When you can’t watch the evening news without seeing a parade of glossy drug commercials—obesity shots, depression pills, diabetes injectables—you’re not witnessing health care; you’re watching a business model. The United States is one of only two countries on Earth that allows prescription drug companies to advertise directly to consumers. The other is New Zealand. That’s it. Everywhere else, lawmakers decided the risks outweigh the benefits. They’re right—and we should follow suit or at least put strong brakes on a practice that pushes people toward expensive, newer drugs they may not need while crowding out safer, cheaper generics.
This isn’t a small, harmless marketing niche. Drugmakers now spend billions each year pushing prescription brands to the public. In 2024, companies poured more than $10 billion into consumer ads across TV and digital, with more than half on television alone. In just the first half of 2025, national TV spending nearly hit $3 billion, and weight-loss and diabetes GLP-1 drugs dominated prime-time slots. That saturation isn’t accidental—it’s a strategy to create demand that patients then carry into the exam room.
The evidence is clear: direct-to-consumer advertising drives prescribing, including when it’s not medically necessary. A 2021 review found that it increases patients’ requests for specific drugs, boosts the likelihood that clinicians will prescribe them, and raises rates of inappropriate use. Earlier research shows the same pattern: brief exposure to drug ads has a large, positive effect on medication demand, and heavily advertised drugs see higher prescribing even when clinical benefit is limited.
We all know the vibe these ads cultivate: “Ask your doctor if X is right for you.” But advertising works by design—especially when it taps fear and hope around chronic conditions. The result is a surge of patients seeking a pill for every problem, while proven lifestyle changes—nutrition, exercise, sleep, substance-use counseling—get sidelined. Worse, the new, patent-protected drugs being pushed aren’t guaranteed to be better for every patient, and they often carry serious side effects—sometimes worse than the condition being treated. The FDA itself stresses that ads must present a “fair balance” of risks versus benefits, which is a polite way of admitting the risks are significant. Even then, regulators have had to tighten rules to force TV and radio ads to present the major risk statement clearly and neutrally. That’s telling.
Meanwhile, the ad blitz steers patients away from tried-and-true generics that save families and taxpayers enormous sums. Generics and biosimilars delivered an estimated $373 billion in U.S. savings in a single year, and FDA case studies show individual prescriptions dropping by thousands of dollars once generic competition arrives. Yet if you bombard the public with brand-name pitches, you make it harder for generics to compete—no matter how effective they are.
Let’s also be honest about who pays for the marketing. One analysis found the largest pharma firms spent $13.8 billion on direct-to-consumer ads in 2023—and wrote those costs off their taxes, leaving $1.5 billion to $1.7 billion in lost federal revenue annually. We’re subsidizing commercials that inflate demand and drive costs. That’s perverse.
Defenders of direct-to-consumer advertising say ads “educate” patients. Some awareness can be good—people do sometimes seek care earlier when they recognize symptoms. But if education were the real aim, we’d see unbranded campaigns about conditions and prevention, not brand saturation during prime time with upbeat music and split-second risk disclaimers. In fact, federal law does not prohibit ads for drugs with serious risks; it merely requires certain disclosures. Regulators have repeatedly had to step in to clarify, standardize and now step up enforcement because ads keep pushing the line. That alone is a sign the system isn’t working.
So what should we do?
First, end the tax deductibility of direct-to-consumer advertising. If companies want to advertise prescription drugs to the public, taxpayers shouldn’t foot the bill. Eliminating this write-off would save money and reduce the incentive to flood the airwaves.
Second, restrict brand-specific broadcast advertising and tighten digital rules. Most countries ban brand-name prescription advertising outright; at minimum, we should follow their lead on TV and require strict gatekeeping online, where influencers and targeted algorithms blur lines between advice and promotion. Recent federal actions to increase enforcement are welcome but insufficient without clear statutory limits.
Third, require head-to-head evidence and plain-language risk summaries. If a company insists on a brand ad, it should have to show real-world benefit over standard therapy or generics, not just over placebo, and present side-effect rates in readable, prominent terms that match the tone and pace of the ad’s happy scenes. Current “fair balance” rules and the 2023 clarity standard are steps, but we need stronger, enforceable formats that truly inform rather than dazzle.
Fourth, promote generics and prevention. Put public dollars into unbranded campaigns that help people manage weight, stress, sleep, nutrition and substance use—and into tools that help doctors and patients choose value, not just novelty. Highlight what generics already save and when they’re the best first-line option.
None of this denies that modern medicines can be life-changing. They can. But a health care system that treats every human worry as a marketing opportunity invites overdiagnosis, overtreatment and avoidable harm. We are awash in ads that encourage hypochondria, normalize “ask your doctor for this brand,” and lure families away from safer, cheaper options. That’s not care—that’s commerce.
The rest of the world learned the lesson. It’s time the United States did, too. Restrict direct-to-consumer prescription drug advertising, stop subsidizing it, and put the focus back where it belongs: evidence, prevention and value for patients—not profits for prime time.
