Despite Big Pharma Claims, Less than One-Third of Drugs Offer Relief to Patients

“Fewer than one-third of the most common drugs featured in direct-to-consumer television advertising were rated as having high therapeutic value, defined as providing at least moderate improvement in clinical outcomes compared with existing therapies.” That is the keynote takeaway from a comprehensive study performed by researchers at the Yale School of Medicine in New Haven, Connecticut.

This finding begs the question: If two-thirds of heavily marketed and advertised drugs are not likely to provide therapeutic value to people, why are patients taking them?

What the Findings Show

A study published in the Journal of the American Medical Association sought to uncover how much benefit heavily advertised drugs have on patients compared to other treatments. The Yale researchers began by collecting monthly lists of the top-advertised pharmaceutical drugs in the United States from an industry publication called Fierce Pharma. The researchers studied advertising trends from 2015 to 2021. Then, they studied the therapeutic value of the advertised drugs by examining the drugs’ ratings by independent health agencies in Canada, France, and Germany.

The researchers classified a drug as having “high benefit” if at least one of the three agencies rated the drug as having at least moderate therapeutic value compared to available alternatives. Conversely, the researchers classified a drug as “low benefit” if the independent agencies had classified the drug as primarily a backup option if better therapies did not work for a particular patient.

The results? Of the 73 drugs heavily advertised between 2015 and 2021, the researchers found only 20 that were highly rated by at least one of the three independent health agencies. Further, those 20 drugs represented only one-quarter ($6 billion of the more than $22 billion) of overall pharma advertising, meaning the pharma companies were spending more advertising dollars on the drugs that were less effective than the 20 highly rated drugs.

“What our study does show is that drug companies tend to focus their advertising on drugs that are not necessarily
the highest benefit drugs.”

Lead research author and medical student at Yale, Neeraj Patel, commented on the odd fact that pharma companies were spending more advertising dollars to push less effective drugs. “What our study does show is that drug companies tend to focus their advertising on drugs that are not necessarily the highest benefit drugs,” Patel said. “One explanation for that might be that drugs with high clinical value probably don’t need much advertising because they’re probably already likely to be recognized and prescribed without the additional promotion. So, the drugs you’re seeing advertised on TV aren’t necessarily the biggest breakthroughs in medicine, like you might assume.” Consumers should be mindful of this because it shows that just because a drug is heavily advertised does not mean it is an effective medication.

Pharma giants push drugs with known side effects, yet—thanks to Patel’s research—questionable efficacy casts doubt on the entire model of pharma advertising. Again quoting Patel, “proponents of direct-to-consumer pharmaceutical advertising often argue that these ads have high public health value by encouraging uptake of the most therapeutically beneficial therapies. Our study pushes back against this argument. The U.S. is one of only two high-income countries worldwide that widely permits direct-to-consumer advertising of prescription drugs. And there’s been a ton of empirical research over the past two decades that has suggested that this type of advertising can be misleading, lead to inappropriate prescribing, and inflate health care costs.” Patel’s research shows that not only are the current methods used by pharma advertisers leading to patients making decisions to consume low-benefit drugs, but they’re also inflating healthcare costs by putting patients on name-brand prescription pills when more affordable, more effective alternative therapies may be available.

The Importance of Regulating Faulty Advertising

The Food and Drug Administration does not review and approve all pharma advertisements before they air. The result? FDA regulators often have to play “catch-up” and regulate advertisements after they are made public, defeating the purpose of an effective regulation model.

The FDA could provide effective oversight if it insisted its regulators approve all pharma advertising before advertisements are aired. Under that model, the FDA could disprove advertisements falsely touting a low-benefit pharmaceutical drug as more effective than other therapies.

The Benefits May Be Overstated, But the Risks Are Not

The benefits of many name-brand pharmaceutical drugs may be overstated by misleading advertising campaigns (campaigns that reach tens of millions of Americans and influence their decisions when in their doctors’ offices). However, the risks that are inherent in such drugs are not overstated. According to the National Institute on Drug Abuse, at least five million Americans are addicted to prescription drugs.

That figure is likely underestimated because another body of research showed that at least 14.3 million Americans report “misusing” prescription drugs. Such misuse could be occasional experimentation, self-medication, using a pharmaceutical drug without a prescription, dependency on medication, or using a medication purchased through illicit means.

The National Institute on Drug Abuse breaks down which prescription drugs are most likely to lead to misuse by analyzing what percentage of the American population misuses several different types of pharmaceuticals. According to NIDA’s findings:

• 1.4% (about 3.9 million people) reported misusing benzodiazepines.
• 1.3% (about 3.7 million people) reported misusing prescription stimulants.
• 3.1% (about 8.7 million people) reported misusing prescription pain relievers.
• 1.7% (about 4.9 million people) reported misusing prescription tranquilizers or sedatives.

Perhaps most concerning, the research shows that young people are increasingly experimenting with prescription drugs. Surveys show young people perceive very little risk in self-medicating on prescription drugs compared to street drugs like heroin, cocaine, or meth. According to the data, 5% of 12th graders misuse prescription drugs.

Addiction Treatment is the Solution for Those Who Can’t Stop Taking Pills

The United States and New Zealand are the only countries where drug makers can market prescription drugs directly to consumers. That means only these two countries allow pharma giants to promote potentially mind-altering drugs that pose a risk for addiction and other harmful side effects. In the long-term, Americans should reconsider this model and instead consider an approach to medicine where decisions are made between patient and doctor, not influenced by pharma advertisers. Given the recent findings that pharma advertisers aren’t even pushing effective medications, it seems all the more clear that pharma advertising needs to become a thing of the past.

In the immediate future, Americans should focus on patients who have become addicted to the very pills that were advertised to them as solutions. People who are addicted must be helped immediately, as prescription drug addiction is a dangerous health crisis that could be fatal. If you know someone who is misusing prescription drugs, please do everything you can to help them enter a qualified drug rehab center as soon as possible. It does not matter whether they have a legitimate prescription for the drugs. Prescription drug misuse and addiction is a dangerous health crisis that must be treated.

Sources:

• JAMA. “Therapeutic Value of Drugs Frequently Marketed Using Direct-to-Consumer Television Advertising, 2015 to 2021.” Journal of the American Medical Association, 2023. jamanetwork.com

• USNews. “Less Than a Third of Heavily Advertised Drugs Have ‘High Therapeutic Value’: Study.” U.S. News, 2023. usnews.com

• NIDA. “Five million American adults misusing prescription stimulants.” National Institute on Drug Abuse, 2018. nida.nih.gov

• NIDA. “What is the scope of prescription drug misuse in the United States?” National Institute on Drug Abuse, 2022. nida.nih.gov

• HHP. “Do not get sold on drug advertising.” Harvard Health Publishing, Harvard Medical School, 2017. health.harvard.edu