Nobel Economist George Stigler once wrote that “advertising is an immensely powerful instrument for the elimination of ignorance.”U.S. Health and Human Services (HSS) Secretary Robert F. Kennedy Jr. announced recently that HSS effectively intends to abandon that tool for prescription drugs that dare to tell actual consumers about their product.
Informing consumers through advertising generates important health benefits. Advertising is more likely for new drugs, more important drugs, and drugs for under-treated diseases with large numbers of potential patients. It increases the number of physician office visits that lead to diagnosis of chronic diseases.
Those effects persist for years, and contrary to the belief that doctors simply cave to their patients’ requests, most do not lead to a prescription for an advertised drug. Advertising for statins to treat high cholesterol increased the number of patients under treatment and improved compliance with the doctor’s directions. Antidepressant advertising increased prescriptions and reduced workplace absenteeism. Advertising of an anti-anemia drug led to more use by anemic chemotherapy patients who were not telling their doctors they were feeling fatigued.
Vaccines are another example. Without advertising, consumers would be entirely dependent on their physician to know that a new vaccine even exists. The substantial consumer campaigns for Shingrix (shingles), Gaurdisil9 (human papilloma virus, which causes cervical cancer), Fluzone (influenza), and various pneumonia vaccines likely increased the number vaccinated.
Studies of past advertising restrictions have found that the ability to advertise improves market performance. When advertising is allowed; prices are lower for eyeglasses, attorneys, gasoline, and even toys and children’s breakfast cereals. Product improvements also come more rapidly. When health claims for foods began in the 1990s, the greatest beneficiaries were relatively disadvantaged consumers such as single parent households and minorities who lacked the time or inclination to seek out official government sources.
FDA’s regulations were written decades ago, when print advertising to doctors placed in medical journals predominated. The rules require the advertisement to include a “brief summary” of prescribing information in the ad itself — typically half a page of fine print.
They require broadcast advertisements to either include the summary or make “adequate provision” for access. Guidance issued in 1997 clarified that a website URL or a toll-free phone number would meet that requirement. This is the “loophole” HHS now wants to close, even though access to URLs is ubiquitous today, unlike in 1997.
Requiring the “brief summary” in television advertising is an effective prohibition. It is simply not possible, and before the guidance broadcast advertising to consumers was virtually nonexistent. At a reasonable speaking pace, a 30 second ad has 90 or so words, but a “brief summary” is an order of magnitude longer. The web page summary for Skyrizi, the most heavily advertised prescription drug in 2024, exceeds 850 words — more than 9 additional ads! It simply won’t happen. And even if it did, few, if any, consumers would remember enough of the technical verbiage to meaningfully improve their decisions about whether to ask their doctor.
Of course, advertising must not be misleading. But advertising is inevitably incomplete. Its role is to identify products that consumers may not even know exist to satisfy an important need, leading them to search for more information — to ask their doctor. There is always more information that would be useful and making that information available through a website link accommodates those who want it. That is particularly true for prescription drugs, where consumers necessarily will encounter a health care professional before they purchase.
If doctors are too solicitous of patients who request a particular drug, that is a problem of physician behavior, not an advertising one. Attempting to solve it by keeping consumers blissfully ignorant is both unwise and unconstitutional.
Professor Howard Beales is Emeritus Professor of Strategic Management and Public Policy, George Washington School of Business. Dr. Beales was Director of the FTC’s Bureau of Consumer Protection in 2001-04.
