Health Privacy: Should Health Marketers Be Able to Target You without Opt-in Consent?

We think not.  Consumers should decide–in advance and fully informed–whether they should be sent ads online for health conditions.  Take a look at WedMD’s privacy policy–which like most marketers hides behind claims that the “cookie”–a digital file placed on your browser”–isn’t personally identifiable.  Here’s what it says [excerpt]:

“Even if you do not register with WebMD, we collect Non-Personal Information about your use of our Web site, special promotions and newsletters…

We collect Non-Personal Information about your use of our Web site and your use of the Web sites of selected sponsors and advertisers through the use of Cookies. Every computer that accesses a WebMD Web site is assigned a different Cookie by WebMD. The information collected by Cookies (i) helps us dynamically generate advertising and content on Web pages or in newsletters, (ii) allows us to statistically monitor how many people are using our Web site and selected sponsors’ and advertisers’ sites, (iii) how many people open our emails, and (iv) for what purposes these actions are being taken. We may use Cookie information to target certain advertisements to your browser or to determine the popularity of certain content or advertisements…Third parties under contract with WebMD may use Cookies or Web Beacons to collect Non-Personal Information about your usage of WebMD’s sites. These third parties may use this information, on our behalf, to help WebMD target our advertising on their sites within their network, and WebMD may further tailor the advertising on these third party sites based on your geographic location (zip code), gender and/or age range to the extent known by these third parties….

WebMD Health Manager tailors the information you receive on your personal Health Manager home page to reflect your interests, concerns and personal health characteristics. We attach a concept unique identifier (CUI) to every piece of information that you provide us. For example, if you complete the HealthQuotient and indicate that you have diabetes, that single piece of information is tagged with a CUI that is specific to diabetes. Every user that indicates he or she has diabetes receives this CUI tag. Each time you view your personalized Health Manager pages, this CUI tag is matched to content from WebMD about diabetes, and if our automated algorithms determine that this is likely to be an important topic to you, it will appear on your personalized pages…”

We don’t mean to single out WebMD–the entire online health and pharma marketing industry requires scrutiny from policymakers and other consumer advocates.  That’s why my CDD is asking both the FDA and FTC to conduct a privacy and consumer protection ‘exam’ of this industry.  Don’t you think such a process should be covered under the new–and much needed–national health care plan!

Yahoo to Pharma Marketers: Come `Engage’ & Target Health Consumers Online

As my CDD has explained to both the FDA and FTC, the digital marketing of drugs and health information require serious privacy and consumer protection safeguards.  What may be acceptable when selling cars & travel online using the online ad tool-set is not appropriate when transferred wholesale to such sensitive categories as drugs.  Here’s an excerpt [pdf] from Yahoo!s promotional piece entitled “Social Media:  Pharmaceutical Marketing in the Age of Engagement.”

Social media marketing is a compelling opportunity for pharmaceutical companies to reach their most influential audience. Recent research conducted by Manhattan-based Hall and Partners Healthcare found that online health consumers are hyper-engaged and leverage almost twice as many information sources

to learn about disease states and prescriptions than the average consumer… For every creator of content – a physician writing a blog, for example – there are

roughly 10 synthesizers actively commenting, sharing, rating and reacting. For each group of synthesizers, roughly 100 consumers read, watch, listen and enjoy

while participating only occasionally. All three of these groups have a valid place within the community. event forms. Just as we have built communities of physicians who speak openly with each other about our products, we have an opportunity to nurture and learn from consumer communities as well. First, we must listen with intent…Analyzing what you hear can reveal a gap in consumer awareness. What’s more, a number of tools have emerged to help consolidate the vast array of social media input, from free online evaluators like Intelliseek, to sophisticated and customized tracking services like Cymfony. Once marketers have a firm grasp on the language, attitudes, brand perceptions and key COLs in their consumer community, pharmaceutical company participation can range from targeted media placement to integration and empowerment. All approaches are open to branded or unbranded programs…

“Medical Searches made up 45% of total online traffic”

That’s what Hitwise says, according to a recent report on search engine marketing.  Online ad spending by pharma is predicted to be $2.2 billion in 2011, “up from $1.2 billion in 2008.

source:  Take advantage of pharma sem: Your Rx for success.  Dan Brough.  Search Engine Marketing: Essential Guide.  DM News. 2009

A Glimpse Under the Data Collection `Hood’: Behavioral, Social Graph, Ad Exchanges, Ad Optimization

As CDD explained to the FTC and data protection commissioners, advances in online ad data collection, selling and targeting raise significant privacy concerns. This rapidly evolving infrastructure of user data auctioning requires scrutiny and safeguards.  Here are some excerpts from jobs in the sector, which gives one a glimpse of what’s going on.

Director of Agency Development- NYC – eXelate

About eXelate

The eXelate Targeting eXchange is the world’s first and largest open marketplace for behavioral targeting data. Through participation on the eXchange, data buyers build an instant behavioral targeting function and optimize their campaign delivery, while data sellers gain insight on their audience, control over their data distribution, and build a new privacy–friendly income stream. The eXchange includes over 40 top ad network/agency buyers and dozens of leading publishers, who deliver targeting data on more than 170 million unique users each month.


Account Manager – NYC – Netmining…

Netmining is a global provider of behavioral marketing solutions that are proven to increase conversion rates across websites, online advertising, email programs and offline sales channels. With a real-time profiling engine that understands each individual’s interests and buying propensity, Netmining enables companies to deliver highly relevant and personalized interactions across the entire customer lifecycle.
Senior Account Manager – Social Targeting Data – NYC – Media6degrees: About Us

We are the first online advertising firm built from the ground up specifically to leverage “social graph” data. The power of this data is captured by the phrase “birds of a feather flock together.”  We have mapped the social graph interactions of nearly 75 million US consumers and are the first company to offer “social targeting” which allows marketers to fully exploit the network value of every individual customer with whom they interact while also significantly improving response rates on new acquisition campaigns.

Our platform employs proprietary cookies to map the social graph. Our core data used to map the social graph has long been part of the standard Internet advertising protocols for trafficking advertisements and has been fully integrated with both Yahoo’s RightMedia platform as well as the DoubleClick Exchange and is accessible to any of the thousands of major marketers who advertise through these vehicles.


Senior Account Executive (2 Jobs) – NYC, SF – TARGUSinfo: 

Its unique identification, verification, qualification and location services enable retailers, call-center operators, Web-based marketers, communication service providers and others to dramatically increase the quality of their services and the effectiveness of their marketing. A privately held company, TARGUSinfo is headquartered in Vienna, Va. For more information, visit

With a focus on delivering measurable, predictable results in a online environment, TARGUSinfo is defining tomorrow’s marketing standards by delivering a display advertising targeting solution to advertising networks, interactive advertising agencies, and publishers.  We currently have a large cookie-based audience solution based on verified offline data assets.


Optimization Consultant, Ad Exchange – NYC – Google

you will be responsible for working with buyers and sellers on the Ad Exchange to optimize their experience (ie. manage yield or drive return on marketing investment). You will be responsible for partnering closely with Product Management, Engineering, Sales, and Services to build models, develop new ones, apply customer specific data, and develop insights.

Black Box Warning Required for Digital Rx Ads

This week CDD expanded its work on public health & digital advertising to include issues related to prescription drug advertising and health marketing online.  It submitted to the FDA, as part of that agency’s proceeding on Internet and social media marketing, comments.  We are speaking on this issue next week in New York.  And we will be dedicating resources via this blog and other venues on the issue.

But meanwhile we will begin by covering some of the latest developments.  In our FDA comments, we raise questions about the online targeting and data collection practices of online health marketers, including the tracking and targeting a consumer by their medical “condition.”  One of the companies we cited was “Everyday Health” and its “ConditionMatch(TM)” marketing system.  Today, that company posted a release saying it was the “faster-growing health network.”  Here’s an excerpt:  GHM audience is up 93% over a year ago — to 32 million unique visitors monthly — due to growth in consumers’ appetite for sophisticated, condition-specific information on niche sites. Advertisers have followed…

One factor driving the ad gains: a precise targeting capability GHM calls ConditionMatch(TM), which profiles “in-market” consumers (people searching for specific medical and wellness information). GHM delivers three primary audience channels: Consumer Medical, Consumer Wellness, and Healthcare Professionals. The Medical Channel delivers condition-specific audiences (e.g., allergy, diabetes, depression); Wellness bridges a marketplace gap by combining fitness and nutrition sites; and HCP aggregates professional website audiences.

“Pharma and CPG brands want condition specific-audiences of scale,” said Bill Jennings, CEO of Good Health Media. “Our site partners attract more a more frequent, loyal audience than broader health destinations online. We’re able to reach people who are actively seeking specific information on partner sites and across the Internet. That’s the ideal platform.”

Google Funds Privacy Research for several leading academics & advances its mobile data collection work

We believe academics should pursue research that is independent–and not funded by vested interests.  Here are some of the academics that just received “Google Focused Research Awards.“  The check also comes with a further relationship with Google [“These unrestricted grants are for two to three years, and the recipients will have the advantage of access to Google tools, technologies, and expertise.]

Ed Felten, Princeton
Lorrie Cranor, Alessandro Acquisti and Norman Sadeh, Carnegie Mellon University
Ryan Calo, Stanford CIS
Andy Hopper, Cambridge University Computing Laboratory
and: Use of mobile phones as data collection devices for public health and environment monitoring: Gaetano Borriello, University of Washington and Deborah Estrin, UCLA

Where Does Google and Microsoft Really Stand–with the IAB and ad lobby or for Consumer Protection?

Both Google and Microsoft serve on the executive committee of the Interactive Ad Bureau, a trade association fighting against consumer privacy proposals in Congress and the FTC.  The IAB just sent a letter signed by other ad and marketing industry lobbyists opposing Obama and congressional proposals to expand the ability of the FTC to better protect consumers.  My CDD just sent emails to officials at both Google and Microsoft asking them to clarify where they stand on the IAB’s letter [see below].  Do our two leading online marketing leaders support financial and regulatory reform, including protecting privacy?  Or does the IAB letter–and Google and Microsoft’s own role helping govern that trade lobby group–really reflect their own position against better consumer protection? Not coincidently, the IAB’s PAC has expanded its PAC contribution giving to congress.

Why does the IAB and other ad groups want to scuttle a more capable FTC?  Think online financial products, including mortgages, pharmaceutical operated social networks, digital ads targeting teens fueling the youth obesity crisis, ads created by brain research to influence our subconscious minds, a mobile marketing system that targets us because it knows our location, interests and behavior.  The IAB is terrified that a responsible consumer protection agency will not only peek under the ‘digital hood,’ as the Obama FTC is currently doing.  But actually propose policies and bring cases that rein in irresponsible and harmful business practices.  So Microsoft and Google:  who are with?  Consumers or the special interest advertising lobby?

letter to Google:  22 January 2010

Dear Pablo, Jane, Peter and Alan:

As you may know, the Interactive Advertising Bureau recently sent a letter  to Congress, along with other ad related groups, opposing the expansion of FTC regulatory authority as proposed in the Consumer Financial Protection Agency bill and related reauthorization [].

Google serves on the executive committee of the IAB’s board.  For the record, does Google support IAB’s stance that, as news reports say, if the FTC is given additional enforcement and penalty-making authority, “the FTC could essentially act as an unelected legislature governing industries and sectors across the economy.”

If Google disagrees with the IAB’s letter, I ask that it make its position public as soon as possible.  I also respectfully request Google state its position regarding the Consumer Financial Protection Agency proposal, as well as its position on expanding FTC authority.


Jeff Chester
Center for Digital Democracy

letter to Microsoft:  22 Jan. 2010:

Dear Mike and Frank:

As you may know, the Interactive Advertising Bureau recently sent a letter to Congress, along with other ad related groups, opposing the expansion of FTC regulatory authority as proposed in the Consumer Financial Protection Agency bill and related reauthorization [].

Microsoft serves on the executive committee of the IAB’s board.  For the record, does Microsoft support IAB’s stance that, as news reports say, if the FTC is given additional enforcement and penalty-making authority, “the FTC could essentially act as an unelected legislature governing industries and sectors across the economy.”

If Microsoft disagrees with the IAB’s letter, I ask that it make its position public as soon as possible.  I also respectfully request Microsoft state its position regarding the Consumer Financial Protection Agency proposal, as well as its position on expanding FTC authority.


Jeff Chester
Center for Digital Democracy

Consumer and Privacy Groups at FTC Roundtable to Call for Decisive Agency Action

Washington, DC, December 6, 2009 – On Monday December 7, 2009, consumer representatives and privacy experts speaking at the first of three Federal Trade Commission (FTC) Exploring Privacy Roundtable Series will call on the agency to adopt new policies to protect consumer privacy in today’s digitized world. Consumer and privacy groups, as well as academics and policymakers, have increasingly looked to the FTC to ensure that Americans have control over how their information is collected and used.

The groups have asked the Commission to issue a comprehensive set of Fair Information Principles for the digital era, and to abandon its previous notice and choice model, which is not effective for consumer privacy protection.

Specifically, at the Roundtable on Monday, consumer panelists and privacy experts will call on the FTC to stop relying on industry privacy self-regulation because of its long history of failure. Last September, a number of consumer groups provided Congressional leaders and the FTC a detailed blueprint of pro-active measures designed to protect privacy, available at:

These measures include giving individuals the right to see, have a copy of, and delete any information about them; ensuring that the use of consumer data for any credit, employment, insurance, or governmental purpose or for redlining is prohibited; and ensuring that websites should only initially collect and use data from consumers for a 24-hour period, with the exception of information categorized as sensitive, which should not be collected at all. The groups have also requested that the FTC establish a Do Not Track registry.

Quotes from Monday’s panelists:

Marc Rotenberg, EPIC: “There is an urgent need for the Federal Trade Commission to address the growing threat to consumer privacy.  The Commission must hold accountable those companies that collect and use personal information. Self-regulation has clearly failed.”

Jeff Chester, Center for Digital Democracy: “Consumers increasingly confront a sophisticated and pervasive data collection apparatus that can profile, track and target them online. The Obama FTC must quickly act to protect the privacy of Americans,including information related to their finances, health, and ethnicity.”

Susan Grant, Consumer Federation of America: “It’s time to recognize privacy as a fundamental human right and create a public policy framework that requires that right to be respected,” said Susan Grant, Director of Consumer Protection at Consumer Federation of America. “Rather than stifling innovation, this will spur innovative ways to make the marketplace work better for consumers and businesses.”

Pam Dixon, World Privacy Forum: “Self-regulation of commercial data brokers has been utterly ineffective to protect consumers. It’s not just bad actors who sell personal information ranging from mental health information, medical status, income, religious and ethnic status, and the like. The sale of personal information is a routine business model for many in corporate America, and neither consumers nor policymakers are aware of the amount of trafficking in personal information. It’s time to tame the wild west with laws that incorporate the principles of the Fair Credit Reporting Act to ensure transparency, accountability, and consumer control.”

Written statements and other materials for the roundtable panelists are available at the following links:





“Cookie Wars, Real-Time Targeting, and Proprietary Self Learning Algorithms: Why the FTC Must Act Swiftly to Protect Consumer Privacy”

That’s the title of comments filed at the U.S. Federal Trade Commission by my Center for Digital Democracy and U.S. PIRG.  I also just gave a presentation with the same name at last week’s meeting of data protection commissioners in Madrid, Spain.   It’s available here.

Here’s an excerpt:   Today, consumers online face the rapid growth and ever-increasing sophistication of the various techniques advertisers employ for data collection, profiling, and targeting across all online platforms. The growth of ad and other optimization services for targeting, involving real-time bidding on ad exchanges; the expansion of data collection capabilities from the largest advertising agencies (with the participation of leading digital media content and marketing companies); the increasing capabilities of mobile marketers to target users via enhanced data collection; and a disturbing growth of social media surveillance practices for targeted marketing are just a few of the developments the commission must address. But despite technical innovation and what may appear to be dramatic changes in the online data collection/profiling/targeting market, the commission must recognize that the underlying paradigm threatening consumer privacy online has been constant since the early 1990’s. So-called “one-to-one marketing,” where advertisers collect as much as possible on individual consumers so they can be targeted online, remains the fundamental approach.

Groups & Scholars Urge Congress to Strengthen FTC’s Ability to Protect Consumers

The advertising lobby has been working to undermine the FTC’s ability to serve the public interest.  Advertisers are fearful that the FTC–finally awakened from a long digital slumber–will actually investigate the numerous problems linked especially to marketing (think prescription drugs, financial marketing of subprime loans, etc.).  They are especially concerned that the FTC will effectively address privacy and consumer protection problems related to privacy, interactive advertising, children and adolescents, and “green” marketing.  Here’s the letter which was sent late yesterday to Chairman Waxman and Ranking Member Barton:

October 28, 2009

Chairman Henry Waxman

Rep. Joe Barton, Ranking Member

Energy and Commerce Committee

(via email)

Dear Chairman Waxman and Rep. Barton:

We write to support the provisions in H.R. 3126, the “Consumer Financial Protection Agency Act of 2009” (CFPA Act), designed to ensure that the Federal Trade Commission has the resources and authority to protect consumers from unfair and deceptive practices.

We believe that the FTC must play a more proactive role addressing critical consumer concerns, including privacy, online marketing, and food advertising to young people.  Therefore, we fully support the legislative language in H.R.3126 that would enable the commission to conduct consumer protection rulemaking under the provisions of the Administrative Procedures Act (APA); provide it with aiding and abetting liability for violations of the Section 5 of the FTC Act involving unfair or deceptive practices; and enable it to seek civil penalty liability for unfair and deceptive practices found to violate Section 5.  We also support providing the FTC independent litigating authority in civil penalty cases.

As you know, the FTC’s ability to serve consumers has been hamstrung because of its “Magnuson-Moss” rulemaking procedure.  As a result, the FTC has not been able to effectively engage in a timely and effective rulemaking process.  By providing the FTC with the same APA rulemaking authority enjoyed by other federal agencies, it will enable the commission to engage in consumer protection activities in a timely manner.


American Academy of Child and Adolescent Psychiatry

Campaign for Commercial Free Childhood

Center for Democracy and Technology

Center for Digital Democracy

Center for Science in the Public Interest

Children Now

Consumer Federation of America

Consumer Action

Consumers Union

Consumer Watchdog

Free Press

Electronic Frontier Foundation

Media Access Project

Privacy Rights Clearinghouse

Privacy Times

Public Citizen

Public Knowledge

Public Health Institute


World Privacy Forum

David Britt, CEO (retired) Sesame Workshop

Prof. Kelly Brownell, Yale University

Prof. Robert McChesney, University of Illinois at Urbana-Champaign

Prof. Kathryn C. Montgomery, American University

Prof. Joseph Turow, University of Pennsylvania

Prof. Ellen Wartella, UC Riverside