A prescription drug promotional ad inside a pharmacy with a consumer shopping in the background

If you’ve spent any time watching TV recently, you probably couldn’t escape all the drug ads, sometimes in quick succession.

A recent televised sporting event, for example, featured one ad for a drug to help you fall asleep, followed by another to keep you awake, according to an editorial in JAMA about drug ads that was written by Howard Bauchner, M.D., and Phil B. Fontanarosa, M.D.

Advertisements like those referenced in the editorial also prompted two Dartmouth researchers to examine how many of the ads consumers are seeing these days. In a study published in the same issue of JAMA, the two researchers found that between 1997 and 2016, spending on consumer ads for any type of healthcare service, such as DNA tests and smoking cessation campaigns, rose to $10 billion from $2 billion. 

More on drugs

The largest share—nearly $6 billion—went for drug ads.

Over the same time period, the total amount consumers spent out of pocket on their prescription medication also skyrocketed to $328.6 billion from $116.5 billion (after industry rebates and discounts), the study found.

Why the explosion in drug ads over the past 20 years?

The study notes that in 1997 the Food and Drug Administration began allowing drugs ads to mention side effects with voice-overs, instead of scrolling through a visual list on the screen, which takes more time. Shorter ads can allow for more ads, says Steve Woloshin, M.D., at the Center for Medicine and Media at the Dartmouth Institute. He wrote the recent JAMA article with his wife, Lisa Schwartz, M.D., who died of cancer in November.

Another possible explanation is that at the same time that drug companies are spending more on drug ads directed at consumers, they’re also spending more marketing the new drugs to physicians, says Adriane Fugh-Berman, M.D., an associate professor in the department of family medicine at Georgetown University who has studied drug advertising. That can increase “irrational prescribing and overuse of medication,” says Fugh-Berman, who was not involved in the JAMA study.

Perhaps the most important reason for the increase: “The ads work,” Woloshin says. “They increase patient requests and prescriptions for advertised drugs, even when there are lower-cost alternatives.”

Indeed, numerous studies suggest that drug ads increase healthcare costs by promoting higher-cost medications when lower-cost, older ones might work as well.

President Donald Trump recently suggested using the ads as a way to control costs, by requiring manufacturers to include the price of the medication in the ads, but it’s still uncertain whether that approach would ultimately reduce drug costs, in part because it’s unclear how consumers would use that information.

Woloshin says that just as drug ads seem to be more numerous, FDA oversight of the ads seems to be lessening. His study notes that the number of drug ads and other promotional materials submitted to the FDA for review each year tripled over the past two decades, to 97,252 in 2016 from 34,182 in 1997. But the number of violations for misleading marketing plummeted to 11 from 156 over the same time period.

It’s possible that the drop in violations means drug manufacturers have gotten more careful with their ads. Still, “consumers should be skeptical about advertised and promoted drugs,” Fugh-Berman says. That means looking for additional sources of information about those drugs, and talking with healthcare providers about other treatment options “that don’t need expensive advertising,” she says.

Here’s what you should consider when watching drugs ads on TV.

Insurance May Not Fully Cover the Drug

In recent years, many TV drug ads have focused on expensive drugs used to treat relatively uncommon, and hard to treat, conditions, such as rheumatoid arthritis, psoriasis, rare cancers, and seizures, according to figures from Kantar Media for the year ending in October 2018.

And those sorts of pricey meds may not be covered by your insurance, especially if you get insurance through your employer. A 2017 survey of employers by the Pharmacy Benefits Management Institute found that when it came to high-cost medications, most of the insurers required a person to try other medications first, required a person to obtain approval from the insurer for expensive medications before filling a prescription, or limited the amount of the drug a person could obtain. Three quarters of employer plans simply did not cover certain drugs, including high-cost drugs, according to the survey.

What to do instead: For complicated medical conditions, which may necessitate higher-cost medications, work with your physician and insurance plan to find covered treatments. If the advertised drug really is the best choice for you but it’s not well-covered by your insurance, see our tips on how get a lower price.

Good to know: Check NeedyMeds for the drug you’re being prescribed to see what Patient Assistance Programs, manufacturer coupons, or other discounts might be available.

Other Treatments Might Work As Well

Other “new” drugs pitched in ads are simply older meds reformulated or repackaged, Fugh-Berman says. Take the example of Vimovo, which is a combination of two common meds: over-the-counter painkiller naproxen (think Aleve) and a drug to prevent acid reflux, esomeprazole (think Nexium). “Would you rather spend $66 for a two-month supply of generic naproxen and esomeprazole, or $2,599 for a two-month supply of Vimovo?” Fugh-Berman says.

What to do instead: If you’re being prescribed a new medication, especially if it’s something you’ve seen advertised, ask your doctor, pharmacist, or healthcare provider whether there is a less-expensive alternative. Old drugs in new forms, such as extended release, or new combinations sometimes have older, lower-cost options available for a fraction of the price.

Pay Attention to Side Effects and Risks

You may automatically tune out the list of possible risks and side effects of a drug that you hear in a commercial. But they are real and often serious, so you should not ignore them, Fugh-Berman says.

Also look to see whether the ad ends by pointing to another source for additional information. That information might contain other important details that you need to know about.

If you take other medications, listen closely to see whether the advertised drug can interact dangerously with other medications. Finally, see how the company describes the benefit of a drug. For example, a drug that seems to be pitched to help your heart might not be proved to reduce the risk of heart attack or death from cardiovascular disease, but simply to lower your cholesterol level.

What to do instead: It’s impossible to learn everything you need to know about a drug from a TV ad. So if an ad does point to another source for additional information, track that down and read it carefully. Also talk with your doctor or pharmacist about just how risky, and effective, the advertised drug really is. Make sure to ask whether other drugs you take, or health problems you have, pose any special risks for the new drug. Finally, don’t assume that just because something is new that means it’s better, Fugh-Berman says. She says that tried-and-true is often safer, cheaper, and more effective. Whenever possible, “Ask your doctor for older, generically available, well-tested, ‘classic’ drugs instead of what is advertised on TV,” she says.