The proliferation of prescription drug advertisements by law firms poses significant risks to public health, according to recent research by Sylvia Hristakeva, an assistant professor at the Cornell SC Johnson College of Business. These 30-second television commercials, which often target individuals who have experienced adverse side effects from medications, can inadvertently dissuade patients from continuing essential treatments.
Hristakeva’s study, titled “Bad-drug Ads or Killer Ads: The Effects of Drug Injury Advertising on Public Health,” published on October 28, 2023, highlights the unintended consequences of these ads. They not only reach those who may have suffered from drug-related issues but also influence patients who benefit from the medications in question. “These ads influence drug utilization in a way that can harm public health,” Hristakeva stated, emphasizing the need for more serious consideration of their content and reach.
The research primarily focused on anticoagulants, which are critical for preventing blood clots and strokes—one of the leading causes of death in the United States. The study examined medications such as Warfarin, introduced in 1953, and newer non-vitamin K oral anticoagulants (NOACs) like Pradaxa, Xarelto, and Eliquis, released between 2010 and 2012.
Using Medicare data from 2015 to 2019 along with advertising data from the litigation tracking firm X Ante, Hristakeva analyzed the impact of drug injury advertisements on prescription behavior and hospitalizations. While the ads do not directly urge viewers to change their medication, they have been shown to significantly alter treatment decisions. Specifically, a $0.19 increase in per capita ad spending correlates with a 2.6% decrease in NOAC prescriptions.
The study also revealed alarming statistics regarding hospitalizations. In counties with a substantial population over age 65, a similar increase in ad spending leads to a 5.76% rise in hospitalizations related to anticoagulant diagnoses. This translates to approximately 3,400 additional inpatient visits annually, resulting in an estimated $68 million in increased hospitalization costs for stroke patients, based on an average of $20,000 per visit.
“This is a conservative estimate,” Hristakeva noted, stressing that it does not account for long-term costs such as follow-up treatment or lost income due to disability.
To address these issues, some states like Texas and Tennessee have enacted legislation aimed at improving transparency in legal advertising. New laws require clearer disclaimers, ensuring that viewers understand these are legal solicitations rather than government alerts, and include warnings advising patients to consult their doctors before discontinuing any medication.
Hristakeva pointed out that federal regulators have also begun to take action, noting that the Federal Trade Commission (FTC) has issued warning letters to law firms regarding misleading advertisements. “We already have regulations that prohibit deceptive advertising,” she stated, highlighting the need for ongoing scrutiny in this area.
Beyond regulatory measures, Hristakeva advocates for public health initiatives that provide accurate, evidence-based information to help patients and healthcare providers navigate the complexities presented by these advertisements. “Helping patients and doctors understand these messages could reduce the unintended consequences,” she concluded.
Support for this research was provided by the National Science Foundation and the Morrison Center for Marketing and Data Analytics at the University of California, Los Angeles. The findings underscore the critical need for a balanced approach to drug advertising that safeguards public health while ensuring that patients receive the treatments they need.
