Pharmaceutical benefit-risk perception and age differences in the USA and Germany

Introduction
Understanding how patients of all ages perceive the benefits and risks of medical treatments is vitally important. Yet, the role of older age on pharmaceutical benefit–risk perceptions has hardly been empirically investigated as a central focus of study.

Objective
This study tested the generalizability of recent pilot findings to explore benefit–risk perception age differences between adults aged 65 years old and over (older group) and those aged 18–64 years old (younger group).

Methods
An online survey representative for age, sex, and education was conducted in Ohio, USA (N = 1520) and Germany (N = 1536). A combination of benefit, risk, and affect questions measured respondents’ perceptions of 18 medicines, tests, vaccines, and procedures. Further questions investigated general perceptions of side effects and effectiveness, as well as respondents’ reliance on different sources of medicines information.

Results
Clear age differences were found that strongly support recent pilot findings. Older adults perceived prescription medicines significantly more positively than their younger counterparts. They had significantly higher benefit and lower risk perceptions for most, but not all, medical treatments investigated. Older adults’ benefit–risk perceptions were more strongly correlated with positive/negative affect, that is, their positive/negative experiences and feelings of “goodness” or “badness” they associated with each medical treatment investigated. They also perceived doctors and pharmacists as more competent and trustworthy. Contrary to popular belief, both age groups ranked their reliance on 15 different medical (e.g. doctors), societal (e.g. social media), industry (e.g. pharmaceutical company websites), and governmental (e.g. regulatory agencies) sources of medicines information remarkably similarly.

Conclusion
Age has an important role in patients’ pharmaceutical benefit–risk perceptions. Findings show that, when designing messages, benefit–risk communicators should incorporate age differences. This includes older patients’ positive perceptions of pharmaceuticals, greater reliance on affect, and information seeking versus scanning behaviour. Field experiments are now needed to test the effectiveness of such changes for improving benefit–risk communication practice.