Paula Span
Tamar Abrams had a awful couple of years in 2022 and ’23. Both her mother and father died; a relationship ended; she retired from communications consulting. She moved from Arlington, Virginia, to Warren, Rhode Island, the place she knew all of two folks.
“I was kind of a mess,” recalled Abrams, 69. Trying to manage, “I was eating myself into oblivion.” As her weight hit 270 kilos and her blood stress, ldl cholesterol, and blood glucose ranges climbed, “I knew I was in trouble health-wise.”
What got here to thoughts? “Oh, oh, oh, Ozempic!” — the tuneful ditty from tv commercials that promoted the GLP-1 medicine for diabetes. The advertisements additionally identified that sufferers who took it misplaced weight.
Abrams remembered the commercials as “joyful” and typically discovered herself buzzing the jingle. They depicted Ozempic-takers cooking omelets, repairing bikes, enjoying pickleball — “doing everyday activities, but with verve,” she mentioned. “These people were enjoying the hell out of life.”
So, simply as such advertisements usually urge, although she had by no means been identified with diabetes, she requested her physician if Ozempic was proper for her.
Small marvel Abrams recalled these advertisements. Novo Nordisk, which manufactures Ozempic, spent an estimated $180 million in direct-to-consumer promoting in 2022 and $189 million in 2023, in line with MediaRadar, which displays promoting.
By final yr, the sum — together with radio and TV commercials, billboards, and print and digital advertisements — had reached an estimated $201 million, and whole spending on direct-to-consumer promoting of pharmaceuticals topped $9 billion, by MediaRadar’s calculations.
Novo Nordisk declined to handle these numbers.
Should or not it’s authorized to market medicine on to potential sufferers? This controversy, which has simmered for many years, has begun receiving renewed consideration from each the Trump administration and legislators.
The query has explicit relevance for older adults, who cope with extra medical issues than youthful folks and are extra apt to take pharmaceuticals. “Part of aging is developing health conditions and becoming a target of drug advertising,” mentioned Steven Woloshin, who research well being communication and decision-making on the Dartmouth Institute.
The debate over direct-to-consumer advertisements dates to 1997, when the FDA loosened restrictions and allowed prescription drug advertisements on tv so long as they included a rapid-fire abstract of main dangers and offered a supply for additional data.
“That really opened the door,” mentioned Abby Alpert, a well being economist on the Wharton School of the University of Pennsylvania.
The introduction of Medicare Part D, in 2006, introduced “a huge expansion in prescription drug coverage and, as a result, a big increase in pharmaceutical advertising,” Alpert added. A examine she co-wrote in 2023 discovered that pharmaceutical advertisements were much more prevalent in areas with a excessive proportion of residents 65 and older.
Industry and academic research have proven that advertisements affect prescription charges. Patients are extra apt to make appointments and request medicine, both by model identify or by class, and docs usually comply. Multiple follow-up visits could ensue.
But does that profit shoppers? Most developed nations take a tough go. Only New Zealand and, regardless of the decadelong opposition of the American Medical Association, the United States enable direct-to-consumer prescription drug promoting.
Public well being advocates argue that such advertisements encourage the use and overuse of costly new medicines, even when current, cheaper medicine work as successfully. (Drug firms don’t hassle promoting as soon as patents expire and generic medicine grow to be accessible.)
In a 2023 examine in JAMA Network Open, as an illustration, researchers analyzed the “therapeutic value” of the medicine most marketed on tv, primarily based on the assessments of impartial European and Canadian organizations that negotiate costs for authorized medicine.
Nearly three-quarters of the top-advertised medicines didn’t carry out markedly higher than older ones, the evaluation discovered.
“Often, really good drugs sell themselves,” mentioned Aaron Kesselheim, senior creator of the examine and director of the Program on Regulation, Therapeutics, and Law at Harvard University.
“Drugs without added therapeutic value need to be pushed, and that’s what direct-to-consumer advertising does,” he mentioned.
Opponents of a ban on such promoting say it advantages shoppers. “It provides information and education to patients, makes them aware of available treatments and leads them to seek care,” Alpert mentioned. That is “especially important for underdiagnosed conditions,” like despair.
Moreover, she wrote in a latest JAMA Health Forum commentary, direct-to-consumer advertisements result in elevated use not solely of brand-name medicine but additionally of non-advertised substitutes, together with generics.
The Trump administration entered this debate final September, with a presidential memorandum calling for a return to the pre-1997 coverage severely limiting direct-to-consumer drug promoting.
That place has repeatedly been urged by Health and Human Services Secretary Robert F. Kennedy Jr., who has charged that “pharmaceutical ads hooked this country on prescription drugs.”
At the identical time, the FDA mentioned it was issuing 100 cease-and-desist orders about misleading drug advertisements and sending “thousands” of warnings to pharmaceutical firms to take away deceptive advertisements. Marty Makary, the FDA commissioner, blasted drug ads in an essay in The New York Times.
“There’s a lot of chatter,” Woloshin mentioned of these actions. “I don’t know that we’ll see anything concrete.”
This month, nonetheless, the FDA notified Novo Nordisk that the company had discovered its TV spot for a brand new oral model of Wegovy false and deceptive. Novo Nordisk mentioned in an e mail that it was “in the process of responding to the FDA” to handle the considerations.
Meanwhile, Democratic and impartial senators who not often align with the Trump administration even have launched laws to ban or restrict direct-to-consumer pharmaceutical advertisements.
Last February, impartial Sen. Angus King of Maine and two different sponsors introduced a bill prohibiting direct-to-consumer advertisements for the primary three years after a drug positive aspects FDA approval.
King mentioned in an e mail that the act would higher inform shoppers “by making sure newly approved drugs aren’t allowed to immediately flood the market with ads before we fully understand their impact on the general public.”
Then, in June, he and impartial Sen. Bernie Sanders of Vermont proposed legislation to ban such ads solely. That would possibly show troublesome, Woloshin mentioned, given the Supreme Court’s Citizens United ruling protecting corporate speech.
Moreover, direct-to-consumer advertisements characterize solely a part of the business’s promotional efforts. Pharmaceutical companies really spend more money advertising to doctors than to shoppers.
Although tv nonetheless accounts for many client spending, as a result of it’s costly, Kesselheim pointed to “the mostly unregulated expansion of direct-to-consumer ads onto the web” as a selected concern. Drug gross sales themselves are bypassing docs’ practices by shifting on-line.
Woloshin mentioned that “disease awareness campaigns” — for all the things from shingles to stressed legs — don’t point out any explicit drug however are “often marketing dressed up as education.”
He advocates more practical instructional campaigns, he mentioned, “to help consumers become more savvy and skeptical and able to recognize reliable versus unreliable information.”
For instance, Woloshin and Lisa Schwartz, a late colleague, designed and examined a easy “drug facts box,” much like the dietary labeling on packaged meals, that summarizes and quantifies the advantages and harms of medicines.
For now, shoppers should attempt to educate themselves in regards to the medicine they see ballyhooed on TV.
Abrams learn rather a lot about Ozempic. Her physician agreed that making an attempt it made sense.
Abrams was referred to an endocrinologist, who determined that her blood glucose was excessive sufficient to warrant remedy. Three years later and 90 kilos lighter, she feels in a position to scramble after her 2-year-old grandson, enjoys Zumba lessons, and now not wants blood stress or ldl cholesterol medicine.
So Abrams is not sure, she mentioned, how one can really feel a couple of attainable ban on direct-to-consumer drug advertisements.
“If I hadn’t asked my new doctor about it, would she have suggested Ozempic?” Abrams questioned. “Or would I still weigh 270 pounds?”
The New Old Age is produced by a partnership with The New York Times.
