title: Pharmaceutical companies and their drugs on social media: a content analysis of drug information on popular social media sites.
abstract: BACKGROUND
  Many concerns have been raised about pharmaceutical companies marketing their drugs directly to consumers on social media. This form of direct-to-consumer advertising (DTCA) can be interactive and, because it is largely unmonitored, the benefits of pharmaceutical treatment could easily be overemphasized compared to the risks. Additionally, nonexpert consumers can share their own drug product testimonials on social media and illegal online pharmacies can market their services on popular social media sites. There is great potential for the public to be exposed to misleading or dangerous information about pharmaceutical drugs on social media.
  
  
  OBJECTIVE
  Our central aim was to examine how pharmaceutical companies use social media to interact with the general public and market their drugs. We also sought to analyze the nature of information that appears in search results for widely used pharmaceutical drugs in the United States on Facebook, Twitter, and YouTube with a particular emphasis on the presence of illegal pharmacies.
  
  
  METHODS
  Content analyses were performed on (1) social media content on the Facebook, Twitter, and YouTube accounts of the top 15 pharmaceutical companies in the world and (2) the content that appears when searching on Facebook, Twitter, and YouTube for the top 20 pharmaceutical drugs purchased in the United States. Notably, for the company-specific analysis, we examined the presence of information similar to various forms of DTCA, the audience reach of company postings, and the quantity and quality of company-consumer interaction. For the drug-specific analysis, we documented the presence of illegal pharmacies, personal testimonials, and drug efficacy claims.
  
  
  RESULTS
  From the company-specific analysis, we found information similar to help-seeking DTCA in 40.7% (301/740) of pharmaceutical companies' social media posts. Drug product claims were present in only 1.6% (12/740) of posts. Overall, there was a substantial amount of consumers who interacted with pharmaceutical companies through commenting (23.9%, 177/740). For the drug-specific analysis, we found that the majority of search results contained drug product claims (69.4%, 482/695); more claims mentioned only benefits (44.8%, 216/482) relative to only risks (27.2%, 131/482). Additionally, approximately 25% (150/603) of posts on Twitter and YouTube were presented as personal testimonials. A considerable percentage of content on Facebook contained advertisements for illegal online pharmacies (17%, 16/92).
  
  
  CONCLUSIONS
  Pharmaceutical companies avoid making drug product claims on their social media accounts but frequently post content that is consistent with FDA definitions for help-seeking DTCA. Thousands of people often view content posted by pharmaceutical companies on social media; users also share company postings making both direct and indirect influence possible. Finally, people are likely to be exposed to drug product claims and information about illegal pharmacies when searching for information about popular pharmaceutical drugs on social media.
authors.affiliation: The Ohio State University, Columbus, OH, United States.
authors.forename: Jennifer
authors.identifier: http://orcid.org/0000-0002-2279-0731
authors.initials: J
authors.lastname: Tyrawski
authors.forename: David C
authors.identifier: http://orcid.org/0000-0002-2315-4796
authors.initials: DC
authors.lastname: DeAndrea
mesh_terms: D003256:Community Participation; D000067088:Direct-to-Consumer Advertising; D004345:Drug Industry; D006801:Humans; D020407:Internet; D040541:Marketing; D008389:Marketing of Health Services; D060946:Pharmaceutical Services, Online / Q000331:legislation & jurisprudence; D061108:Social Media; D014481:United States
keywords: Facebook; Twitter; YouTube; direct-to-consumer advertising; eDTCA; eHealth; illegal online pharmacies; online pharmaceutical services; pharmaceutical drugs; social media