title: Differences in the volume of pharmaceutical advertisements between print general medical journals.
abstract: BACKGROUND
  Pharmaceutical advertisements have been argued to provide revenue that medical journals require but they are intended to alter prescribing behaviour and they are known to include low quality information. We determined whether a difference exists in the current level of pharmaceutical advertising in print general medical journals, and we estimated the revenue generated from print pharmaceutical advertising.
  
  
  METHODS
  Six print general medical journals in Canada, the United States, and the United Kingdom were sampled between 2007 and 2012. The number of advertisements and other journal content in selected issues of the Canadian Medical Association Journal (CMAJ), Canadian Family Physician (CFP), Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM), British Medical Journal (BMJ), and Lancet were determined. Revenue gained from pharmaceutical advertising was estimated using each journal's 2013 advertising price list.
  
  
  RESULTS
  The two Canadian journals sampled (CMAJ, CFP) contained five times more advertisements than the two American journals (JAMA, NEJM), and two British journals (BMJ, Lancet) (p<0.0001). The estimated annual revenue from pharmaceutical advertisements ranged from £0.025 million (for Lancet) to £3.8 million (for JAMA). The cost savings due to revenue from pharmaceutical advertising to each individual subscriber ranged from £0.02 (for Lancet) to £3.56 (for CFP) per issue.
  
  
  CONCLUSIONS
  The volume of pharmaceutical advertisements differs between general medical journals, with the two Canadian journals sampled containing the most advertisements. International and temporal variations suggest that there is an opportunity for all general medical journals to reduce the number of pharmaceutical advertisements, explore other sources of revenue, and increase transparency regarding sources of revenue.
authors.affiliation: Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gettings
authors.affiliation: Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom ; Undergraduate Medical Education, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Braden
authors.initials: B
authors.lastname: O'Neill
authors.affiliation: United States Department of Veterans Affairs, Washington, District of Columbia, United States of America.
authors.forename: Dave A
authors.initials: DA
authors.lastname: Chokshi
authors.affiliation: Division of Medical Communications, Brigham and Women's Hospital, Boston, Massachusetts, United States of America ; Department of Medicine, Newton-Wellesley Hospital, Boston, Massachusetts, United States of America.
authors.forename: James A
authors.initials: JA
authors.lastname: Colbert
authors.affiliation: Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom ; Undergraduate Medical Education, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Gill
authors.affiliation: Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada ; Assistant Professor, Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gerald
authors.initials: G
authors.lastname: Lebovic
authors.affiliation: School of Health Policy and Management, York University, Toronto, Ontario, Canada ; Emergency Department, University Health Network, Toronto, Ontario, Canada ; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Lexchin
authors.affiliation: Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada ; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada ; Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Navindra
authors.initials: N
authors.lastname: Persaud
mesh_terms: D000329:Advertising / Q000706:statistics & numerical data*; D004345:Drug Industry / Q000191:economics*; D018156:Journalism, Medical; D010506:Periodicals as Topic / Q000191:economics* / Q000706:statistics & numerical data*; D011327:Printing