I like to think of myself as an optimistic person. That’s why I was so gratified to read FDA Commissioner Dr. Marty Makary’s article in JAMA (September 12, 2025) titled: “The FDA’s Overdue Crackdown on Misleading Pharmaceutical Advertisements.” The People’s Pharmacy has been lobbying the Food and Drug Administration for years to get rid of those damnable commercials. At long last it seemed as if prescription drug ads’ death was within sight. If the Commish of the FDA announced a “crackdown” then I was ready to celebrate. It would appear that my excitement may have been misplaced, though. Six months after the big proclamation, it seems to me that prescription drug ads are as pervasive as ever.
What is Wrong With the United States?
The United States is distinctive in many ways, but at least one unique characteristic may finally be under scrutiny. We are one of just two countries in the world that permits prescription drug advertisements to be beamed directly to consumers–that is, to patients rather than doctors. (The other, if you were wondering, is New Zealand.)
Lest you think the Kiwis are seeing the same upbeat dancing and singing commercials that we are watching, you would be wrong. Their “direct-to-consumer” (DTC) ads are much more restrained. Physicians and medical associations have opposed these commercials there, so the pharmaceutical industry in New Zealand has been more cautious. In the US, there seems to be no such constraint.
All that seemed to change last fall, though. The Food and Drug Administration sent thousands of letters to pharmaceutical firms and issued a press release declaring a crackdown on deceptive drug advertising. At the same time, the agency issued about a hundred cease-and-desist orders to companies with ads it deemed deceptive.
Finally Drug Ads’ Death Was FDA Sanctioned
Not only did Dr. Marty Makary let his colleagues know that he was declaring war on drug commercials in the pages of a prestigious medical journal (JAMA (Sept. 12, 2025), he also submitted a Guest Essay to The New York Times. It was titled “I Run the F.D.A. Pharma Ads Are Hurting Americans” (Sept. 13, 2025).
In that article, Dr. Makary noted:
“American drug advertisements are filled with dancing patients, glowing smiles and catchy jingles that drown out the fine print. It’s not education — it’s distraction by design. This is not how the practice of medicine is supposed to be.”
We could not agree more. And judging from comments we have received, many readers and health professionals also find prescription drug commercials offensive, manipulative and a poor substitute for objective patient education.
I Jumped the Gun on Drug Ads’ Death
Here is my second public confession. I thought that drug companies might take prompt action after receiving tough warning letters from the Food and Drug Administration. Many of those letters required companies to respond:
“Within fifteen (15) working days of receipt of this letter please provide a written response…”
It seemed as if the FDA was really cracking down! I was hoping that some of the most misleading commercials would disappear quickly and that many others would be curtailed. I actually thought that within several weeks we would see some of the most over-the-top commercials start to disappear.
But more than six months have passed. As far as I can tell, there have been no obvious changes to prescription drug ads directed to consumers. Although we have inquired, the FDA has not revealed what it plans to do about pharma ads on TV.
Drug Ad’s Death Watch Seems Greatly Exaggerated
One example is a commercial for Rinvoq to treat rheumatoid or psoriatic arthritis. A woman hikes through a forest, lifts a log off the trail, picks berries and ends up on a picturesque mountain top overlooking a beautiful vista. (Many people with significant arthritis – rheumatoid or psoriatic– might have a little trouble climbing mountains and lifting logs, even with a powerful medicine on board.)
While all this is going on, we hear an announcer describing possible adverse drug reactions:
“Rinvoq can lower your ability to fight infections. Before treatment, test for TB and do blood work. Serious infections, blood clots, some fatal; cancers, including lymphoma and skin; serious allergic reactions; GI tears; death; heart attack; and stroke occurred.”
Commercials that show people dancing, playing hockey, kayaking, fishing, berry picking, crossing rocky streams, and hiking up mountains make it seem as if these medications are amazingly effective. It’s hard to pay attention to messages about death, cancer and blood clots when people are having such a great time. Is this what the FDA means when it says some pharma commercials could be misleading?
When will the FDA Implement the Drug Ads’ Death Watch?
I believed the Food and Drug Administration when it announced on September 9, 2025:
“By closing loopholes and stepping up enforcement, the FDA will protect patients, safeguard public health and hold the pharmaceutical industry accountable.”
I am getting impatient, though. The letters that the FDA sent in September requested a response within 15 days. Has the agency received meaningful answers? We don’t know.
The LONG History of Drug Advertising:
In some ways, direct-to-consumer drug advertising goes back a long time. In the 19th century, traveling salesmen would put on shows to peddle patent medicines wherever they went. Back then, there was no FDA nor even any television.
By the mid-20th century, TV offered a wonderful opportunity for companies to promote their over-the-counter products. If you are old enough, you can remember ads for Excedrin, Alka-Seltzer, Preparation H and Listerine, among other products. But people were not accustomed to advertisements for prescription drugs.
The Beginning of Prescription Drug Ads:
The first TV ad for a prescription medicine was aired on May 19, 1983. It was not elaborate, merely telling people that if they were taking prescription ibuprofen (Motrin), they could get it cheaper as Rufen. No description of what it was for or any side effects. Just price.
Pharmaceutical manufacturers and regulators alike were disconcerted by this novel idea, and a moratorium on DTC ads went into effect in September 1983. The FDA changed its mind and permitted such commercials in 1985, but it required full disclosure of side effects. Perhaps that’s why there was not an immediate rush to take advantage of this new opportunity.
The Floodgates for Direct-To-Consumer Advertising Opened:
Things changed in 1997, though. The FDA relaxed the requirement on full disclosure, so long as the ad made “adequate provision” for people to get more information through a website or toll-free number, for example.
With that loophole, the floodgates opened. Spending on DTC prescription drug ads went from $360 million in 1995 to $7 billion last year. On some shows, it seems as if nearly every other commercial is for a prescription medication to treat psoriasis, diabetes, colitis or rheumatoid arthritis.
Why Drug Ads Won’t Disappear Overnight
A lot of people were hoping that the FDA would ban drug ads outright. That almost assuredly would have failed on First Amendment grounds. Pharmaceutical company lawyers would have gone to court and likely won.
So the FDA came up with a different strategy: close the 1997 loophole and require far more complete safety disclosures in commercials.
If companies must present long, detailed risk information clearly, slowly, and prominently—with large readable text—commercials may become so long, expensive and unattractive that they are no longer practical.
In other words, the FDA may not ban drug ads—but it may make them unprofitable.
Considering that pharmaceutical companies spent more than $7 billion advertising their products on television in 2025, a 16 percent increase over the prior year, this is a very big deal.
Drug Ads’ Death Watch: We Are Still Waiting
So here we are on Drug Ads’ Death Watch—still waiting.
Readers Respond:
Readers have been watching too. Here are just a few of their comments:
- “I’ve seen several Jardiance commercials recently…”
- “There are still a lot on the ABC World News every evening.”
- “They are full of drug ads… I haven’t noticed any difference.”
- “Wishful thinking. There are just as many Pharma ads as ever.”
- “I haven’t seen fewer people dancing and singing about their prescriptions.”
FDA Commissioner and Drug Ads’ Death
In his Opinion piece in the New York Times (September 13, 2025) FDA Commissioner Dr. Marty Makary offered these insights:
“Over the last several years, drug companies have increasingly gamed the system. Those days are over. We are taking drug marketing claims seriously and making our regulatory standards transparent. We are restoring honesty and accountability in drug advertising to protect patients and rebuild public trust. The billions of dollars drug companies spend on advertising would be better spent on lowering drug prices for American consumers.”
To borrow from Mark Twain…
Reports of Drug Ads’ Death May Be Greatly Exaggerated.
Has the FDA really declared war on misleading pharmaceutical advertising? If the agency follows through on its plan to require full and clear safety disclosures, prescription drug commercials could become far less common. Or…did the pharmaceutical industry lean on the FDA and HHS to slow down this initiative?
How long will it take?
Months?
Years?
I honestly don’t have a clue. The FDA is not sharing details.
So we would like to ask you, dear reader, to stay tuned and vigilant. If you see any changes over the next several months, please let us know. The FDA moves slowly, so let’s remain patient—but not complacent. Why not let Dr. Makary know how much you would like to see the end to misleading prescription drug commercials on television.
Please let friends and family know about the possibility of drug ads’ death so they too can stay vigilant and let us know if there are any changes in the months ahead. Thank you for supporting our work!
