medicines cost, healthcare marketing

Drug companies used to focus their marketing strategies exclusively on doctors. They spent millions on sales representatives who traveled the country chatting up physicians and handing out free samples. There was no such thing as direct-to-consumer (DTC) drug advertising. Now It seems as if every third commercial on television is for a medication. A physician from the 1980s would be astounded to see prescription drug ads to treat cancer, ulcerative colitis, rheumatoid arthritis or psoriasis.

The Spread of Prescription Drug Ads:

Prescription drug ads pay for a lot of your television viewing. If you have the impression that there are more such commercials on TV than there used to be, you are correct.

A study published in JAMA (Jan. 8, 2019) found that direct-to-consumer advertising went from $2.1 billion in 1997 to $9.6 billion in 2016. The proportion of marketing dollars spent on reaching consumers also increased during the last two decades. It went from 11.9% of total marketing dollars in 1997 to 32% of the total in 2016.

A Brief History of Prescription Drug Ads

In 1983 then FDA commissioner Arthur Hayes asked drug companies if they were planning to push for prescription drug ads directed at patients. According to an article by Dylan Scott (Stat, Dec. 11, 2016):

“Almost all of them said, ‘No, that would be a terrible idea.’”

In 1984 drug companies responded to Representative John Dingell from Michigan about DTC drug advertising:

R.T. Parfet, Chairman of the Board, Upjohn Company, (U.S. House of Representatives, 1984):

“The view of the Upjohn Company is that the direct advertising of prescription pharmaceuticals to consumers…would be detrimental to the pharmaceutical industry and, more importantly, a potentially disruptive element in our medical delivery system as a whole…Our view is that there is a vast difference between education and promotion…Product specific consumer ads could increase costs.”

Allan S. Kushen, Senior Vice President, Public Affairs, Schering-Plough (U.S. House of Representatives, 1984):

“We have serious concerns about proposals to allow advertising directly to patients. We do not believe it is in the public health interest; indeed we believe that, in most cases, it cannot safely be accomplished.”

Edgar G. Davis, Vice President, Corporate Affairs, Eli Lilly and Company (U.S. House of Representatives, 1984):

“We do not believe that commercial advertising of prescription drugs is appropriate…prescription drugs embody a complex set of factors with potential human effects that can best be evaluated by the physician…Therefore, we believe that the need for the physician’s supervision of any prescription drug taken by the patient is paramount and that the potential pressures of public advertising of prescription drugs on the scientific decisions of the physician are both unwise and inappropriate.”

An About Face About Prescription Drug Ads

In 1997, for reasons that remain mysterious to us, the FDA decided to make it easier for drug companies to advertise prescription drugs directly to consumers. The companies conveniently forgot their concerns about such practices. The floodgates opened.

The special communication in JAMA (Jan. 8, 2019) by Drs. Schwartz and Woloshin noted the change from 1997 to 2016:

“DTC prescription drug advertising increased from $1.3 billion (79 000 ads) to $6 billion (4.6 million ads [including 663 000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies.”

Can you believe it? In 2016 there were 663,000 TV commercials for prescription drug ads! We bet there were a lot more than that in 2018.

Names like Chantix (“I’m Ray and I quit smoking with Chantix”), Trelegy (“The Power of 1-2-3”), Trulicity (“I can do more to lower my A1C”) and Xeljanz (“the Unjection”) may sound familiar. They are good examples of television marketing of expensive prescription drugs.

Do DTC Prescription Drug Ads Work?

There is little question that these commercials are effective. Drug companies would not spend billions of dollars if they weren’t getting a substantial return on their investment.

What they may not realize, however, is how much the American public dislikes these ads. Here is just a smattering of comments we have received.

Chris in Florida wrote:

“The drug ads should actually show the TV actors experiencing the side effects of the advertised drug with an annoying soundtrack in the background. If one of the side effects is potential death, then show a funeral scene. I think that would make a funny SNL skit.

“They should also show a range in price per dose. That will not distract the audience. It would cause big pharma stocks to plummet, and only then will they pull their distracting ads.”

Jerry in North Carolina stated:

“Pharma ads should be banned for the simple reason that we are not qualified to make those decisions ourselves based on showing us happy people. Only our doctors are.

“A health care system such as ours makes as much profit from their product as they can. Showing happy faces is how they get us to ask our doctor for it. European countries do not allow prescription drug commercials to be aired.”

Patricia in California said:

“Everyone complains about ads, but no one does anything about them. I turn the channel off and don’t go back but invariably when I go to CNN, there they are again.

“I would like someone to explain to me why telling everyone they may commit suicide or have a heart attack or stroke is a good selling point. I wouldn’t take any of them. Also, this is the reason drugs are off-the-chart expensive.”

Keith in Massachusetts summed it up:

“All I have to say is AHHHH! I am going crazy listening to them. I am ready to break the TV. I run to mute it.”

One of the co-authors of the JAMA study, Dr. Steve Woloshin, told Kaiser Health News:

“Marketing drives more testing. It drives more treatments. It’s a big part of why health care is so expensive, because it’s the fancy, high-tech things that get marketed.”

We Have Complained to the FDA!

We are starting to sound like a cracked record when it comes to complaints about prescription drug ads. We are especially aggravated about the “formula” that drug companies have come up with to distract people from the part of the commercial that talks about nasty side effects. In virtually every ad you will see people smiling and having a good time when the announcer starts listing horrific drug side effects. Here is an article we wrote about this:

Do NOT Trust People Smiling During Drug Commercials

Do NOT Trust People Smiling During Drug Commercials

We complained about this practice to the FDA’s Office of Prescription Drug Promotion. Here’s what came back in response:

“Thank you for taking the time to alert us to potentially misleading promotion.  You and other healthcare providers are some of the most important resources we have in monitoring promotional activities in the prescription drug market.  Below is a detailed explanation of how we will use the information you have provided to help stop misleading promotion.

“If you provided contact information in your complaint, an Office of Prescription Drug Promotion (OPDP) representative may contact you to see if you would like to discuss your complaint.”

As far as we can tell there has been no follow-up. People are still smiling during the scary parts of the commercials. There is one other tactic. The latest Chantix “Cold Turkey” commercial has come up with other visual strategies to distract you. Here is a link so you can see for yourself.

Are you FED Up Yet?

If you have become fed up with prescription drug ads, why not let the Commissioner of the Food and Drug Administration know? You can contact

  • Dr. Scott Gottlieb, Commissioner of the FDA
  • 10903 New Hampshire Ave
  • Silver Spring, MD, 20993-0002.

Ultimately, though, this will likely require an act of Congress. You may want to express your thoughts to your Senator and Representative.

Share your feelings about prescription drug ads below in the comment section.

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  1. V J

    Grossly deceptive! For years these drug commercials have been beyond irritating and are just increasing in number. The worst side effects are mentioned when the people on the screen are the happiest. These should never have been allowed to be broadcast. We complain about the high cost of drugs, and this is a major reason. Lawyer ads were banned from TV for many years. Since they’ve been allowed, the same proliferation has occurred. WHY? Contact your Congressional Representative and U.S. Senators, and register your disgust.

  2. Diane

    I can’t believe it is legal to show these drug ads. It should not be! It’s not that we can go to the store and buy them even if we wanted to so why do we have to listen to people with a smile telling you a side effect may be death! It is as bad as spam mail and robo phone calls. What’s the difference?

  3. Don

    Drug company revenue is the reason for the advertising, and it is allowed because the politicians who make policy are bought and paid for. Can you say lobbying? I think there are backroom deals going on in the pharmaceutical and political community.

  4. Rita

    If I see or hear a pharmaceutical advertised on TV or radio, I’m determined I WILL NEVER ALLOW THAT CHEMICAL IN MY HOUSE. Yeah, if their ads didn’t fatten their bank accounts maybe they’d get the message. We’re not DUMMIES – let’s stop acting that way and “buying’into their hype!

  5. Lyle

    I have not seen a single drug ad that was useful. They’re all cheesy and not worth watching. DVR the TV and fast forward through the ads – this technique keeps me sane. Which of the seven deadly sins come into play here? GREED!

  6. Retired RN

    Notice, also, that when the side effects are listed there is frequently a puppy on the screen — I guess to comfort us. Every ad is factored into the price of the drug. Considering the cost of a network TV ad, no wonder the drug prices are off the charts.

    One funny story: When NSAIDs were being advertised, before the recalls, my then 11 year-old son said to me, “Mom, I want the pill that teaches you to ice skate.” Out of the mouth of babes. For me, I want the pill that lets me play par golf.

  7. Gary
    North Carolina

    All good comments. Let’s look at the legsl aspects. They are blantly deceptive. Close your eyes so you don’t see the happy faces and just focus on the side effects to have to mention. Is there a consumer law suite there?

  8. Mary

    Someone earlier commented, “Since when is a doctor going to listen when a patient requests something they heard on TV?” There are some unscrupulous doctors out there who will write scrips for anything because they get kickbacks from pharma companies (look it up).
    When my daughter was little I had to take her to the doc with a bad ear infection. We had an appointment. She was crying and in pain but they skipped over our appt. and called in the drug rep who was also in the waiting room so he could “bribe” the doc in exchange for pushing certain drugs.
    My biggest beef is commercials telling you to ask your doctor if you have Peyronie’s disease (if you do you would absolutely know it, no question) and a newer commercial trying to convince people who stay up too late on facebook or twitter that they have Narcolepsy!!
    An old friend of mine actually had Narcolepsy and he was not overly tired during the day. He would just suddenly fall asleep for a few moments (even in the middle of a conversation). When he awoke he felt refreshed and went on with his day. This is a neurological condition. If you fall asleep during a movie or on the bus and don’t wake up until everyone gets up to leave, you need to look at your nighttime sleeping habits.
    And by the way, I know the PP has to pay bills too, but yes, there is a pharmaceutical ad scrolling on this page as I type.

  9. Beverley J.

    I only wish that I could be as happy as those portrayed in the ads who have cancer and other debilitating ailments. I have C.O.P.D. and some arthritis & I am not as happy as these actors seem to be. Maybe if I picked up one more drug it would make me gleeful. Like everyone, I believe these ads should be stopped for reasons already stated. I mute & read when one comes on.

  10. Patricia

    I hate these ads. They are misleading and detrimental to the public.

  11. Doreen R.

    I HATE, HATE, HATE, HATE them. I DVR most of the television I watch just so that I do NOT have to watch those drug commercials. I recently volunteered to do a Nielson TV rating specifically to complain about drug ads.

  12. Joan

    I stopped watching almost all TV except for pbs channels. Get new from radio. This ads, as well as for alcohol and cigarettes used to be illegal.
    But money always wins out.
    Get more honest news coverage from bbc and other foreign channels.

    • Sally

      When do you see ads for cigarettes on TV? They have been banned for a very long time.

  13. Marilyn

    I don’t think there is anyone that wants to see ads for prescription drugs on television. Since when is a doctor going to listen to a patient to suggest something they saw on TV? The side effects mentioned in the TV ads should be enough for people to NOT want to take the advertised prescription product. The money the pharmaceutical companies spend on these advertisements should go toward lowering prices on pharmaceutical drugs!

  14. Sally
    Jamestown, NC

    I absolutely HATE these ads that tell you what to ask for your doctor to prescribe. We change the channel!

  15. John
    Greenville, SC

    As a retired Hospital CEO, I am disgusted with the smiling faces and the jingles associated with the advertising. They are even smiling as the mandatory warning, including that of death, are given. Consumers are not qualified, nor am I with 33 years in hospitals, to decide what pharmaceutical(s) that I need. I leave that up to my physicians.

    Further, advertising costs! And we are paying exorbitant dollars for our prescriptions.

  16. Patti-Jo Frainey

    did you know an ad for embrel appeared twice in this forum?

  17. Marilyn
    South Palm Beach, Fl

    The United States is the only country in the World that allows prescription drugs to be advertised on TV. This is a major problem for our citizens. And what is the motivation? GREED.

  18. Diane

    There are only two nations on this planet – New Zealand and the USA. It is a VERY BAD idea. It raises the cost of medication, it encourages undue expectations for patients, and sadly some ads appear at prime time slots where the use of the medication is inappropriate for young child to view. What young child needs to ask parents what Viagra is used for? The ads themselves result in a huge waste of time for nurses, doctors and pharmacists explaining why the medication is inappropriate for a particular patient. Advertising raises undue hopes for patients and their families – especially in the field of oncology.
    Prescription drug advertise should NOT BE ALLOWED!!

    Denny (A OncologyPharmacist) and Diane

  19. The Wonderer

    Here’s a refreshing thought. How about the medical professionals determine the root cause of our myriad of maladies, rather than throw pharmaceuticals at us? Or convince us that we need th drugs to feel better, persuading patients that the answer is in a bottle, rather than a solution to the problem. Revolutionary!

  20. Lynn Han

    It seems to me that all of the advertisements make it seem like: it’s ok to take a drug, don’t worry about taking a drug you’ll still be happy smiling etc.. I was taught taking drugs were bad – when did it start becoming ok to take a pill; a joint; an injection? Besides surgery for life threatening illness drugs and surgery should be the absolute LAST resort, and I repeat – only for life threatening illnesses!

  21. Lisa
    Bloomsburg, PA

    I am not a doctor and therefore do not have the qualifications to decide what medicine is best for me. Why not use the billions spent in consumer advertising and use it to off-set the cost of the actual medicine to keep it affordable or put the money back into research?

    As for the songs they use to promote the drug? They become an annoying earworm that would make me refuse the drug even if my doctor did want to prescribe it for me!

  22. Richard

    I too despise Pharma adds on TV. Aside from all the side effects the ads are just plain irritating and deceptive as well as not telling you that the vast majority of people can’t afford the extravagant prices charged. Pharma coupons, they’re a joke as well. I just checked on one and the coupon gave me a $20 discount on an $843 30 day prescription. if you want to see just how ridiculous the pricing is, just go to GoodRx and plug in the drug names you see advertised, but you better be sitting down. Why doesn’t the FDA do something about the atrocious legal drug problems, simple, people are being paid off. nuff said.

  23. Carol
    Vernon, AZ

    I am appalled at the wasteful advertising of drugs. I change channels! This money should be used to reduce the horrendous cost of drugs.

  24. Tim

    All the arguments against advertising by Pharma are absurd. As a consumer, I should be made aware of what is available. However, just because I am aware does not mean I will or can run out and buy the drug, as I need my doctor to agree and write a prescription! I don’t need the nanny state to manage what I know.

    As for the side effects, I believe you are being a bit disingenuous considering you know that *all* adverse events that occur during clinical drug testing have to be reported, even those that are not necessarily due to the drug. For example, headaches, erectile dysfunction, nausea, and other common events can and do happen irrespective of taking a drug. For example, 50% of men in their 50’s experience ED at some time, and if they happen to be in a clinical trial, that has to be reported.

    If you don’t like the ads, turn off the TV or mute it. I do that for all commercials….

  25. Marty B.
    Greensboro, NC

    For a long time, I have looked for a way to be proactive about the incessant parade of pharmaceutical ads wanting you to self-diagnose your illness then ask your doctor to prescribe but informing them of your conditions that they should already know. The amount of money being spent is obscene and offensive in a time when soaring drug costs keep some from getting proper health care. I will try giving my opinions to my representatives but I am not optimistic they want to offend big pharma.

  26. Karma

    You can bet that if you are watching an ad on TV for a prescription drug, you can’t afford it!

  27. frances

    The drug industry spends BILLIONS on advertising. Why not direct that money to lower drug costs? How misleading these ads are. And shouldn’t your doctor already know what drugs you are taking? I’d like to see one person that takes a cancer drug smiling, happily playing with children/grandchildren, dining with hubby, just going on with their lives. In my world they’re on the couch or in bed fighting the ravages of side effects. Do we pay attention to these ads? NO! We rely on our doctor’s knowledge.

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