Direct-to-consumer (DTC) pharmaceutical advertising is not only inescapable, it is literally barraging Americans on all fronts. One cannot get through any commercial break on either cable or streaming services without being targeted by said marketing. From my personal experience, on average, an American will witness eight to 10 pharmaceutical commercials per hour of television/streaming viewing. Over the course of a single year, that same American consumer will be exposed to 16 hours of televised pharmaceutical advertisements, far outpacing even advertisements for lawyers. Sadly, a significant amount of that time is devoted to the enumeration of side effects, not benefits, of enticing potions. Such a merciless deluge of pharmaceutical enticement has metastasized to radio and internet as well.
DTC pharmaceutical advertising is not bad for business. It’s just bad.
This statement is not intended as a revelation or as an epiphany. It should not be considered provocative or controversial, at least among the medical community. Never mind among the majority of the world, where only the U.S. and New Zealand even permit such activity. It is an opinion that should be regarded as indisputable fact, not a fascinating contrary argument never before explored.
Acceptance of this premise, however, does provoke certain considerations. I have never quite understood the wisdom or utility of such widespread pharmaceutical commercialism. Direct encouragement of pharmaceutical products to the general public implies that patients bear the responsibility of alerting their physicians to the existence and value of such medical advances, instead of the other way around. What patient should, or would, trust a doctor who needs a reminder about current medical care from their patient?
The inability of the typical consumer-patient to appreciate the many nuances of medical practice underscores how disingenuous Big Pharma’s tactics have become. Recently developed expensive medications with complex biologic or pharmacologic mechanisms of action are implied as first-line solutions, almost always contrary to responsible medical practice. Physicians must then relinquish valuable time and effort explaining the reality of stepwise medical care.
The implication, whether intended or not, is that physicians are insufficiently, if not dangerously, uninformed. Extending this underlying message one step further, physicians represent nothing more than middleman dealers of products otherwise out of reach for patients to obtain themselves. The slick Hollywood-esque production of these advertisements, replete with clever animation or suddenly carefree patients enjoying life in slow-motion bliss, certainly enhances a grip on the trust of a vulnerable patient viewership. Medical care, unlike shoes or phone plans, shouldn’t be driven by patient persuasion or usurped by exaggerated promises of life disease-free. It should be driven by medical need and scientific reality.
Does treating medication like household products violate marketing common sense as well as medical common sense? DTC advertising for car dealerships, alcoholic beverages, shoes, or fast food relies on the ability of consumers to explore and purchase such products on their own. Prescription drugs or devices, however, can be pursued only with the cooperation of a third party (i.e., physicians), thus seemingly ignoring a major focus on the ever-important return on investment. Marketing 101 should have covered this, as well as including warnings against abbreviations without explanation (could I have CIDP? TD? WTF? OMG …). Are such insights too simplistic, or are they Achilles’ heels in an otherwise calculated predatory scheme by pharmaceutical corporations?
I digress. Consider the more intangible repercussions on dignity and reputation. Diabetic-directed commercials, for example, visualize actors actually dancing and rejoicing at the golden opportunity to use a new diabetic/weight loss medication. Radio advertisements in my local area even assure potential patients “their visit is free if one signs up for hormonal treatment during that visit.” Is that even legal, never mind ethical? Are patients really exploitable enough to be manipulated with bribery and an essentially BOGO (Buy One, Get One) enticement? According to Big Pharma and Big Medicine, they may be …
Such demeaning DTC advertising impugns the dignity of vulnerable patients who struggle with prescription side effects and costs, never mind lifestyle obstacles. Moreover, unfettered medical/pharmaceutical advertising does damage to the dignity, reputation, and standing of physicians, guilty by association.
Besides such damage to the reputation and credibility of physicians, can DTC enticement actually cause physical harm to patients themselves? It is, at least in my experience and as documented in the literature, indisputable that polypharmacy among patients in the U.S. is rampant, and is fertile ground for adverse drug interactions and dangerous medical consequences. Not coincidentally, American patients in general are on more medications than their counterparts in the vast majority of countries that ban DTC advertising. A direct cause-and-effect relationship would be difficult to prove, but where there’s smoke …
Simply taking a stand on the deleterious nature of DTC pharmaceutical bludgeoning is easy. It should be complemented by proposed solutions. Toward that end, I offer remedial actions. Consumers (patients) are not the appropriate targets for advertisements, as noted above. They cannot actually select, order, preauthorize, and obtain the newest biologic or medication. Physicians, the gatekeepers of the pharmaceutical armamentarium, should be the target.
I would encourage reception of responsible pharmaceutical representatives to physician offices. I realize this method is held in deep scorn among many medical practices, and not without good reason. But my own experience has been positive and truly educational. I accept only representatives who prove their integrity and value with factual information, provide prompt and objective answers to my skeptical questions, and are always accompanied by a medical/pharmacology liaison professional. Developing a cadre of such trusted pharmaceutical representatives, with strict scheduling, has allowed my practice an educational and responsible direct-to-physician model. A model not guided by or beholden to a direct profit motive.
I do not disdain medications and “traditional” medical practice in favor of natural/behavioral alternatives (although I consider them at times complementary). Furthermore, I accept that without the capabilities and resources of pharmaceutical companies, our current state of medical intervention would be far more primitive. Profit does drive progress, for better or for worse. I will therefore not hold my breath for necessary pharmaceutical self-policing and internal responsibility.
Which brings me to the point of this article: DTC pharmaceutical advertising is an unholy example of an unfettered alliance between corporate pharmaceuticals, capitalism, and medication (over)reliance. Such a perfect storm of greed represents an abdication of responsibility for the very population to supposedly be helped.
Consequently, the real solution must rely on a total ban of DTC outreach through responsible governmental edict. Government regulation is always a potential slippery slope, but it has worked well with almost every other country regardless of medical delivery and reimbursement. Powerful lobbying efforts and well-entrenched political contributions may stand in the way but are not unsurmountable. Medical consumers and physicians, both belittled and maligned by these obstacles, must protest in concert. The current administration’s willingness to intervene into the private business arena makes this the right time. Already the administration and its FDA have come down on “false and misleading” TV, social media, and website pharmaceutical advertising of unofficial versions of prescription drugs. A narrow focused intervention, but an important step nonetheless toward more widespread regulation.
Turn Make America Healthy Again into Make American Medicine Believable Again, snuffing out Big Pharma’s disservice to consumers dependent on its products and advancements. Perhaps a bitter pill for Big Pharma to swallow, but it is, indeed, time for strong medicine.
Should the U.S. ban direct-to-consumer pharmaceutical advertising once and for all? Share in the comments.
Scott Eveloff, MD, is a physician living in Overland Park, Kansas, having served the medical needs of far-flung towns in rural Missouri for more than 30 years while actively publishing his perspectives on ethics in medicine. He has published extensively in the medical literature, earning him appearances on ABC’s "20/20 Medical Mysteries," ABC News "Nightline," and the "Dr. Oz Show." Dr. Eveloff has remained a passionate advocate for the disabled, publishing the nonfiction book "Both Sides of The White Coat" and most recently a novel, "Do Not Resuscitate." He is a 2025–2026 Doximity Op-Med Fellow.
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