Richard Swett: Ban The Ads That Inflate Drug Prices
Prescription drug prices just recorded their sharpest annual decline in more than six decades, according to new federal inflation data released last month. That may be little consolation for American families, who still pay among the highest prices in the world for their medicines.
The truth is, drug costs could fall further if Washington at last confronts one of the most obvious, and strangely neglected, contributors to excessive prescription-drug spending: the relentless advertising of prescription medicines directly to consumers.
You know the ads. A middle-aged couple strolls along a beach. A grandfather dances at a wedding. Someone with a serious chronic illness suddenly discovers kayaking. Then comes the soothing voice warning that the drug may cause infections, organ damage, suicidal thoughts or death — followed, inevitably, by the instruction: “Ask your doctor if [brand name] is right for you.”
That last sentence is the entire business model.
Americans are being encouraged to walk into doctors’ offices and request specific prescription drugs despite having neither the medical training nor the information necessary to determine whether those drugs are appropriate. And pharmaceutical companies spend billions of dollars encouraging them to do it because advertising works.
Research bears this out. A systematic review of direct-to-consumer drug advertising found that patients exposed to such advertising request advertised medicines and frequently receive them. In one FDA survey cited by the review, nearly half of patients who asked for a specific advertised brand reported receiving it.
There is an even more troubling wrinkle. A JAMA study examining 150 of America’s best-selling prescription drugs found that drugs with lower added clinical benefit devoted a significantly larger share of promotional spending to direct-to-consumer advertising than drugs offering greater clinical benefit.
In other words, advertising can be particularly valuable when the medicine cannot sell itself on making you healthier.
This turns the traditional doctor-patient relationship on its head. Physicians spend years learning how to weigh efficacy, side effects, contraindications, competing treatments and patient histories. Consumers spend 60 seconds watching actors play pickleball while a pharmaceutical company presents its product in the most appealing legally permissible way.
Then doctor and patient meet in the examination room as if those two sources of information deserve comparable weight.
And that is precisely the point. These advertisements are not designed to educate patients about disease. They are designed to create demand for a particular product before a physician has examined the patient. They transform a medical consultation into something it was never supposed to be: a sales opportunity in which the customer arrives already asking for the brand.
There is another absurdity: Patients ultimately help pay for the advertising used to persuade them to seek the drugs.
Prescription-drug advertising directed at consumers grew from $1.3 billion in 1997 to $6 billion in 2016, according to research published in JAMA, which counted 4.6 million prescription-drug advertisements in that year alone. More recent estimates put the broader drug-advertising market substantially higher.
Those expenditures do not materialize from nowhere. Advertising is a business expense built into an industry’s economics, just like staffing, administration and manufacturing. Americans therefore inhabit a bizarre system in which patients finance, through the healthcare economy, enormously expensive campaigns designed to stimulate demand among those same patients.
Adding insult to injury, virtually every other developed country has decided this makes little sense. The United States and New Zealand remain the notable exceptions in permitting direct-to-consumer prescription-drug advertising.
There is growing political support for doing exactly that. Sens. Bernie Sanders and Angus King have introduced the End Prescription Drug Ads Now Act, which would prohibit direct-to-consumer prescription-drug advertising across television, radio, print, digital platforms and social media. Legislation has also been introduced in the House. Calls to end or sharply curtail the practice are increasingly coming from across the political spectrum and from grassroots organizations such as the Pharmaceutical Accountability Project.
The pharmaceutical industry is not going down without a fight. In 2025, the pharmaceuticals and health products industry spent a record $457.3 million on federal lobbying in the United States. It is the top-spending industry on federal lobbying.
They will argue that advertising educates patients. Occasionally it may. But public-health education does not require branded pharmaceutical marketing. We do not need commercials for a $1,000-a-month medicine to tell Americans that diabetes, depression, psoriasis or obesity can be treated.
Government agencies, physicians, medical associations and nonprofit organizations can provide disease education without a financial incentive to steer patients toward a particular patented product.
The recent decline in prescription prices demonstrates that policy, competition and generics can make medicine more affordable. Congress should build on that progress by addressing the commercial machinery that pushes patients toward expensive branded medicines in the first place.
Prescription drugs are not breakfast cereal, automobiles or running shoes. The person deciding which one you need should be your doctor — not an advertising agency.
There is a remarkably simple way to restore that distinction.
Ban the ads.
