Study shows that 70% of drugs advertised on TV have “low therapeutic value”
Some new drugs sell themselves with impressive safety and efficacy data. For others, well, there are television commercials.
Just over 70 percent of prescription drugs advertised on television were rated as having “low therapeutic value,” meaning they offer little benefit compared to drugs already on the market, according to a new study. Studyappearing in JAMA Open Network, is consistent with longstanding skepticism that heavily promoted drugs have high therapeutic value.
“One explanation could be that drugs with significant therapeutic value are likely to be recognized and prescribed without advertising, so manufacturers have a greater incentive to promote drugs of lesser value,” said the authors, who include researchers from Harvard, Yale and Dartmouth.
The US is one of only two countries that allow direct-to-consumer (DTC) drug advertising, such as TV commercials. (The other is New Zealand.) Doctors, medical associations and consumer advocates they fought for a long time against unusual practice. In 2006, the consumer protection group Public Citizen condensed DTC advertising as “nothing less than the end of the doctor-patient relationship—an attempt to turn patients into agents of drug companies while pressuring doctors for drugs they may not need.”
In 2015, the American Medical Association called for a complete ban on DTC ads for prescription drugs and medical products. AMA members said the ads “drive demand for expensive treatments despite clinical effectiveness of less expensive alternatives.”
But DTC drug ads have continued, fueled by billions of dollars from the pharmaceutical industry.
Convenience not added
For the new study, researchers led by Aaron Kesselheim, who directs Harvard’s Program On Regulation, Therapeutics, And Law (PORTAL), reviewed monthly lists of the most advertised drugs on TV in the US between 2015 and 2021.
They also sought therapeutic value ratings for these drugs from independent health assessment agencies in Canada, France and Germany. Value ratings are based on the drugs’ therapeutic benefit, safety profile and strength of evidence compared to existing drugs. Any drug rated “moderate” or higher was classified as a “high value” drug for the study. For drugs with multiple ratings, the study authors used the most favorable rating, which the authors note could overestimate the proportion of drugs with greater benefit.
Of the most advertised drugs, 73 had at least one value rating. Collectively, drug companies spent $22.3 billion on advertising for those 73 drugs between 2015 and 2021. Even with generous ratings, 53 of the 73 drugs (roughly 73 percent) were categorized as having little benefit. Together, these low-benefit drugs accounted for $15.9 billion in advertising spending. The three most preferred drugs with low benefit by dollar amount were Dulaglutide (type 2 diabetes), varenicline (smoking cessation) and tofacitinib (rheumatoid arthritis).
The prospects for change are bleak, the authors note. “Policymakers and regulators could consider limiting direct-to-consumer advertising to drugs with high therapeutic or public health value or requiring standardized disclosure of comparative efficacy and safety data,” Kesselheim and colleagues concluded, “but policy changes would likely require industry cooperation or face a constitutional challenge.”