Proper Publicizing in CEECs – Path to Successful Social Media Commercials

Lack of laws defining the boundary between proper and improper publicizing in Central and Eastern European Countries (CEECs) leads to the urgent need to specify some essential statutes that ensure the identification of hidden or misleading commercials and prevention of improper advertising on social media. 

In most European countries there are yet no strict laws indicating requirements for promotional posts for medical devices on social media. Nevertheless, according to the guidelines of the Lithuanian legislation, a post on social media becomes an advertisement if: 

• The promoter (influencer) gets paid for advertising; 
• The promoter (influencer) receives a discount for a product or is presented with free samples of a product as a salary; 
• The promoter (influencer) creates a contest and gives away advertised products or special discount codes as prizes; 
• The promoter (influencer) states that he/she personally wants the product and he/she is compensated for it; 
• A photo or a video material conveys the promoter’s satisfaction of the product; 
• The seller lends a product to the promoter (influencer) for a definite amount of time for advertising purposes (2). 

Exclusive attention must be paid for commercials with a target audience consisting of children under 18 years old where direct inducement to buy cannot be used. Furthermore, commercials cannot be used to form an image that their product can possibly make children physically, psychologically, or socially superior (1).

Nevertheless, there are no definite penalties for inappropriate advertising, but to be certain that the content which you are creating or sharing on Facebook  or Instagram  is indicated correctly, you always should follow these main tips: 

• Information on social media must be marked as commercial whenever a product or a service is mentioned; 
• Content that is created for Lithuanian audience or in the Lithuanian language must be marked with hashtags #Reklama and #Remiama or #Sponsored; 
• Content that is created for a foreign audience or in the English language must contain hashtags #Sponsored and/or #Ad; 
• It is not enough to only mention in the description that your content is of promotional nature. Mentioned hashtags must be easily visible in a promotional video or a photo.;
• Often used phrase “Special thanks to <name of sponsor>“ as gratitude is not enough to make it obvious that the content was promotional and that the product was received for free; 
• Marking the name of a product or a company with a tag “@“ in the promotional material or presentation of a website link in the description is considered as not enough (2). 

Exclusive attention must be paid for a new trend on social media – stories. Hashtags #Reklama and #Remiama or #Sponsored (for Lithuanian content) and #Ad and/or #Sponsored (for foreign content) must be visible and easily readable and proper font size and text color must be ensured (2). 

It is pointed out, that in Lithuania it is forbidden to promote over-the-counter medicines on social media. 

Restrictions for disclosure of patient related information on social media (“Patient’s image”) 

Influencers are held equal to patients so they are prohibited to use their names, surnames, image of patient (recommendations, experiences, patient cannot be shown in a hospital environment) and recommendations of health care facilities, health care professionals, or their organizations cannot be used for commercial purposes. However, the use of the age of a patient is not regulated, thus considered allowed. Consequently, the use of before and after pictures to promote medical devices are allowed if the photos are not retouched with editing programs for filter effects, etc. (1). 

In an aim to better understand the current situation about advertising medical devices or over-the-counter (non–prescription) medicines on social media, hereinafter are listed certain EU countries with a brief description of key requirements. 

Key requirements for advertising non-prescription medicine and medical devices in Latvia 

Based on legislations it is possible to promote medical devices and over-the-counter (non–prescription) medicines on social media only with general recommendations being followed. Advertising must be designed for promotional purpose only in such a way that there could be no doubt that the information distributed is an advertisement and the product being advertised is over-the-counter medicine, including: 

• Name and general name; 
• Instructions for correct use; 
• Invitation to read the patient information leaflet; 
• Invitation to consult with a physician or a pharmacist; 
• A warning in Latvian: “Zāļu nepamatota lietošana ir kaitīga veselībai” (Eng.: Inappropriate use of medicine can be harmful to your health); 
• Identifiable advertiser / sponsor (4). 

All advertisements of medical devices on social media must be marked with #Sponsored / #Ad markings which cannot be hardly noticeable or hidden with other hashtags or necessary actions such as “swipe up“. 

Key requirements for advertising non-prescription medicine and medical devices in Estonia 

Over-the-counter medicines (non–prescription) can be advertised on social media if these general legislations are being followed: 

• Medicinal Product Act; 
• Advertising Act. 

All promotional materials must include a warning: “Tähelepanu! Tegemist on ravimiga. Enne tarvitamist lugege tähelepanelikult pakendis olevat infolehte. Kaebuste püsimise korral või ravimi kõrvaltoimete tekkimisel pidage nõu arsti või apteekriga“ (Eng. Important! This is a medicinal product! Before using please read the product information leaflet. If you have any further questions on the use of this medicine, ask your doctor or a pharmacist). 

No personal opinions about medicinal products are allowed to be posted by influencers on social media. Nevertheless, they can share publicly their emotional thoughts of the procedure, but the product name or the name of the doctor (specialist) cannot be mentioned. Personal photos and article reprints can be used as promotional material only with a signed agreement of the author. 

Also, it is strongly recommended to use easily noticeable hashtags #Sponsored / #Ad on Facebook  and Instagram  posts or stories. 

Key requirements for advertising non-prescription medicine and medical devices in The Czech Republic / Slovakia 

Over-the-counter medicines (non–prescription) can be advertised on social media if: 

• The product is not used as a reimbursement for promotional services of an influencer; 
• Posts in social media must comply to promotion of medicines – all posts are submitted to the Agency of Slovakia before the start date of use; 
• A warning for adverse event reporting (like in press, radio, or TV commercials) is included (5). 

Health care providers or actors cannot advertise over-the-counter medicines and recommendations by health care providers or patient organizations are prohibited. Undoubtedly, it is strongly recommended to use easily noticeable hashtags #Sponsored / #Ad on Facebook  and Instagram  posts/stories. 

Requirements for advertising medical devices on social media are similar to all previous countries, only these points are special: 

• On Facebook, the text must always include the following sentence: The contribution to the promotion of <sponsored company>; 
• On Instagram, there are two options. There must be a certain sentence under the text of a post: contribution to the promotion of <sponsored company>. Otherwise, the post must have a hashtag #<company name>promo  marking all promotional materials. The usage of these methods may vary according to the type of advertisement and the decision of the creators; 
• However, stories  are a special form of social media content where an excess of text could be a disadvantage. As a result, all promotional materials must be marked with a hashtag #<company name>promo  which shows the company‘s belonging and promotional purpose (3). 

Key requirements for advertising non-prescription medicine and medical devices in Hungary 

Advertising medical devices and over-the-counter medicines (non–prescription) on social media in Hungary is described by requirements as listed below, starting with Facebook: 

• All safety and legal information must be placed into a fixed post called Notes; 
• Individual posts must contain shortened safety and legal notifications with an URL link titled “detailed safety and legal information could be found in Notes”; 
• Fixed post with a headline must be maintained with all safety and legal information; 
• The possibility of getting to know the user guide for Facebook  must be ensured, as well as reference and link to Community guidelines (6). 

On Instagram: 

• Shortened safety and legal information must be available in the company’s account bio with a link to the webpage; 
• Safety information must be added to each post; 
• Stories  are presently not used, so there are no requirements yet. 

Advertisement of over-the-counter medicines (non–prescription) in Hungary is allowed, but only with following restrictions: 

• Non–prescription medicines can be promoted to the public only if the promoter (influencer) receives no reimbursement for promoting the product; 
• A warning for adverse event reporting (like in press, radio, or TV commercials) must be included; 
• Health care providers or actors cannot advertise over-the-counter medicines; 
• Recommendations by health care providers or patient organizations are prohibited; 
• In Hungary the influencer is considered as a representative of a promoter, so anything she/he says is considered as an advertisement;
• Sharing personal experience is not forbidden for influencers but must be in accordance with a patient information leaflet to avoid off–label*  using (6). 

*Relating to the prescription of a drug for a condition other than that for which it has been officially approved. 

To summarize, it must be emphasized that prescription medicines are strictly forbidden to be promoted on social media in any of the previously mentioned countries. Furthermore, general data protection regulations must be ensured, and identifiable patients’ information cannot be disclosed. All visualizations including before and after photographs or video materials of patients must contain a patient consent form. Stated requirements for publicizing medical devices are only recommendations due to the absence of special laws intended for advertising on social media, therefore it is strongly recommended to take necessary actions for the prevention of misleading or hidden commercials on social media. 

If you want to get more information about advertising on social media, don’t hesitate to contact us! 

Paulina Janusauskiene, Mpharm 

Regulatory Affairs

Biomapas 

References 

1. Parliament of the Republic of Lithuania. Law of promotion.
2. State consumer protection service. Guidelines for advertising on social media.
3. The Parliament of the Czech Republic. Regulation of advertising.
4. Cabinet of Ministers. Procedures for Advertising Medicinal Products and Procedures by which a
   Medicinal Product Manufacturer is Entitled to Give Free Samples of Medicinal Products to Physicians.
5. The National Council of the Slovak Republic. Act of Advertising.
6. Peter Holchacker. Can barriers be broken: web2 and the pharmaceutical industry?
   Domestic legal regulation of the use of social media.
7. Dave Chaffey. Global social media research summary 2020.