For the new study, researchers led by Aaron Kesselheim, who leads Harvard’s Program On Regulation, Therapeutics, And Law (PORTAL), looked at monthly lists of the top-advertised drugs on TV in the US between 2015 and 2021. They also looked up therapeutic value ratings for those drugs from independent health assessment agencies in Canada, France, and Germany. The value ratings were based on drugs’ therapeutic benefit, safety profile, and strength of evidence, as compared with existing drugs. Any drug rated “moderate” or above was classified as a “high value” drug for the study. For drugs with multiple ratings, the study authors used the most favorable rating, which they note could overestimate the proportion of higher-benefit drugs.
Of the top advertised drugs, 73 had at least one value rating. Collectively, pharmaceutical companies spent $22.3 billion on advertising for those 73 drugs between 2015 and 2021. Even with the generous ratings, 53 of the 73 drugs (roughly 73 percent) were categorized as low-benefit. Collectively, these low-benefit drugs accounted for $15.9 billion of the ad spending. The top three low-benefit drugs by dollar amount were Dulaglutide (type 2 diabetes), Varenicline (smoking cessation), and Tofacitinib (rheumatoid arthritis). The outlook for change is bleak, the authors note. “Policy makers and regulators could consider limiting direct-to-consumer advertising to drugs with high therapeutic or public health value or requiring standardized disclosure of comparative effectiveness and safety data,” Kesselheim and his colleagues concluded, “but policy changes would likely require industry cooperation or face constitutional challenge.” The report notes that the U.S. is “one of only two countries that allows direct-to-consumer (DTC) drug advertisements, such as TV commercials.” The other is New Zealand.
