DOSE OF REALITY: JAMA NETWORK ANALYSIS SHINES LIGHT ON HOW BIG PHARMA PUSHES SALES OF HIGH-PRICED BLOCKBUSTERS BY TARGETING CONSUMERS ON SOCIAL MEDIA
Brand Name Drug Companies Sidestep Guardrails Meant to Protect American Patients Through Digital Direct-to-Consumer (DTC) Marketing Strategies
In case you missed it, research published in the Journal of the American Medical Association (JAMA) Network analyzed the staggering expansion of Big Pharma’s direct-to-consumer (DTC) advertising across non-traditional mediums like social media, less subject to oversight and regulatory guardrails than traditional media like television and radio. The study found brand name drug makers are increasingly investing in influencer content and digital strategies that look like ordinary personal stories or health tips but function as marketing designed to further push high-priced, blockbuster products.
The researchers analyzed “740 high-engagement, regulator-relevant social media posts that had amassed more than 57.5 million views as of January 2025,” including a large number from “lifestyle/celebrity influencers.” They found, “efficacy claims were made in 511 posts (69.1%),” while “information on risks or adverse effects was mentioned in 247 (33.4%) of all 740 posts.” In addition, only 32.3 percent of “posts making efficacy claims… included any information on risks or adverse effects.”
The study highlights how this playbook allows Big Pharma to sidestep guardrails that apply to television or radio advertising set by the U.S. Food and Drug Administration (FDA) and Federal Trade Commission (FTC). These guardrails, designed to protect consumers from misleading claims and arm them with information to best make health care decisions with their doctor, are not being applied to Big Pharma’s algorithm-boosted digital strategies meant to increase sales of high-priced brand name drugs through social media. As a result, millions of Americans are being exposed to Big Pharma’s aggressive marketing tactics without guardrails on claims, disclosures about risks — or even, in some instances, the fact that it’s paid marketing at all.
On top of that, social media algorithms actively amplify this material to the users most likely to respond to it — a built-in advantage that helps Big Pharma steer patients toward blockbuster brand name drugs with virtually no guardrails, regardless of whether the patient may actually clinically benefit from the product.
The analysis should further encourage policymakers’ work to scrutinize Big Pharma DTC advertising and the role played by these strategies in increasing costs for American patients and the U.S. health care system. The administration and Congress can build on existing momentum for solutions to hold Big Pharma accountable for staggering spending on misleading advertising steering consumers to high-priced brand name drugs, including by increasing list price transparency.
Additional Key Facts on Big Pharma’s DTC Advertising
- Price Hikes and Big Ad Spending Go Hand-in-Hand: For several of the pharmaceutical industry’s best-selling products, Big Pharma repeatedly hikes prices while pushing these drugs to consumers via DTC ads. This combination drives up spending for consumers and the entire health care system. Take Bristol Myers Squibb and Pfizer’s blockbuster blood-thinning drug Eliquis, for example. The brand name drug makers have spent more than $1 billion on direct-to-consumer advertising for the drug since 2013. Meanwhile, the drug makers have increased the drug’s price by at least six percent per year for ten years. When Eliquis came to market in 2013, it carried a monthly price tag of $250 – but in 2022, the list price for a one-month supply of Eliquis was $529, more than double when it came to market.
- DTC Advertising Can Lead to the Overutilization of Expensive, Older Meds: As a 2023 Forbes column highlights, DTC advertising can contribute to “the (over)use of higher-cost drugs over generics and less expensive alternatives,” which can lead to increased spending on prescription pharmaceuticals.
- One-Third: In fact, another JAMA Network research paper from January 2023 found that advertising spending on drugs considered having “high therapeutic value” accounts for fewer than one-third of all DTC pharmaceutical advertisements. As the paper states, “[d]irect-to-consumer advertising is associated with use of higher-cost drugs over generics and less expensive alternatives.”
- 7 out of 10: An October 2021 study from AHIP found that seven of 10 of the largest pharmaceutical companies by revenue spent more on sales and marketing in 2020 than R&D.
- One of Two Countries Globally: There are only two countries in the world that allow DTC advertising for pharmaceuticals: New Zealand and the United States.
- Nine out of 10: Nine in ten American voters are concerned drug companies spend billions of dollars per year on DTC advertising for prescription drugs, oftentimes writing off their ad spending for tax purposes.
- $1.7 Billion per Year: A March 2025 analysis released by The Campaign for Sustainable Rx Pricing (CSRxP) found the combined impact of Big Pharma increasing sales of high-priced brand name drugs and writing off their marketing spending to reduce their tax burden cost U.S. taxpayers between $1.5 and $1.7 billion per year.
Read the full research letter from JAMA HERE.
Read CSRxP’s analysis on the taxpayer cost of Big Pharma’s DTC advertising HERE.
Learn more about bipartisan, market-based solutions to hold Big Pharma accountable HERE.
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