Marketing Strategies

Only a few articles focused on the marketing strategies of online pharmacies. Levaggi et al [79] and Orizio et al [84] disclosed the persuasive statements more frequently used by websites to promote their products, and identified arguments regarding privacy, service and drug quality, price offers, reassurances that buying drugs online is legal, and the suggestion that you can obtain a drug while avoiding a visit to the doctor. In particular, privacy issues were about the use of personal data and discreet packaging; service quality statements regarded short delivery times, online tracking of the state of the orders, and—indirectly—displaying testimonials by people who had already bought online; and price offers referred to encouragement to buy bulk purchases (found by Armstrong et al [57], European Alliance for Access to Safe Medicines [65], and Mahé et al [81] as well), lower prices than in “brick and mortar” pharmacies, fidelity bonuses, free delivery, and special discounts [79]. Armstrong et al [57] reported that one-third of their sample pointed out the advantages of ordering online, including confidentiality, ease of ordering, and lower cost. Forman and Block [70] analyzed the implied legitimacy and credibility claims, which they divided into 3 types: medical legitimacy, found in 82% of online pharmacies (eg, pictures of lab coats, rx/health symbols, and pharmaceutical logos); legal legitimacy, found in 72% (eg, government logos, explicit and implicit claims of being legal, and FDA approval statements); and retailer legitimacy, found in 24% (eg, customer testimonials). They also reported claims about shipping regarding security (52%), secretiveness (70%), reshipment if seized (2%), risk of seizure by US customs (6%), free delivery (24%), and the delivery company (52%). All the websites in Gernburd and Jadad’s [74] sample put forward benefit claims. One website in Eysenbach’s [66] sample even offered to ship cimetidine together with a Viagra order because it causes “a 56% increase in plasma sildenafil concentration when co-administered”. Gurau [75] pointed out that providing contact information may be a way to reduce the perceived risk of online transactions; moreover, statements about price, convenience, choice, and discreetness of service are more frequently used by online pharmacies not asking for a prescription than by those asking for one. Advertising prescription-only medicines was also found by Bessel et al [60] in 20% of online pharmacies. Orizio et al [86] pointed out that the marketing strategies adopted by online pharmacies enhance consumers’ peripheral reflection: by analogically playing with the sale of other commodities, they magnify aspects of online trading that consumers might find convenient, but overshadow the nature and risks of the actual products they sell.

Quality

The presence of at least 1 quality certification was found to range from 12% to 13% [60,70,86] to 28% [58], but Tsai et al [93] did not find any websites displaying certificates. Researchers found certificates about the quality of the health contents and/or about security in the money transaction.

Regarding health content quality, Arruanda [58] found that the most frequent quality certificate was VIPPS [96] (9%), followed by the HON code [97] (5%). Bessel and colleagues’ [60] sample had quality certification on 12% of the websites: the national pharmacy authority, the HON, and the JCAHCO [98]. Makinen et al [27] reported finding the HON code and VIPPS seal. Peterson’s sample in 2001 [87] had 12% of websites with the VIPPS seal, rising to 18% in 2003 [88]. The European Alliance for Access to Safe Medicines [65] study found that 4% of the sample was licensed by a board of pharmacy or had an appropriate pharmacy listing, while 20% had a “stamp approval” from a recognized society or association, but they found when clicking on them that 86% gave a link to a bogus “approval” webpage. Soares Gondim and Borges Falcao [92] found that 15 of the 16 websites analyzed lacked the Brazilian National Health Surveillance Agency seal.

As regards the security of the money transaction, Arruanda [58] found the VeriSign seal [99] (8%), Forman and Block [70] found Verified by Visa and Master Card securicode logos, and Makinen et al [27] reported finding the TRUSTe seal [100]. As well, 24% of Peterson’s sample in 2001 [87] incorporated secure socket layer technology, rising to 33% in 2003 [88].

A special study was performed by Kuzma [78] about the Web vulnerability of a random sample of 60 online pharmacies. She chose as her testing tool the N-Stalker Web Application Security Scanner 2009 Free Edition 7.0, which showed that a majority of worldwide online pharmacies do not provide adequate protection for their consumers, especially in cross-site scripting. The NABP [10] found that 17% of the websites in their sample did not have a secure site.

Kunz and Osborne [77] assessed the readability of 16 online pharmacies using Storytoolz; they found that the majority of the information provided on direct-to-consumer pharmaceutical websites is written at a level far higher than that which the average consumer can understand.

Date: 2016-03-03; view: 709