When Have We Seen Enough Drug Ads on TV?

     Ten years ago, I finished my doctorate in Health Administration and wrote Health Attitude: Unraveling and Solving the Complexities of Healthcare. One of the topics I wrote numerous magazine articles about and on-the-air interviews was about direct-to-consumer (DTC) TV advertising. I felt strongly about the issue and ten years later I feel even more strongly about it. DTC TV advertising is not needed and has negative effects as I will describe below.

At the time, Millions of viewers of the Superbowl watched a celebrity step out of a limo and heard Mario Lopez, Jr., television host and actor, highlight the need to fight her toenail fungus. The ad suggested people with toenail fungus need Jublia, a $1,000 drug not covered by Medicare. A clinical study showed the cure rate for the drug was 15%. Anyone with toenail fungus has either talked to their doctor about it, researched it online, or is not bothered by any symptoms. The ad had more than 2,000 TV airings. The AMA, which represents more than 200,000 physicians in every state, said the growing proliferation of TV ads is driving demand for expensive drugs despite the availability of clinically effective and less costly alternatives. Following are my six reasons why the ban should be implemented ASAP.

1. Direct to consumer advertising can create artificial demand. The people in the ads are professional actors and actresses. They know exactly how to create an image of certain lifestyles and illnesses. Watching the ads over and over can lead to psychosomatic effects in consumers. They may conclude they have the advertised disease and demand the drugs which can help them achieve the lifestyle they see on TV.
2. The pharmaceutical industry spent $4-5 billion on video advertising in 2023. I do not believe the ads improve American health. Consumers know how to use the Internet and search the many excellent health-related web sites such as WebMD, Medline Plus, Healthline, the Cleveland Clinic, the Mayo Clinic, and many others. They can search on any symptom they may have and find understandable information about diagnoses, treatments, side effects, and preventive measures. The rise of AI chatbots gives consumers even more depth of information. They can be well prepared to discuss further with their doctor if needed.
3. The TV ads are inappropriate. They portray an image to children and young adults the only way to have a happy life in later years is to take drugs. Seniors may be led to worry unnecessarily about a condition they may not have.
4. The AMA said direct-to-consumer advertising inflates demand for new and more expensive drugs, even when lower priced alternatives may be available and equally effective. For example, anticoagulants (blood thinners) are taken daily by more than two million people. The cost is typically $20 per month for Warfarin, the most common drug. The industry has created three new alternative drugs which cost more than $600 per month. Three companies make comparable thinners. The price is almost identical for each. Competition? The new thinners are superior in several ways and are heavily advertised, urging people to talk to their doctor. For many people the lower cost drug is adequate, and the new drugs can have new side effects. I can attest to that personally.
5. The biggest problem in the American healthcare system is the high cost. The TV ads add to the cost. Taxpayers are subsidizing the cost of TV advertising because it is a tax-deductible expense. Many other expenses are not tax deductible because the IRS considers them unnecessary to the conduct of business. The pharmaceutical industry has convinced members of Congress consumers need to hear the message about new drugs directly from the manufacturers.
6. The U.S. and New Zealand are the only two developed countries that allow direct-to-consumer TV advertising of prescription drugs. Many European and Asian countries have excellent healthcare systems at a per capita cost 50-80% of what the U.S. spends. The outcomes on average are equal or better than in the U.S. None of these countries allow TV ads for drugs.

The pharmaceutical industry has done a lot of good for the world. Most babies born in 1900 did not live past age 50. Although the United States ranks #49 in the world, our life expectancy has risen to 79. Several factors have led to the increasing life span. Drugs created by the pharmaceutical industry have certainly contributed. The industry has also created drugs which enable people crippled with arthritis and other diseases to be happy and productive. Pharmaceutical research to create the wonder drugs is expensive and risky. Many drugs do not make it to the market. Profit creates the incentive to take the risks and the return on investment for the drug industry deserves to be above average. However, it has become disproportional. Pharmaceutical companies have a median gross profit margin of 76.5%. The S&P 500 companies have a median gross profit margin of 37.4%. Congress has given the industry a blank check to set prices. There are numerous watchdogs who look at industry merger and acquisition activity, anticompetitive behavior, and a ban of direct-to-consumer TV advertising.

Now the question is whether the new administration can make an impact on the cost of healthcare. The pharmaceutical industry maintains a significant lobbying presence and provides substantial political contributions. As of 2024, the pharmaceutical and health products industry employs 1,478 lobbyists, with 58% of them being former government employees. This high percentage of “revolving door” lobbyists indicates the industry’s strong connections to government.

In 2024, the pharmaceutical and health products industry spent $293,701,614 on lobbying. This represents a significant increase from previous years. For the 2023-2024 election cycle, pharmaceutical and health products Political Action Committees (PACs) have contributed $7,638,410 to political candidates, $3,269,050 to Democrats and $4,315,360 to Republicans.

Around the time I published Health Attitude, the lobby convinced Congress to ban Medicare from negotiating the price of drugs. (They even convinced Congress to give hundreds of millions of dollars in preferential treatment to individual drug companies). The last administration took victory laps after more than ten years. They said they had taken down big pharma for the benefit of consumers on Medicare. Medicare covers more than 4,000 drugs. The new ability to negotiate the price of drugs for Medicare was announced in 2022. Look at the details. The negotiated prices would start in 2026 for only 10 drugs. For 2027 the list would grow to 15 drugs. Can you imagine GM or Tesla exempting from negotiations for 99.8% of the millions of parts it buys? The government has. Meanwhile many taxpayers struggle to pay the rapidly growing cost of drugs. Some skip doses or share with family members. Some go bankrupt. Pharmaceutical industry, 1. Taxpayers, 0.

There are many lobbies; every industry has them. At times they do good things and prevent Congress from doing something stupid. In the case of pharmaceuticals, it is clear the lobby has a lock on Congress and causes them to act more for the benefit of the drug industry than for consumers.