Selling Health, Selling Illness, or Just Selling Drugs?
A Look at a Potential Ban on Prescription Drug Ads

Amidst a tense confirmation hearing, newly appointed Secretary of the Department of Health and Human Services (HHS) Robert F. Kennedy (RFK) Jr. made clear his opposition to many widespread and evidence-based public health measures such as vaccination and fluoride in the water, despite some efforts to appear more moderate in his viewpoints on vaccines. However, among his largely detrimental plans for HHS, Secretary Kennedy is in favor of a policy change that many in the public health sphere and in the American public do support: banning prescription drug advertisements. Although this ban likely stems from his strong position against the pharmaceutical industry, the possibility of a federal ban on prescription drug advertising raises important, longstanding questions about the value of these advertisements to public health and to the American consumer.

Prescription drug advertisements, also known as direct-to-consumer advertising (DTCA), are common in the U.S., with pharmaceutical companies spending billions on DTCA every year. Prescription drug ads on TV are particularly recognizable; many of the ads on TV today feature emotive images, narratives, and music (e.g., picture a woman biking through the park or shopping at a farmer’s market). Although these ads may seem like the norm to the average American consumer, DTC advertisements are unique in that their goal is to boost drug sales by prompting consumers to request a prescription from their doctor, thus bypassing the more traditional doctor-patient interaction. Because of this dynamic, critics of DTCA argue that these advertisements can lead to overprescribing, increased drug prices, and, more generally, harm the patient-physician relationship. As such, most countries have banned DTCA, with the notable exceptions of the U.S. and New Zealand.

However, there are also benefits to the DTCA model. By going directly to the consumer, these advertisements can increase help-seeking behaviors and combat under-treatment of certain conditions. The ads can also educate consumers on rare or stigmatized conditions such as depression or bipolar disorder. Regardless of arguments for or against, these advertisements are a major source of health information for American consumers.

But, it is important to note that the information presented in these ads, and the way in which it is presented, is largely biased by their central goal: to sell you a product. Research has shown that DTC ads disproportionately use various marketing tactics that inhibit viewer comprehension (e.g., visual complexity, movement) during the segment of the advertisement that communicates drug risks (i.e., the major statement). Importantly, all drugs are not advertised equally; a recent study found that 68% of the most heavily advertised drugs have a lower added clinical benefit compared to similar medications. Because these advertisements are designed to sell you a specific drug—one that is likely deemed more profitable by drug marketers—they fail to present a comprehensive picture of available treatments for a certain condition (e.g., lifestyle changes, generics), limiting their educational value to the consumer.

But does this mean that DTC ads should be banned altogether? To date, many academics and organizations, including the American Medical Association, have called for a total ban on DTCA of prescription drugs, arguing that they are harmful to public health and echoing concerns about the patient-physician relationship and DTCA’s effect on overprescribing. But many others argue that the issue is more complex. For instance, experts have suggested that these advertisements likely address underprescribing as well as drive overprescribing of prescription drugs. And research has shown that DTCA can have a positive impact on underdiagnosis and undertreatment of certain conditions by prompting the consumer to seek treatment for their symptoms, although critics argue that it is unclear whether such help-seeking translates into clinically relevant care.

Regardless, it is clear that we need federal reform targeting prescription drug ads. Although there have been previous legislative efforts to more strictly regulate DTCA (e.g., incorporating drug prices into the adverts), they have failed to generate traction in Congress. In terms of Secretary Kennedy’s potential ban, many anticipate that this policy will run into the First Amendment, which protects some forms of commercial speech.

To be clear, the emerging rhetoric that opposes vaccines and other advances in the pharmaceutical industry is detrimental to discourse and public health as a whole. And, even if Secretary Kennedy does pursue a total ban on DTCA, he has also expressed interest in cutting the budget of the FDA, the main regulatory power for pharmaceutical marketing. However, this growing debate surrounding DTCA in our current political environment could lead to improvements in these advertisements. For instance, even if the new HHS administration does not achieve an outright ban, some argue that this could provide adequate pressure on pharmaceutical companies to change their marketing practices as they have done in the past.

Although many things remain uncertain, the push for a federal ban on DTCA could be an opportunity for stakeholders to advocate for much-needed reform on prescription drug advertising, improving the health information that is available to the everyday consumer.