A Screenful of Sugar?

Prescription Drug Websites Investigated

by Jon C. Schommer (Author) Lewis H. Glinert (Author)
©2014 Monographs XIV, 192 Pages
Series: Health Communication, Volume 10


With drug information rapidly migrating to the Web, the chronically poor standards of drug information available to consumers in the developed and the developing world are being further compromised. This book offers insight into the uncharted waters of prescription drug information and promotion on the internet and suggests how it might be transformed into an unprecedented agent for good. It traces the social and political history of prescription drug information and marketing to Western consumers, offers a social and communicative profile of prescription drug Web sites, and evaluates the most widely used sources of prescription drug information, from government organizations and information companies and TV-related sites, to health service provider sites, manufacturers’ brand sites, and social media, including YouTube and Wikipedia. The focus throughout is on practical outcomes: How can information for consumer decision making be optimized and how can consumers use it responsibly?

Table Of Contents

  • Cover
  • Title
  • Copyright
  • About the author
  • About the book
  • This eBook can be cited
  • Table of Contents
  • Acknowledgements
  • Preface
  • Disclosure
  • Fair Use
  • Disclaimer
  • Chapter One: Prescription Drug Information For Consumers: How Did We Get Here?
  • The Age of Change and Patient Empowerment? The Patient Package Insert
  • Direct-to-Consumer Advertising for Prescription Drugs
  • Direct-to-Consumer Drug Advertising on the Tightrope
  • The Outcomes of Drug Advertising: How Much Do We Know?
  • 1. Educational Value
  • 2. Contributions to the Quality of Clinical Care
  • 3. Effects on Patient Adherence
  • 4. Promotion of Questionable Prescribing Practices
  • 5. Over-Diagnosis and Medicalization
  • Why Is There Such a Mixed Review?
  • What About New Zealand?
  • 1. Provision of Health Care Information to Consumers
  • Negatives
  • Positives
  • 2. The Appropriate and Quality Use of Medicines
  • Negatives
  • Positives
  • 3. Practicable and Cost-Effective Regulation
  • Negatives
  • Positives
  • 4. Appropriate and Proper Standards for Prescription Medicine Advertising
  • Negatives
  • Positives
  • 5. Medicalization
  • Negatives
  • Positives
  • 6. Impact on Patient-Doctor Relationships
  • Negatives
  • Positives
  • 7. Fiscal Pressures and Costs to Consumers
  • Negatives
  • Positives
  • What About the Rest of the World?
  • Migrating to the Web
  • Who Are the Key Players?
  • The Food and Drug Administration (and Similar Agencies in Other Countries)
  • Pharmaceutical Manufacturers
  • Health Care Insurers and Providers
  • Patients
  • Chapter Two: Welcome to a Prescription Drug Site
  • Who Uses Prescription Drug Sites, How and Why?
  • Where Drug Leaflets Have Failed—and Websites Need to Succeed
  • What Are the Search Engines Listing—and How Come?
  • Who Is Behind This Drug Information, and Is It Reliable?
  • When Is a Website User-Friendly?
  • First: There Is No Intuitive Route Through a Website
  • Second: The Overall Thrust of a Website Is Hard to Judge
  • Third: We Do Not “Read” an Individual Web Page in the Way We Read a Printed Page
  • Fourth: Content Keeps Changing—Without Warning
  • Fifth: Own-Site Search Boxes Are a Problem to Use
  • Sixth: Designers Seem to Relish Tiny Print
  • Finally: The Mother of All Problems
  • Broader Problems With the World Wide Web
  • Protecting the Vulnerable: American Seniors and the Less Literate
  • Text, Context, Message
  • What the Public Looks for in a Drug Website—and What We Checked for
  • Chapter Three: Government-Sponsored Organizations: PubMed Health – Why Does It Top the List?
  • What Is PubMed Health?
  • Who’s in Charge?
  • What Does PubMed Tell You?
  • How Well Is PubMed Organized?
  • How Well Is PubMed Written?
  • Chapter Four: Information Companies and TV-Related Sites
  • Who’s in Charge?
  • What Does About.com Tell You?
  • How Well Is About.com Organized?
  • (a) Urgent vs. Non-Urgent Action on Side Effects
  • (b) Other Important Side Effect Actions
  • (c) Conditions You Must Report to Your Doctor
  • (d) Interactions
  • Information and Promotion Shouldn’t Mix
  • WebMD.com
  • A Headache for WebMD
  • Who’s in Charge and Who’s Responsible?
  • Accreditation—What Does It Really Tell You?
  • WebMD Content
  • The Home Page
  • Find a Drug (If You Can)
  • Promotion or Information?
  • How Well Was WebMD Organized?
  • Medicinenet.com (Affiliate of WebMD)
  • Who’s in Charge and Who’s Responsible?
  • Content
  • How Was Medicine.net Organized?
  • Bad Language
  • Drugs.com
  • Extra Content
  • But Less Organization
  • (a) Contents List and Site Map
  • (b) Logical Arrangement of Navigational Links
  • (c) Content Cohesion
  • (d) Fencing Between Ads and Information
  • (e) Foregrounding Urgent Warnings
  • Chapter Five: Entering a Health Service Portal
  • Mayoclinic.com
  • Who’s in Charge?
  • Content
  • Neat Organization
  • How About a “Prompt Box”?
  • Ads and Information
  • Language
  • Summary
  • Walgreens.com
  • Who’s in Charge?
  • Content
  • Organization
  • Language
  • In Sum
  • Chapter Six: In the Brand’s Den
  • The Direct-To-Consumer TV Ad—Father of Brand.com
  • “C” for Content
  • The Big Issues
  • What We Explored and What We Found
  • 1. Packaging a Brand Site
  • a. Is There a Word for a Brand.com Site?
  • b. Link Titles and Page Descriptions: The Promise and the Reality
  • What To Make of It
  • 2. Ailment, Brand and Other Forms of Confusion
  • 3. Promotional Imagery: The Gorilla on Your Page
  • Something Called Trust
  • 4. Who Is Really Behind the Message?
  • 5. Accuracy, Hype and Ad-Speak
  • In Conclusion
  • Chapter Seven: Social Media
  • The Social Media and Your Health
  • Like Me, Like Me Not: The Pharma Industry, Facebook and the Social Web
  • Youtube
  • YouTube Nation
  • Education or Entertainment—or What?
  • Viewer Beware
  • Our Drug Searches
  • (1) Lisinopril
  • Lisinopril Ordered by Relevance
  • 1. Lisinopril
  • 2. Healthy Eating : Lisinopril Medicine Side Effects
  • 3. Lisinopril
  • 4. CCSVI and Lisinopril
  • 5. Lisinopril and Mini-Gastric Bypass
  • 6. Lisinopril Commercial
  • Related Clips
  • (1) Are You Tired of Your Blood Pressure Medicine?
  • (2) Lisinopril—Here’s Something Better!
  • (3) lisinopril—DON’T DO IT, this is Better
  • (4) Lisinopril
  • (5) Healthy Eating : How to Increase Your Metabolism Naturally
  • Lisinopril Ordered by Rating
  • 1. Healthy Eating: Lisinopril Medicine Side Effects
  • 2. Sexual Healing—Sexual Dysfunction and Impotence
  • 3. Random Video-Hypoglycemic Scare. Ugh!
  • 4. SoGood.TV: Healthy Choices and Easy Vegetable Side Dishes
  • 5. Ace Inhibitors Discover the Benefits and the Risks Associat [sic]
  • (2) Searching Zoloft and Plavix
  • Brand Promotion? Unbranded Sponsorship?
  • 1. How to Treat Anxiety Disorders with Zoloft
  • 2. Zoloft Commercial
  • 3. Zoloft (Sertraline Hydrochloride)
  • 4. Plavix Suspension
  • Summing Up
  • Legal Footnote
  • www.patientslikeme.com
  • A Website with a Noble Mission
  • How It Works
  • Looking up a Specific Drug
  • Impressions of PatientsLikeMe
  • Ad-free Zone
  • Reference Guide or Patient Profile?
  • Wikipedia
  • What Really Is Wikipedia?
  • How Credible Is a Wikipedia Entry?
  • In General
  • Anonymity
  • Neutrality
  • Verifiability
  • For Medications
  • Gaps and Fingerprints
  • Wikipedia and Brands
  • How People Actually Use and Perceive Wikipedia
  • Wikipedia Prescription Drug Pages
  • General Profile
  • Format
  • Content
  • Self-Presentation and Quality Control
  • Infliximab (Remicade)
  • Duloxetine (Cymbalta)
  • Summary
  • Chapter Eight: A Prescription for Change
  • Intelligibility and Other Issues of Usability
  • Credibility
  • Transparency and Probity
  • Advisories to Consult a Health Care Professional
  • So Where’s the Panacea?
  • Ethical Considerations: Ideals and Dilemmas
  • A Dizzy Mix of New Realities
  • The Stakeholders: Goals and Responsibilities
  • The Public
  • The Medical Profession, Educators and Advocacy Groups
  • Commercial Providers of Drug Information
  • Manufacturers and Marketers
  • The FDA, Congress and the Courts
  • How We Would Transform Drug Information Websites
  • Content
  • Oversight
  • Organization
  • Language
  • Chapter Nine: How to Use a Prescription Drug Website
  • Know Yourself
  • 1. What Type of Health Care Consumer are You?
  • How Do You Make Choices?
  • 2. How Do You Process Information?
  • 3. How Do You Prefer to Make Decisions?
  • Know the Source
  • Persuasion
  • Information
  • Knowledge and Resource Evaluation (KARE)
  • Knowledge and Resource Evaluation (KARE)
  • Know Yourself
  • Know the Source
  • Know Your Pharmacist
  • References
  • Index
  • Series Index



The authors gratefully acknowledge Daniel Sepulveda Adams, PhD for his assistance in obtaining data about the trends in spending for direct-to-consumer advertising. Dr. Sepulveda Adams is a Research Scientist for PRIME Institute, Minneapolis, Minnesota, USA. The authors also gratefully acknowledge Basma Gomaa, DVM for her assistance in obtaining data about the trends in the use of social media. Dr. Gomaa is a PhD student in Social and Administrative Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA. ← ix | x →

← x | xi →



This text is part of a Peter Lang Publishing series in Health Communication. The purpose of the series is to examine the powerful influences of human and mediated communication in delivering care and promoting health. The books in this series describe strategies for addressing major health issues, such as “reducing health disparities, minimizing health risks, responding to health crises, encouraging early detection and care, facilitating informed health decision making, promoting coordination within and across health systems, overcoming health literacy challenges, designing responsive health information technologies, and delivering sensitive end-of-life care.”

There has been a global information explosion. A quick trawl on the World Wide Web can land information about anything—including prescription drugs. Information, however, is no prescription for knowledge, let alone for sound decision making. The World Wide Web and the search engines that power it promise the earth, but, as studies consistently confirm, yield large measures of frustration or distraction. With drug information rapidly migrating to the Web, the chronically poor standards of drug information available to consumers in both the developed and the developing world are, in our view, being further compromised—while American marketing of drugs to consumers, hitherto more or less restricted to its own borders, has now been handed a global online audience.

The Internet holds out possibilities for knowledge and decision making across the social and global spectrum that would have seemed a fantasy a generation ago. ← xi | xii → It all hangs on the good will and imagination of just a few key players—and the good sense of the ordinary end-user.

Our book offers insight and suggests means for change as we navigate the uncharted waters of prescription drug information and promotion. Amid all there is to analyze and criticize, we have trained our sights on practical outcomes: how can information for consumer decision making be optimized? In our opinion, even manufacturer-sponsored websites can become trusted sources of information since they are scrutinized by the FDA (U.S. Food and Drug Administration) and manufacturers arguably hold the best information available about their products. The challenge is how to make full disclosure of information in a balanced manner and across society.

We first trace the social and political history of prescription drug information and marketing to Western consumers (chapter 1) and in chapter 2 we offer a social and communicative profile of today’s prescription drug website and the communicative properties of websites in general. Among our chief concerns: Who uses such drug sites, how and why? How do they compare with more ‘traditional’ drug information channels? Who is behind drug information and how trustworthy is it? What part do search engines play? What are the hallmarks of user-friendly websites in general? How do text, context, image and message interact in this new hypertextual stew? How are the elderly and less literate faring and what can be done?

Drawing on insights from health education, communication and Web usability, we then describe and evaluate a sample of the most widely used sources of prescription drug information: sites maintained by government organizations (chapter 3), sites maintained by information companies and TV-related sites (chapter 4), health service provider sites (chapter 5), manufacturers’ brand sites (chapter 6), and social media, including YouTube and Wikipedia (chapter 7). In each case, the focus is on four dimensions crucial to the success of the message: content, organization, language, and indication of oversight.

In chapter 8, we pull together the lessons of these five chapters in such a way as to offer policy-makers, patient advocates and the health industry a focused and feasible prescription for change. In the last chapter (chapter 9), we come back to you as health-seeker. We provide self-assessment tools that you can use to learn more about yourself and how you tend to use information and make decisions, and how you can avoid the perils of misleading information. We also give pointers on how to evaluate the source of information to see if it is credible and trustworthy. For those who are interested, we provide a self-assessment tool called the Knowledge And Resource Evaluation (KARE) that the patient can complete and then share with a physician and pharmacist to help them understand how the patient likes to receive information and make decisions. Finally, we give pointers about how patients can best utilize the most highly trained and knowledgeable health ← xii | xiii → professional when it comes to prescription medications and how to put all of the diversity of information about them into good decision making. That person is the pharmacist. We explain a new service called Medication Therapy Management that is now covered by most U.S. insurance plans and allows patients to make an appointment with their pharmacist to go over medication-related questions and to discuss how to choose the very best medications.

We hope that this book will be found informative. But more than that, we hope that it will make consumers (for every party to this matter is also a consumer) feel more confident that there are good ways to sort through all of the information about prescription drugs and make the very best decisions for themselves and for their families.


Throughout this book, we refer to names of organizations, companies, products, and services. We do not hold direct financial interest in any of these, but acknowledge that retirement funds in which we have invested are likely to have holdings in some of the companies mentioned in this book. We do not track that, nor do we instruct our retirement fund managers in how to directly invest our funds in such companies.


In some parts of the book, we include screenshots of information publicly available on the Internet in order for the reader to see examples of information we are discussing. We include these under fair use guidelines in which we reproduce them for purposes such as criticism, comment, reporting, teaching, scholarship and research.


It should be noted that our mention of organizations, companies, products, and services does not represent any endorsement (positive or negative) on our part. We have limited our evaluation and comments to the way information is presented and have used examples for illustrative purposes only. Finally, statements made in the screenshots included in this book should not be used by readers for informational or decision-making purposes. They are part of an information source that is more extensive than what is shown in this book. ← xiii | xiv →

← xiv | 1 →


XIV, 192
ISBN (Softcover)
ISBN (Hardcover)
Publication date
2013 (September)
drugstore sugar kit medic aid money drugs
New York, Bern, Berlin, Bruxelles, Frankfurt am Main, Oxford, Wien, 2014. 192 pp.

Biographical notes

Jon C. Schommer (Author) Lewis H. Glinert (Author)

Jon C. Schommer (PhD, the University of Wisconsin – Madison) is a professor at the University of Minnesota. His research is related to the provision, use, and evaluation of drug products and pharmacist services. Lewis H. Glinert (PhD, London University) is a professor at Dartmouth College. His research is related to discourse, language planning, and sociolinguistics, with a focus on risk information.


Title: A Screenful of Sugar?
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210 pages