Updated 21 June 2021: A good number of people have asked me if I have updated the numbers in this essay. For the past few months I've done similar analyses and things are getting worse. For the first two points below, the numbers have more than doubled and in some cases they have tripled. When I put over-the-counter remedies including various types of toilet tissues into the analyses the numbers drastically increase. Perception is reality—we are indeed continually being swamped with these sorts of advertisements with no end in sight, despite most people and physicians wanting them to disappear.
"Next time you see a TV commercial for a prescription drug, remind yourself that you know nothing about medical treatment and that everybody who made the commercial has a financial interest in your future behavior." —Eric Horowitz, Psychology Today, How Pharmaceutical Ads Distort Healthcare Markets
During the past year, I've felt overwhelmed by the number of TV commercials for a wide variety of drugs. I've also heard other people expressing the same feelings, and a few months ago someone asked if I knew of any studies on the prevalence and patterns of ads for prescription drugs and over-the-counter remedies. I didn't, so I did a web search for relevant essays on advertising by different drug companies and found a very useful one published in December 2017 in The New York Times by Joanne Kaufman called "Think You’re Seeing More Drug Ads on TV? You Are, and Here’s Why." Kaufman notes, "According to Kantar Media, a firm that tracks multimedia advertising, 771,368 such ads were shown in 2016, the last full year for which data is (sic) available, an increase of almost 65 percent over 2012." In an essay titled "The Effort to Rid TV of Pharma Ads," Bioethicist Christopher Lane notes, "The United States and New Zealand are the only advanced economies on the planet to allow such advertising."
A September 2018 piece by Jacob Bell, "Pharma advertising in 2018: TV, midterms, and specialty drugs" tells us that the pharmaceutical industry is one of the biggest spenders in advertising in the United States. Bell writes, "The numbers behind those decisions are quite staggering. Just considering television, 187 commercials for about 70 prescription medications have collectively aired almost half a million times since the start of 2018. And to do that, drug companies shelled out $2.8 billion, according to marketing analytics provider iSpot.tv."
What catches my ears and eyes are the ways in which drug presentations are made, often beginning with a personal story about someone suffering from a specific disease and how a particular drug helped them along. All well and good, until we learn that the players are usually fake patients called "actor portrayals" and fake doctors, often referred to as "actor portrayals" or "doctor dramatizations." After learning what a drug might be good for, the ads consist of rapid staccato-like talk about possible side-effects and lists in a tiny text that are virtually impossible to read.
Along these lines, Kaufman writes, "Swelling of legs, hands and feet; capillary leak syndrome; fever; muscle pain; unusual bruising; dizziness, blurry vision; rash; hives; blisters; nervous system and blood disorders; lymphoma; swollen tongue; dry mouth; weight gain; inability to fight infections; nausea, diarrhea; constipation; depression; dehydration; suicidal thoughts. Oh, and death. These are just some of the side effects mentioned in television advertisements for prescription drugs." Maryann Kuzel, who's in charge of analytics at Publicis Health, a section of Publicis Groupe, notes, “At some point, the side effects become white noise.”
Some numbers about the prevalence and patterns of TV ads for drugs
I wanted to see if there were any good reasons for feeling overwhelmed by all sorts of drug ads, so I did an analysis of the frequency of such ads and what followed or preceded them as I watched various programs on different channels. New drugs, or at least those that are new to me, seem to come on at least weekly, often accompanied by new three-letter acronyms.
Here's what I found in an analysis of 300 data points taken randomly between 5 am and 9 pm during the past two months:
- When I turned on my TV, 16% of the time the ad that was already on or the first that came on was for a prescription drug.
- When I switched from one channel to another, 13% of the time the ad that was running on the new channel also was for a prescription drug, sometimes the same one that was on the previous channel. (Ads for over-the-counter products for a wide variety of conditions also get thrown into the mix. Many also have disclaimers that seem to render them pretty ineffective.)
- Less than 33% of the length of ads was devoted to what the drug can potentially do, accompanied by, or followed by, rapid talk and mostly unreadable notes about possible "white noise" side-effects. Ads for some drugs also note these are not the only possible side-effects, it will not work for everyone, or beware of drug interactions if you're already taking other medications.
I fully realize that these are pilot data, or what some people might call "couch data." They also reflect my personal patterns of watching TV and changing channels. It's also been noted that many drug ads target senior audiences who tend to watch TV at certain hours of the day and who might be especially vulnerable to these commercials. My impression is that the trends I noted aren't matched by advertisements for most other products, except, perhaps, by insurance ads.
The cost of the drugs also isn't given, although there has been a push that commercials offer this vital information. Furthermore, we're not offered quantitative information about risks or side-effects. I also can't find much information on how many people who see different ads actually talk to their physicians about this or that drug or the number of physicians who treat patients based on these discussions. The Kaiser Family Foundation found that 28 percent of the people who viewed a drug ad on TV went on to ask a physician about the medicine and 12 percent left with a prescription.
How does the industry get away with it?
"I think the dosage needs adjusting. I'm not nearly as happy as the people in the ads." — comment to The Effort to Rid TV of Pharma Ads
The numbers I collected seem to be rather high, given the huge number of non-drug ads that can potentially be seen on TV every day. And, despite the American Medical Association (AMA) calling for banning ads for prescription medications directly to consumers and claims that they do more harm than good, TV drug ads remain prominent. From an essay by David Lazarus, "...A new study finds that U.S. authorities take such a lackadaisical approach to so-called direct-to-consumer drug ads that many of the commercials violate federal guidelines and, unsurprisingly, the quality of information presented is alarmingly low." Yale University's Joseph Ross, who led the study, notes, “The advertisements don’t often represent the best treatment or medication available." We also know that the information provided by direct-to-consumer advertising can be misinterpreted by seniors.
There also are some other problems. For example, in an essay called "The Truth Behind Drug Commercials," Brian Engle writes about a commercial for a stool softener to help treat opiate-induced constipation (OIC). He writes, "The discussion surrounding the commercial brought light to the ridiculousness of the entire concept. The pharmaceutical company was marketing a medication to treat a condition caused by overmedication. When you think about it, it’s actually the perfect cycle for the pharmaceutical companies whereby an increase in sales of one medication directly increases the demand of the other with the only losers being us, the consumers."
Let me emphasize that I'm sympathetic to people who suffer from a wide variety of conditions that require prescription medications and other remedies. However, according to many experts, the prevalence of TV ads doesn't really help them and often can be harmful. They're also annoying.
I hope other people will follow up with some more information about the frequency and patterns of TV drug ads. While these numbers also will reflect personal patterns of TV watching and channel changing, they will help to explain why so many people feel bombarded, surrounded, and defeated by drug commercials and why so many experts, including physicians themselves, want them to disappear for a number of valid reasons.
The most useful buttons on my TV remote, other than those used for turning it on, are the ones for muting sound and switching channels. However, the latter button seems to have lost some of its effectiveness for protecting me from TV commercials for drugs.
Wide-ranging discussions about TV drug commercials can be seen here.
While it's difficult to estimate how many different ads play on TV each day, some information can be seem here.
For more information on TV ads for all types of insurance, click here.
Engle, Brian. The Truth Behind Drug Commercials. April 9, 2017. Health Policy Musings.
Kaufman, Joanne. Think You’re Seeing More Drug Ads on TV? You Are, and Here’s Why. New York Times, December 24, 2017.
Lazarus, David. TV commercials for prescription drugs ‘doing more harm than good’. Los Angeles Times, April 10, 2018.