Tamar Abrams had a lousy couple of years in 2022 and \u201923. Both her parents died; a relationship ended; she retired from communications consulting. She moved from Arlington, Virginia, to Warren, Rhode Island, where she knew all of two people.<\/p>\n
\u201cI was kind of a mess,\u201d recalled Abrams, 69. Trying to cope, \u201cI was eating myself into oblivion.\u201d As her weight hit 270 pounds and her blood pressure, cholesterol, and blood glucose levels climbed, \u201cI knew I was in trouble health-wise.\u201d<\/p>\n
What came to mind? \u201cOh, oh, oh, Ozempic!\u201d \u2014 the tuneful ditty<\/a> from television commercials that promoted the GLP-1 medication for diabetes. The ads also pointed out that patients who took it lost weight.<\/p>\n Abrams remembered the commercials as \u201cjoyful\u201d and sometimes found herself humming the jingle. They depicted Ozempic-takers cooking omelets, repairing bikes, playing pickleball \u2014 \u201cdoing everyday activities, but with verve,\u201d she said. \u201cThese people were enjoying the hell out of life.\u201d<\/p>\n So, just as such ads often urge, even though she had never been diagnosed with diabetes, she asked her doctor if Ozempic was right for her.<\/p>\n Small wonder Abrams recalled those ads. Novo Nordisk, which manufactures Ozempic, spent an estimated $180 million in direct-to-consumer advertising in 2022 and $189 million in 2023, according to MediaRadar, which monitors advertising.<\/p>\n By last year, the sum \u2014 including radio and TV commercials, billboards, and print and digital ads \u2014 had reached an estimated $201 million, and total spending on direct-to-consumer advertising of prescription drugs topped $9 billion, by MediaRadar\u2019s calculations.<\/p>\n Novo Nordisk declined to address those numbers.<\/p>\n Should it be legal to market drugs directly to potential patients? This controversy, which has simmered for decades, has begun receiving renewed attention from both the Trump administration and legislators.<\/p>\n The question has particular relevance for older adults, who contend with more medical problems than younger people and are more apt to take prescription drugs. \u201cPart of aging is developing health conditions and becoming a target of drug advertising,\u201d said Steven Woloshin, who studies health communication and decision-making at the Dartmouth Institute.<\/p>\n The debate over direct-to-consumer ads dates to 1997, when the FDA loosened restrictions and allowed prescription drug ads on television as long as they included a rapid-fire summary of major risks and provided a source for further information.<\/p>\n \u201cThat really opened the door,\u201d said Abby Alpert, a health economist at the Wharton School of the University of Pennsylvania.<\/p>\n The introduction of Medicare Part D, in 2006, brought \u201ca huge expansion in prescription drug coverage and, as a result, a big increase in pharmaceutical advertising,\u201d Alpert added. A study she co-wrote in 2023 found that pharmaceutical ads were much more prevalent<\/a> in areas with a high proportion of residents 65 and older.<\/p>\n Industry<\/a> and academic research<\/a> have shown that ads influence prescription rates. Patients are more apt to make appointments and request drugs, either by brand name or by category, and doctors often comply. Multiple follow-up visits<\/a> may ensue.<\/p>\n But does that benefit consumers? Most developed countries take a hard pass. Only New Zealand and, despite the decadelong opposition of the American Medical Association<\/a>, the United States allow direct-to-consumer prescription drug advertising.<\/p>\n Public health advocates argue that such ads encourage the use and overuse of expensive new medications, even when existing, cheaper drugs work as effectively. (Drug companies don\u2019t bother advertising once patents expire and generic drugs become available.)<\/p>\n In a 2023 study in JAMA Network Open, for instance, researchers analyzed the \u201ctherapeutic value<\/a>\u201d of the drugs most advertised on television, based on the assessments of independent European and Canadian organizations that negotiate prices for approved drugs.<\/p>\n Nearly three-quarters of the top-advertised medications didn\u2019t perform markedly better than older ones, the analysis found.<\/p>\n \u201cOften, really good drugs sell themselves,\u201d said Aaron Kesselheim, senior author of the study and director of the Program on Regulation, Therapeutics, and Law at Harvard University.<\/p>\n \u201cDrugs without added therapeutic value need to be pushed, and that\u2019s what direct-to-consumer advertising does,\u201d he said.<\/p>\n Opponents of a ban on such advertising say it benefits consumers. \u201cIt provides information and education to patients, makes them aware of available treatments and leads them to seek care,\u201d Alpert said. That is \u201cespecially important for underdiagnosed conditions,\u201d like depression.<\/p>\n Moreover, she wrote in a recent JAMA Health Forum commentary<\/a>, direct-to-consumer ads lead to increased use not only of brand-name drugs but also of non-advertised substitutes, including generics.<\/p>\n The Trump administration entered this debate last September, with a presidential memorandum<\/a> calling for a return to the pre-1997 policy severely restricting direct-to-consumer drug advertising.<\/p>\n That position has repeatedly been urged by Health and Human Services Secretary Robert F. Kennedy Jr., who has charged that \u201cpharmaceutical ads hooked this country on prescription drugs.\u201d<\/p>\n At the same time, the FDA said it was issuing 100 cease-and-desist orders<\/a> about deceptive drug ads and sending \u201cthousands\u201d of warnings to pharmaceutical companies to remove misleading ads. Marty Makary, the FDA commissioner, blasted drug ads<\/a> in an essay in The New York Times.<\/p>\n \u201cThere\u2019s a lot of chatter,\u201d Woloshin said of those actions. \u201cI don\u2019t know that we\u2019ll see anything concrete.\u201d<\/p>\n This month, however, the FDA notified Novo Nordisk<\/a> that the agency had found its TV spot for a new oral version of Wegovy false and misleading. Novo Nordisk said in an email that it was \u201cin the process of responding to the FDA\u201d to address the concerns.<\/p>\n Meanwhile, Democratic and independent senators who rarely align with the Trump administration also have introduced legislation to ban or limit direct-to-consumer pharmaceutical ads.<\/p>\n Last February, independent Sen. Angus King of Maine and two other sponsors introduced a bill<\/a> prohibiting direct-to-consumer ads for the first three years after a drug gains FDA approval.<\/p>\n King said in an email that the act would better inform consumers \u201cby making sure newly approved drugs aren\u2019t allowed to immediately flood the market with ads before we fully understand their impact on the general public.\u201d<\/p>\n Then, in June, he and independent Sen. Bernie Sanders of Vermont proposed legislation to ban such ads<\/a> entirely. That might prove difficult, Woloshin said, given the Supreme Court\u2019s Citizens United<\/em> ruling protecting corporate speech<\/a>.<\/p>\n Moreover, direct-to-consumer ads represent only part of the industry\u2019s promotional efforts. Pharmaceutical firms actually spend more money advertising to doctors<\/a> than to consumers.<\/p>\n Although television still accounts for most consumer spending, because it\u2019s expensive, Kesselheim pointed to \u201cthe mostly unregulated expansion of direct-to-consumer ads onto the web\u201d as a particular concern. Drug sales themselves are bypassing doctors\u2019 practices by moving online.<\/p>\n Woloshin said that \u201cdisease awareness campaigns\u201d \u2014 for everything from shingles to restless legs \u2014 don\u2019t mention any particular drug but are \u201coften marketing dressed up as education.\u201d<\/p>\n He advocates more effective educational campaigns, he said, \u201cto help consumers become more savvy and skeptical and able to recognize reliable versus unreliable information.\u201d<\/p>\n For example, Woloshin and Lisa Schwartz, a late colleague, designed and tested a simple \u201cdrug facts box<\/a>,\u201d similar to the nutritional labeling on packaged foods, that summarizes and quantifies the benefits and harms of medications.<\/p>\n For now, consumers have to try to educate themselves about the drugs they see ballyhooed on TV.<\/p>\n Abrams read a lot about Ozempic. Her doctor agreed that trying it made sense.<\/p>\n Abrams was referred to an endocrinologist, who decided that her blood glucose was high enough to warrant treatment. Three years later and 90 pounds lighter, she feels able to scramble after her 2-year-old grandson, enjoys Zumba classes, and no longer needs blood pressure or cholesterol drugs.<\/p>\n So Abrams is unsure, she said, how to feel about a possible ban on direct-to-consumer drug ads.<\/p>\n \u201cIf I hadn\u2019t asked my new doctor about it, would she have suggested Ozempic?\u201d Abrams wondered. \u201cOr would I still weigh 270 pounds?\u201d<\/p>\n The New Old Age is produced through a partnership with\u00a0The New York Times<\/a>.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n