Here’s Why Big Pharma Spends More On Ads Pushing Lower Benefit Drugs, Study Suggests


Big pharma spends more money on advertising for drugs that have lower health benefits for patients, according to a study published in JAMA on Tuesday, shedding new light on the almost uniquely American practice amid fierce debate over whether direct-to-consumer prescription drug ads should be banned.

Key Facts

The proportion of advertising spending allocated to direct-to-consumer ads was an average of 14.3 percentage points higher for drugs with a low added benefit compared to those with a high added benefit, according to the peer-reviewed analysis of the 150 best-selling branded prescription drugs in 2020.

Nearly two-thirds of the country’s top-selling prescription drugs—92 of the 135 drugs data was available for—were rated as offering patients low added benefit by health agencies in France and Canada, the researchers found, relying on the foreign agencies as no U.S. agency compares prescription drugs for effectiveness.

Promotional spending for prescription drugs varied wildly, the researchers said, with a median spend of $20.9 million per drug and a median of 13.5% of the promotional budget allocated to direct-to-consumer ads.

Manufacturers of the top six best-selling drugs spent the bulk of their promotional budgets—more than 90%—targeting consumers directly rather than clinicians for a range of treatment options for conditions including HIV, multiple sclerosis and numerous cancers.

Meanwhile drugs that treat metabolic issues and digestive tract problems received a substantially lower share of direct-to-consumer advertising compared to overall promotional budgets, the researchers said.

The findings could suggest pharma firms are aiming promotional dollars directly towards consumers, rather than clinicians, as part of a “strategy to drive patient demand for drugs that clinicians would be less likely to prescribe,” said the study’s lead author Michael DiStefano, a researcher at Johns Hopkins.

Surprising Fact

Just two countries in the world allow drug makers to market prescription medications directly to consumers: the U.S. and New Zealand. Most countries ban the practice.

Key Background

Most countries prohibit directly advertising prescription medications to the public, something the WHO says influences both people and, indirectly, the medical professionals treating them, making it “harder to make decisions on evidence based medicine.” The American Medical Association opposes the practice and, alongside other health organizations, is pushing to outlaw it in the U.S. Pharmaceutical firms claim patients benefit from the commercials and that they have a right to know what options are available to them. Critics argue the ability to sideline professionals and market to the public directly incentivizes companies to exaggerate the benefit of their drugs without detailing possible side effects, a situation regulators hoped to remedy by requiring ads to dedicate time to risks, leading to the well-known, rapid fire laundry list of side effects.

Big Number

$6 billion. That’s how much researchers estimate pharma spent on direct to consumer ads in 2016. The figure grew significantly from 1996, when consumer ad budgets totaled $1.3 billion.

Crucial Quote

“Another consideration is the U.S. doesn’t currently rate prescription drugs,” said study author Gerard Anderson, a professor of health policy at Johns Hopkins. “Imagine if the drug ads you saw on TV were required to tell you how well the drug performed against alternative drugs for the same disease. That might change how interested you would be in the drug.”

Further Reading

How lax social media policies help fuel a prescription drug boom (Protocol)

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