Posted on 04/05/2025 1:46:56 PM PDT by nickcarraway
Reports of over-prescribing and excess drug spending make regulation necessary
Drug commercials have become commonplace in the U.S. The average American watches more than nine drug advertisements a day, or more than 16 hours a yearopens in a new tab or window. Only two countries in the world, the U.S. and New Zealandopens in a new tab or window, permit direct-to-consumer marketing of prescription medications. Since the practice became routine in the 1990s, concerns have been voiced about how such marketing creates unhelpful and even harmful pressures on patients, doctors, and communities. And while those concerns are not new, recent reports of over-prescribingopens in a new tab or window and excess drug spendingopens in a new tab or window make it more important than ever to pause direct-to-consumer marketing.
The State of Direct-to-Consumer Pharmaceutical Ads
In 1962, spurred by the discovery that thalidomide, marketed in Europe as a sleeping pill, caused severe birth defectsopens in a new tab or window, Congress granted FDAopens in a new tab or window the authority to regulate drug advertisements. The FDA Office of Prescription Drug Promotion is responsible for ensuring that advertisements are truthful, accurate, and present a fair balanceopens in a new tab or window of risks and benefits. However, there are inherent challenges in regulating such advertisements.
While the secretary of HHS, the department that oversees the FDA, has the authority to ensure advertisements are reviewed before they are public, such review is not mandatory and often fails to happen in practice. One study showed that only 32% of drug commercialsopens in a new tab or window were reviewed by the FDA prior to being broadcast in 2004; at this time, just four people at FDA were responsible for reviewing pharmaceutical advertisements.
More recently, HHS Secretary Robert F. Kennedy voiced his intentopens in a new tab or window to ban direct-to-consumer drug advertisements on television and elsewhere. How the Trump administration's recent mass federal firings will impact the Office of Prescription and Drug Promotion and if that will further slow the office's review of ads and complaintsopens in a new tab or window remains to be seen. Further, while the FDA regulates advertisements on public television and social mediaopens in a new tab or window, influencers promoting products on social media are not regulated. Taken together, excess drug promotion with limited oversight floods the public every day.
The Trouble With Drug Ads
Pharmaceutical companies who pay for direct-to-consumer drug marketing argue that it empowers patients in their relationships with their healthcare providersopens in a new tab or window. Yet, research has shown that drug advertising can lead to use of more expensive drugsopens in a new tab or window in place of lower-cost, generic alternatives, as well as less appropriate prescribing. Additionally, fewer than one in three drugsopens in a new tab or window advertised in 2016 were therapies that provided even moderate benefit over existing options. This means that drug advertisements, in numerous cases, lead to individuals paying more money without substantial benefits.
Studies have also shown that certain drug advertisements for the treatment of HIV resulted in a false sense of protection, leading to increased behaviorsopens in a new tab or window associated with spreading HIV. Drug advertisements can also lead to overprescribing and inappropriate useopens in a new tab or window of medication. While overprescribing can cause unnecessary side effects, the larger issue is that pharmaceutical companies typically market newer medications -- medications for which long-term side effects are not yet known. As a result, there are several more recent stories like that of thalidomide.
In 2004, rofecoxib (Vioxx), widely promoted as a pain reliever, was found to increase the risk of serious heart problemsopens in a new tab or window. In 2010, the appetite suppressant sibutramine (Meridia) was found to increase the risk of heart attacks and strokesopens in a new tab or window. Both drugs were voluntarily withdrawn from the market.
The Vioxx controversy led some in Congressopens in a new tab or window to call for limits to drug advertising, including a delay in advertising for a couple of years after the drug is introduced. Yet, advertising has not waned -- if anything, direct-to-consumer drug marketing has expanded. In 2020, pharmaceutical companies spent nearly $6.6 billionopens in a new tab or window on direct-to-consumer marketing alone, a 90% increaseopens in a new tab or window in spending compared to 2012.
A Balanced Compromise
It is important to note, however, that increasing public awareness of new medications can have benefits. Medication to prevent HIV, for example, must be taken within 72 hours of an exposureopens in a new tab or window to be effective, and public awareness is essential to ensure such medications are used. Additionally, individuals may learn about the conditions they have and the availability of treatments. But such information should come from doctors and community health advocates -- not drug companies.
Of course, we must also recognize that drug companies depend on sales to incentivize them to develop new therapies -- and we are not here to stunt innovation. A balanced compromise might be to restrict specific brand advertising directly to consumers but allow efforts to increase awareness and education around specific conditions or diseases. Meanwhile, it makes sense for pharmaceutical companies to continue direct advertisements to health professionals in medical journals and through expositions at medical meetings. However, given the harms and increased consumer costs of medications, Secretary Kennedy should act on his previously stated intent and take the opportunity to pause direct-to-consumer advertising now.
Lao-Tzu Allan-Blitz, MD, MPH, is a pediatrician and adult medicine specialist at Brigham and Women's Hospital and Harvard Medical School in Boston. Jeffrey D. Klausner, MD, MPH, is a professor of population and public health sciences at the University of Southern California Keck School of Medicine in Los Angeles, and a former CDC medical officer.
Maybe it’s because everything he does opens in a new tab or window.
?
Why don’t he just tell the 500 billion dollar industry to shut down all tv?
(90 percent of the commercials I see are for drugs)
Same reason Trump is president and people ignore him and ignore that fact
Why don’t he just tell the 500 billion dollar industry to shut down all tv?
(90 percent of the commercials I see are for drugs)
Same reason Trump is president and people ignore him and ignore that fact
Or geoengineering. California is blanketed today.
Sorry. Read through your posted text and it will make sense.
I don’t get it. This is the same article from the headline.
Drug companies have Amendment I rights.
In my youth, health insurance didn’t pay for drugs.
I’m 66. I’ve never had an outpatient drug paid for by insurance.
In my youth, I was covered by Blue Cross/Blue Shield hospitalization. My mother wrote checks to pay for doctor visits and prescriptions.
I don’t know but sometimes there is metadata or something or other that automatically posts when you copy paste. No big deal, just making light of how it reads. You’re cool.
The Citizens United decision would suggest that corporations have free speech rights.
The problem is probably with the Administrative Procedures Act. It takes a while to change the rules, and requires notice and time for public comment. RFK, Jr., may be able to shut down new ads, i.e., those not yet approved, but those that have already been approved are a problem.
Perhaps. Does that mean a drug company can make an ad claiming that their pill will make you lose 50 pounds if there is no evidence?
Anything where the pharma industry is involved is going to take a long time and a lot of court battles. They won’t go away quietly.
Because the FDA doesn’t have anywhere near that kind of authority. The FCC might be able to ban them on broadcast, but even then that leaves cable, satellite and the internet wide open. We don’t live in a dictatorship, the government’s power are DELIBERATELY limited.
Fox News alone would lose 3/4ths of its sponsors…
Is that a bad thing?
Correct. Broadcast and cable news outlets derive 75% of their revenues from pharmaceutical companies. The company news store.
A little editing on your part to delete the 23 “new tab or windows” would have made your post readable.
How about if a drug is advertised on TV, it’s cost could not be paid by insurance?
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