As a reformed hypochondriac, I’m extremely vulnerable to the allure of pharmaceutical ads. I self-referred for GLP-1s years ago after seeing advertisements, and even though I am a diabetic, what followed were horrific health outcomes: hospitalizations, extensive procedures, scans, MRIs, pancreatitis, anemia, and thousands in medical expenses.
So I understand why new Health and Human Services Secretary Robert F. Kennedy Jr. has long called for a ban on pharmaceutical advertisements on TV.
But that seems unlikely to happen. The pharmaceutical industry is simply too strong — it spends billions of dollars on direct-to-consumer (DTC) advertising and lobbying efforts.
Banning pharmaceutical advertisements could also lead to unintended consequences. Just as alcohol prohibition drove demand underground, restricting DTC pharma ads might push consumers toward less reliable sources of medical information, such as social media influencers, unregulated online forums like Reddit, Quora, and TikTok or even black-market drug channels.
Furthermore, DTC commercials channel revenues necessary for pharma companies to complete costly research and development while also supporting media outlets that provide a megaphone for free speech.
But if we can’t ban pharmaceutical ads, we can at least rein them in. Policymakers can play an integral role in addressing the manipulative advertising practices rampant in the industry, while still allowing for DTC commercials and consumer education. The goal is to help consumers make informed, evidence-based decisions about their health care.
Pharmaceutical companies, like “mackerels in the moonlight,” stink and shine at the same time. While these organizations are among the most innovative in the world and have transformed the lives of people with both chronic and acute disease, they are also businesses with for-profit motives and a need to make sales. As a capitalist, I’m all for it. The DTC advertisements showcase the shine — which is that innovation and increasing awareness of important treatment options and patient access — but also emit a stench in how they cleverly promote a medication by showering the screens with actors frolicking through the woods, dancing down the street, or playing basketball.
Pharma ads, designed to manipulate and persuade viewers into requesting medications they may not need, should not purposely drive a psychological desire in the viewer. They exploit our fears of being sick, coercing us to take more prescriptions, leading to side effects that need to be addressed by more prescriptions. It’s a costly cycle (both physically and fiscally) for the individual as well as the entire health ecosystem.
Instead of an all-out ban, regulators need to install stricter regulations on transparency and accuracy in pharma ad design and creative, with an eye toward standards that protect the most vulnerable patient populations and address misleading claims while preserving access to vital health information.
Regulatory change is already underway. In November 20, 2024, the FDA outlined new rules for TV drug ads to use simpler, clearer language without distracting visuals or audio effects. Companies are also required to show on-screen text about side effects while the audio information plays. But companies get to decide whether to use a few keywords or a full transcript of text about side effects alongside audio.
These updates are a step in the right direction. Pharmaceutical companies should be required to use a neutral tone while presenting factual, science-based representations of medication benefits. However, by only limiting side effect text disclosure to key words, and not explicitly banning ad “speed reads,” or prohibiting audio or visual elements that lean into frolicking actors, there is still plenty of leeway for misleading viewers.
It may be a bridge too far to enforce a requirement for ads to mention alternative, nonpharmaceutical treatment options, when appropriate, such as lifestyle changes or therapy, but often it’s just what the doctor ordered. This would shift drug marketing from selling a silver bullet to a serious consideration of how medication fits within a patient’s overall health journey.
Concurrently, there appears to be a growing demand for more explicit, accessible communication from drug companies around what impact patients are experiencing with their prescriptions. But, aside from a few outliers, pharma advertising is being propped up by drugs with lower efficacy rates.
Research from Johns Hopkins Bloomberg School of Public Health found that a higher proportion of promotional spending allocated to direct-to-consumer advertising was associated with drugs rated as having lower added clinical benefit than for those having higher added clinical benefit. So not only are we — the American public — expected to have paid an estimated $460 billion in 2024 on prescription drugs, but there is also a high likelihood we have been taking and paying for drugs with the least benefit.
Advertisements and other communications around pharmaceuticals should clearly disclose the clinical efficacy of the drugs being sold to the American public. The most aggressive reform would restrict the ability to advertise to drugs that demonstrate minimal added clinical benefit, creating a clinical threshold of effectiveness before they can be aired to the public. If the money and time spent to research these drugs is driving real, positive impact in lives rather than padding the bottom line of pharmaceutical companies, those companies should welcome the chance to highlight the real-world impact of their work rather than the fantasy of a life transformed by a new pill.
These advertisements particularly prey on the estimated 6.9% of the population with illness anxiety, which once included me.
My experience may be extreme, but our system needs to shift away from consumer self-referring to one refocused on educating providers around what the latest pharmaceutical innovations mean for their patients. Rather than returning to the days of gift-toting pharmaceutical reps, the federal government should fund independent drug education programs to counterbalance pharma-driven narratives, with an emphasis on how pharmaceutical interventions should be applied in parallel to lifestyle changes or other social or mental health support for patients. Providers are the ones left to manage the side effects of the drugs their patients take and should be armed with the latest and greatest data possible to proactively guide and support the people in their care.
Instead of banning advertisements, we need to regulate and reduce manipulative marketing tactics with guidelines to limit the visual nirvana the drug companies represent and to prioritize patient health. Limitations on the use of emotional appeals and guidelines that enforce the inclusion of facts and risks will create realistic expectations and refocus on helping patients make more informed decisions about their health care and find a solution that fits them.
Hal Rosenbluth is the CEO of New Ocean Health Solutions, a digital health tech company dedicated to transforming how individuals, employers, and health plans navigate the health journey.