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70% of drugs advertised on TV have ‘low therapeutic value’, study finds

70% of drugs advertised on TV have ‘low therapeutic value’, study finds

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Some new drugs are marketed with impressive safety and efficacy data. For others, well, there are TV commercials.

According to a new study, just over 70 percent of prescription drugs advertised on television are rated as having “low therapeutic value,” meaning they offer little benefit compared to drugs already on the market. Learningappearing in JAMA Open Network, is consistent with longstanding skepticism that highly touted drugs have high therapeutic value.

“One explanation may be that drugs with significant therapeutic value are likely to be recognized and prescribed without advertising, so manufacturers have a greater incentive to advertise drugs with less value,” said the authors, who include researchers from Harvard, Yale and Dartmouth.

The US is one of only two countries that allow direct-to-consumer (DTC) drug advertisements, such as TV commercials. (The other is New Zealand.) Doctors, medical associations and consumer advocates have long been set up against the unusual practice. In 2006, the consumer advocacy group Public Citizen summary DTC advertising as “nothing less than the end of the doctor-patient relationship – an attempt to turn patients into agents of drug companies while they pressure doctors for drugs they may not need.”

In 2015, the American Medical Association called for a complete ban on DTC ads for prescription drugs and medical devices. AMA members said the ads “drive demand for expensive treatments despite clinical effectiveness of cheaper alternatives.”

But DTC drug ads continue, fueled by billions of dollars from the pharmaceutical industry.

The benefit has not been added

For the new study, researchers led by Aaron Kesselheim, who directs Harvard’s Program on Regulation, Therapeutics and Law (PORTAL), looked at monthly lists of the most advertised drugs on US television between 2015 and 2021.

They also sought therapeutic value assessments for these drugs from independent health assessment agencies in Canada, France and Germany. Value estimates are based on the drugs’ therapeutic benefit, safety profile and strength of evidence compared to existing drugs. Any drug rated “moderate” or higher was classified as a “high value” drug for the study. For drugs with multiple ratings, the study authors used the most favorable rating, which the authors note may overestimate the proportion of drugs with a higher benefit.

Of the top-advertised drugs, 73 had at least one value. Collectively, pharmaceutical companies spent $22.3 billion advertising these 73 drugs between 2015 and 2021. Even with the generous estimates, 53 of the 73 drugs (roughly 73 percent) were categorized as having low efficacy. Combined, these low-benefit drugs account for $15.9 billion in advertising spending. The top three drugs with low benefit by dollar amount were Dulaglutide (type 2 diabetes), varenicline (smoking cessation) and tofacitinib (rheumatoid arthritis).

Prospects for change are bleak, the authors note. “Policymakers and regulators could consider limiting direct-to-consumer advertising to drugs of high therapeutic or public health value or requiring standardized disclosure of comparative efficacy and safety data,” Kesselheim and colleagues concluded, “but policy changes likely to require industry cooperation or face a constitutional challenge.”


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