Direct-to-Consumer Advertising is Driving up Cost of Prescription Drug

Image description: A happy elderly couple sitting on a sofa, smiling with a remote in their hand watching TV.

By Dr. Chandra Char

Published in Aging in America News on July 21, 2026 https://aginginamerica.news/2026/07/21/direct-to-consumer-pharma-advertising/

Imagine yourself or your 80-year-old grandmother, retired at home watching Days of Our Lives or The

Price is Right in the afternoon on a weekday. During commercial break, As Seen on TV and

pharmaceutical company ads spark your curiosity. You think, “maybe I do need a Chia Pet,” or “that drug

could really help me with my depression.”

On average American viewers watch approximately 9 drug ads per day on TV and that rate can be higher

for seniors who are watching day-time programing. These direct-to-consumer (DTC) drug ads are

particularly predatory toward seniors. Ads can feel personally relevant for seniors when showcasing

conditions such as arthritis, diabetes, heart disease etc. Also, these ads pull on viewers heart strings

creating an emotional cost. When viewers see a relatable scene or experience, they are left to believe

that a particular prescription drug can heal their condition and help them return to the pickleball court

not realizing that the commercial they watched was a complete fiction of marketing magic. The use of

celebrity endorsements of drugs can enhance the likeability factor of certain brands and influence

persuade viewers to favor specific drugs.

American pharmaceutical companies spend approximately $6 to $14 billion a year on DTC drug

advertising and write off billions of dollars in advertising expenses as standard business deductions. This

further robs American taxpayers of roughly $1 billion in tax revenue each year. Currently, the United

States and New Zealand are the only developed countries that allow DTC advertising. Most countries

have banned or restricted DTC drug ads to protect consumers from misleading or exaggerated claims

around their healthcare.

For example, the catchy tunes and bright colors in DTC ads can influence consumers, particularly seniors,

to seek brand-named drugs rather than more affordable but lesser-known generics. Americans pay

roughly 4.2x more for brand-named prescription drugs than people in other wealthy countries because

aggressive marketing pushes cheaper, effective generics out of the picture. These brand-named drugs

are often not covered by insurance at the same rate as generics, requiring patients to pay more out of

pocket to meet their deductible. Research shows that patients who request a specific medication at an

appointment are more likely to receive it from their doctor.

Furthermore, DTC ads frequently rely on misleading claims that undermine the advice and treatment

plans of medical professionals. DTC ads capitalize on the credibility and authority of healthcare experts,

clinical language, and medical office scenery to create the impression that products advertised as

medicine must be safe. This type of misleading messaging can skew perception, making the catchy

messaging more memorable than the laundry list of side effects. This marketing can be particularly

harmful to seniors who may have limited social networks and rely on television as their primary source

of information. Seniors experiencing reduced cognition and hearing challenges lower information

comprehension and recall. Among adults 60 years of age and older with hearing loss, have decreased

comprehension when speech rate increased. DTC ads play a specific role in creating challenges for

seniors around understanding the risks of drugs and information when the voice over speed increased

when presenting information about drug side effects.

Americans are waking up to the dangers of DTC drug advertising and urging the government to act. In

2024, Health and Human Services Secretary Robert F. Kennedy promised to end drug advertising on

television. Over the past five years, Congress has also introduced nearly twenty Bi-partisan bills to ban

or reduce DTC drug advertising to support prescription cost transparency for seniors who are the

primary consumers of prescription drugs. For example, the Drug-Price Transparency for Consumers Act

of 2025 had bipartisan backing in support and would have required all DTC advertisements for

prescription drug and medical products covered under Medicare and Medicaid to clearly and

transparently disclose the cost of a 30-day supply of the prescription. Moreover, state legislators are

taking action. In February, the Maryland Senate introduced the Elimination of DTC Pharmaceutical

Advertising Deduction bill to make it so that pharmaceutical companies can no longer deduct DTC drug

ads, including TV, radio, print, social medial and digital platforms, on their Maryland state tax returns.

The tax revenue would be distributed to the Maryland Department of Health to reduce the cost of

health insurance premiums and boost Medicaid eligibility. This bill is still under review.

Unfortunately, most of these DTC ad elimination bills have fizzled out despite the fact that 88% of

Americans support changes to DTC ad policies like requiring drug companies to include the list of

medication prices in advertisements. Seniors need improved health and media literacy to keep up with

this ever-evolving high tech world. Community-based education programs that can teach seniors how to

understand a drug add and side effects can increase comprehension, self-efficacy and reduce the

chances of seniors being misled by DTC ads. Seniors could also benefit from stronger, empowered

patient-provider communication. Seniors need positive encounters with their doctors where they can

ask questions about advertised drugs and where doctors are equipped to respond thoughtfully and

educate patients rather than dismiss or comply. Helping seniors identify which DTC ad features are

important can increase comprehension and empower patients. Additionally, doctors can encourage

shared decision-making to enhance patient-provider communication by improving prescription therapy

that aligns with the patient’s values, medical needs, preference and health goals in order to empower

the patient in their healthcare journey.

DTC ads are a public health issue and influences the way we think about aging. DTC ads define aging by

medical conditions that require prescription drug solutions to return to everyday activities. This

perspective shapes the way older adults perceive their health and the way younger people perceive

aging. The medicalization of aging sends a message that healthy aging is only possible through the

support of prescription drugs. Deliberately targeting vulnerable populations who are not equipped to

defend themselves and parse through complex medical information raises serious ethical questions. A

society that cares about healthy, dignified aging for everyone should be concerned about an industry

that profits from medicalizing aging and age-related health conditions.