... 37
4.2 Health Communication’s Contribution to Health Literacy ..................................... 40
4.2.1 Health Promotion and Pharmaceutical Advertising as Sources of Information
and Empowerment ................................................................................................... 43
4.2.2 Deconstructing Pharmaceutical Advertisements: What Can They Achieve? .......... 45