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Do Direct-to-Consumer Drug Ads Do More Good Than Harm?

The Evidence Suggests a Ban on Ads May Not Be A Well-Targeted Solution

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As any American TV watcher knows, the pharmaceutical industry invests billions each year in advertisements promoting remedies for arthritis, diabetes, depression, and many other conditions. The United States is one of two countries in the world that permits pharmaceutical companies to advertise directly to consumers. Recently, policymakers from across the political spectrum, from Bernie Sanders to President Trump, and even the American Medical Association have called for banning or reforming direct-to-consumer (DTC) advertising of prescription drugs, in part because it encourages the use of the most expensive brand-name drugs.

While banning DTC advertising might appear to be sound public policy, evidence about advertising’s effects suggests the case for such a ban is not as strong as it may initially appear. LDI Senior Fellow Abby Alpert recently published a Viewpoint in JAMA Health Forum reviewing what is known from studies about DTC advertising.

Here are three reasons why Alpert believes the evidence may not support a ban on direct-to-consumer advertising to reduce inappropriate prescription drug use:

1. Prescription drug ads are already held to a higher standard than other consumer products.

While there is a common critique that DTC advertisements may be misleading, the quality of information in prescription drug advertisements is subject to a higher standard than in any other consumer market. Under current regulations, advertisements must provide information consistent with the U.S. Food and Drug Administration–approved product label and present a balanced view of the benefits and risks associated with the product.

2. While DTC advertisements do lead to increased prescriptions, this generally means improved access to beneficial treatment.

Another concern is that DTC advertisements lead to wasteful spending by encouraging overuse of expensive brand-name drugs. However, multiple layers of gatekeepers within the healthcare system help limit inappropriate use. When a patient requests an advertised drug, physicians can prescribe an alternative. Similarly, the patient’s insurance formulary may determine whether they receive another brand or a lower-cost generic drug

There is strong evidence that DTC advertising increases the use of both promoted drugs and nonadvertised generic competitors through both increased treatment initiation and improved medication adherence. For example, a study on a heavily advertised class of statins, viewed as high-value treatment, found that advertising led to both switching to the advertised brand and an overall increase in statin users.

While advertising benefits many patients who would have otherwise gone untreated, there is evidence that it may lead to some overuse. A randomized clinical trial showed that patients who requested an antidepressant were much more likely to receive a prescription than patients who did not request treatment–both in cases where treatment was clearly indicated and where it was more clinically marginal. On balance, however, the evidence suggests that although DTC advertisements may lead to some overuse, they substantially increase patients’ access to beneficial medications. Banning DTC advertisements may reduce drug expenditures by decreasing overuse, but it could also exacerbate underuse, underdiagnosis, and nonadherence, which add substantial costs to the health care system.

3. DTC ads lead to engagement with the health care system that reduces untreated conditions.

Studies have found an increase in physician visits due to advertising. These visits often lead to diagnoses of unrelated health issues or the initiation of nonpharmaceutical treatments and sustained engagement with physicians. Studies of patient and physician perceptions suggest that potential benefits of DTC advertising include enhanced information-seeking by patients and increased requests for appropriate prescriptions.

Read the full piece here.

“Assessing the Case Against Direct-to-Consumer Drug Advertisements” by Abby Alpert and Neeraj Sood appeared in the November 14, 2025 issue of JAMA Health Forum.

Author

Julia Hinckley

Julia Hinckley, JD

Director of Policy Strategy

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