By Karen L. Kier
Pharmacist on behalf of the ONU Healthwise Team 

In 1991, the film Hook directed by Steven Spielberg was released. The film was the sequel to the 1911 novel Peter & Wendy. The movie starred Robin Williams as Peter Pan, Dustin Hoffman as Captain Hook, and Julia Roberts as Tinkerbell. Jimmy Buffett and David Crosby made cameo appearances as pirates in the movie. 

In advertising, a hook is an angle used to grab attention. There are numerous ways to provide a hook. Color in ads is used to grab attention and influence mood or feelings. Powerful emotions such as humor, nostalgia, or sadness can provide a hook. Jingles create a brand awareness and loyalty. (Some recent drug ads have passed mere jingle to the style of a Broadway musical.) The use of celebrities is a common practice. A newer method is termed FOMO or the fear of missing out, such as a limited supply.

The pharmaceutical industry is no different when it comes to finding the hook for their ads. In 2021, the pharmaceutical industry spent 8 billion dollars on ads and 2022 was no different coming in at $8.1 billion. The top advertised drugs included $491 million for Dupixent®, $180.2 million for Ozempic®, $167.2 million for Rybelsus®, and $158.6 million for Jardiance®.

These drug names appear on television, billboards, magazines, and the side of buses. The United States is one of only two countries in the world allowing direct-to-consumer (DTC) for prescription medications. New Zealand is the other country. 

DTC started in 1997 when the FDA eased restrictions on advertising to the public. The FDA oversees prescription drug ads and requires them to be truthful, balanced, and accurately communicate information. 

There are known benefits to DTC including educating on conditions and treatments as well as raising awareness or lessening the stigma associated with certain diseases. Some of these ads promote early detection and screening to improve health.

More recent data published in 2023 in JAMA by Johns Hopkins University researchers provides evidence indicating DTC could be more harmful than helpful. The February study evaluated the top 150 prescription drugs. The study found 15% of the drugs advertised had very little clinical benefit if any over the less expensive options on the market including generics. The researchers noted the pharmaceutical company spent more advertising money on the drugs with the least benefit to the patient. The authors noted for every 1.5% increase in spending on drug ads, the prescription volume increased by 10%. The Hopkins’ researchers concluded the DTC ads drive up the cost of healthcare in this country. 

Do the ads work to increase sales? Yes, they do! The companies would not be spending millions of dollars on ads if they did not work. 

A December 14, 2023 article in Bloomberg Law highlighted the severe consequences of social media influencers who promote prescription use with drugs such as Ozempic® and Wegovy® for weight loss. The FDA developed guidance in 2014 for social media advertising, which is essentially being ignored by social media influencers according to Bloomberg. 

When did the advice of social media influencers override the knowledge and education of healthcare professionals?  Social media has the hook!  

The FDA does provide an avenue for healthcare professionals and the public to lodge a complaint. The agency runs The Bad Ad Program. The program is designed to raise awareness among healthcare professionals relating to misleading or false information pertaining to prescription drug ads. Anyone can submit a complaint and it can be anonymous. You can email [email protected] or call their toll-free line at 855-RX-BADAD (855-792-2323). 

Besides prescription bad ads, there is a major concern in the United States for commercials targeting the public to engage with online websites promoting therapies for weight loss, hair loss, and sexual dysfunction. The difficulty can be knowing which sites are ethical and legal versus those who are operating illegally and outside of the US. 

On January 10, 2024, the FDA issued a warning to healthcare professionals and consumers about the marketing of semaglutide products. The brand names for semaglutide include Ozempic® injection for diabetes, Rybelsus® oral tablets for diabetes, and Wegovy® injection for weight loss. Some companies and websites are promoting compounded semaglutide as a substitute for the brand name. The FDA received numerous complaints about counterfeit drugs, wrong ingredients being used, wrong dosing and labeling issues, and harmful ingredients in the compounding of semaglutide. 

Due to the FDA having semaglutide on its list of medications in short supply, this allows for compounding versions to be made available. The compounded drugs must follow federal requirements. The FDA has warned of companies using the wrong salt form of semaglutide, which has dangerous side effects. It is important to get medications from a trusted source. Do research on companies before purchasing products. 

Don’t get hooked!  Talk to your healthcare professionals about prescription medications and have an open and honest conversation. 

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