Consumers have joined the courts and Congress this year in giving thumbs-down to DTC advertising. Not only are viewers finding the ads less memorable, many have stopped watching altogether. Thirty-two percent of all drug ads are actively ignored on TV, while 45 percent of ads are skipped using personal video recorders, such as TiVo, according to CNW Marketing Research.

What is a brand team to do? Well, if consumers are ignoring the commercials for the shows, why not put the commercials in the shows?

The integration of pharmaceutical brands into the story lines of entertainment shows may be a new evolution in the industry's focus on DTC advertising, say two UCLA medical school researchers in the paper, "Pharmaceutical Product Placement: Simply Script or Prescription for Trouble?" published last May in The Journal of Public Policy and Marketing (see "Detailing Dr. House: Promotion or Risky Prescribing?"). In 2006, they counted 462 mentions of prescription meds on TV shows. This, according to Nielsen Product Placement, is double the figure from the year before.

Product placement advertising (also called stealth or subliminal advertising) is the insertion of a product or service into a script or scene of a TV show or movie, usually for a price negotiated with the network, producer, or scriptwriter. It has proven to be a highly effective method of marketing for a host of different products, from food to computers to cars. The overall market for product placement rose 3.5 percent to $3 billion in 2004, according to the paper's authors, professor Dominick Frosch and research assistant Sony Ta.

While controversy exists over how effective and ethical product placement is, most agree that as a marketing tool it has two big things going for it—it is relatively inexpensive, and is as-yet unregulated.

Pharmaceutical companies seem to have been slow to adopt product placement as part of their marketing mix. No pharma company has admitted having anything to do with the surge of drug mentions on TV shows. And only one company, Organon Pharmaceuticals, has openly embraced product placement. (To promote their NuvaRing contraceptive, they paid to have a poster appear in the examining room on the sitcom Scrubs.)

Why the reluctance? Frosch believes it could be due to the conservative nature of drug companies, and perhaps a concern about trivializing medicines and illness by associating them with entertainment. Or maybe, at a time when DTC is being so closely scrutinized, companies would just as soon keep whatever product placement marketing they're engaged in as quiet as possible.

Nonetheless, Frosch says the potential for pharma product-placement marketing remains, and the inclusion of drug names in scripts is, at present, poorly supervised. Drugs are a different kind of product, says Frosch, and promoting them through product placements requires new FDA guidelines.

To find out more about his views, we interviewed Dr. Frosch by phone:

If pharma denies involvement in the frequent drug mentions on TV, why should we be concerned? Whether or not the drug mentions are deliberate and effective is very difficult, if not impossible, to determine without inside knowledge. But clearly there have been some documented placements that we note in our paper. Zoloft in (the 1999 movie) The Sixth Sense, Nuvaring in Scrubs, and we had a suspicion about the use of Lupron in the episode of (the Fox drama) House. (This claim was denied by the show's medical adviser—see "Detailing Dr. House: Promotion or Risky Prescribing?").

Would you explain why product placement is so powerful as a marketing tool? When you're watching a television program and the commercial break comes on, you know what you're seeing is an advertisement. I think a light goes on in people's heads that says, "I'm being promoted to." But when a brand is integrated into a storyline, and it's not perceived as an advertisement, it legitimizes the use of the product in a very different way.

What do you perceive are the dangers to the consumer, if any, of this kind of product placement marketing? Prescription drugs are a different class of product. Oftentimes, they have risks that are inherent to using them even if you use them according to directions. For consumers to make informed decisions, they need to be able to understand the potential benefits and risks of the product. The point of our paper is to say that there's a regulatory void here, and there's a potential for misuse or for consumers to be misled about products.

You call for regulations. Who would establish the guidelines? It seems to fall between agencies. The FDA and the FCC have different views on how to define this. The FDA does not clearly define even what constitutes an advertisement. So that would need to be clarified. The FCC, on the other hand, might state the need for a sponsorship list in the credits. The other sort of alternative would be to recognize these as drug placements. That is, if you can figure out a way to identify them as advertisements, and then require them to follow the same guidelines as typical prescription drug ads.

Do you think there's a difference between calling a drug by its brand name and calling a drug by its generic name? Our sense was: If there was a case where [a drug mention] was a product placement, it more likely would be the one described by the commercial name, not by the generic name. But then, these are medical shows so it's perfectly legitimate for there to be talk of products. The difference is when someone has been paid to use a particular product.

In other words, just saying the name of a drug doesn't make it an advertisement? No, but promoting it does.