Prescription for Change: DTC Pharma Advertising Could Face Major Crackdown

Direct-to-consumer (DTC) pharmaceutical advertising could soon be coming to an end in the US.

According to a Bloomberg report, the Trump administration and HHS Secretary RFK Jr. are preparing to crack down on pharma DTC advertising by making it more expensive to advertise drugs on TV.

The administration is weighing a proposal that would prohibit pharmaceutical companies from deducting DTC advertising costs as business expenses on their taxes.

Another policy being considered by the administration would require drug advertisements to provide more comprehensive disclosures of side effects. Analysts at ODDO BHF noted in a client memo that such a rule would likely result in longer, and consequently more costly, ads.

Instead of seeking an outright ban through an FDA policy change, which would likely face legal challenges under the First Amendment Act, RFK Jr. is looking to pursue legislative action through Congress.

News of the administration’s plans comes just days after Independent Senators Bernie Sanders of Vermont and Angus King of Maine introduced the End Prescription Drug Ads Now Act, which seeks to ban pharmaceutical companies from engaging in DTC advertising across television, radio, print, digital platforms and social media entirely.

Related: US Senators Propose Bill to Include Prices in Prescription Drug Ads

Targeting pharmaceutical advertising has long been part of RFK Jr.’s platform. During his unsuccessful 2024 presidential bid, he made it a campaign issue. Just two days before the election, he posted a video from a Trump rally and wrote on Instagram and X, “Let’s get President Trump back in the White House and me to DC so we can ban pharmaceutical advertising.”

The potential changes could disrupt the estimated $10 billion annual DTC pharma ad market, which heavily relies on television, digital platforms and other consumer-facing media channels.

According to analysis by MediaRadar, pharma and healthcare ad spending increased 7% over 2023. Wiping the marketing clean of DTC advertising would create an unprecedented upset for the industry.

In the US, DTC pharmaceutical advertising has long been a defining — and controversial — feature of the country’s healthcare landscape.

The US remains one of only two countries, alongside New Zealand, that allow DTC advertising of prescription drugs. This unique legal environment has helped create a lucrative and influential advertising ecosystem involving not just pharmaceutical companies, but also advertising agencies, broadcasters and digital media platforms.

For decades, pharmaceutical companies have leveraged this legal leeway to drive brand recognition, patient engagement, and, ultimately, demand. In 2023 alone, DTC pharma ad spending in the US exceeded $8 billion.

Television ad spending also surged in early 2025, rising 30% in the first quarter compared to the same period last year. Major contributors to that growth included Johnson & Johnson (Tremfya), Novartis (Pluvicto) and Lundbeck and Otsuka (Rexulti).

The US Government Accountability Office reported in 2021 that nearly all DTC advertising spending in the US was directed toward brand-name drugs, with roughly two-thirds of that spending concentrated on just 39 products.

Efforts to implement sweeping bans on DTC drug advertising date back to the 1970s but have repeatedly been blocked by legal challenges, as US courts have upheld such advertising as protected speech under the First Amendment.

More incremental regulatory changes, however, have proven more feasible. For instance, last year the FDA updated its rules for TV and radio ads, requiring that the “major statement” outlining a drug’s side effects be delivered in a manner that is “clear, conspicuous and neutral.”

Related: Top 10 New Prescription Drug TV Commercials in 2024

Momentum has been building against DTC advertising from multiple fronts, and lawmakers and government officials aren’t focused solely on banning DTC ads. In February, US Senators Dick Durbin and Chuck Grassley introduced the Drug-price Transparency for Consumers (DTC) Act of 2025 to disclose pricing in prescription drug advertising.

In April, another bill was introduced targeting the tax benefits drugmakers receive from advertising. Called the No Handouts for Drug Advertisements Act, the legislation seeks to eliminate tax deductions for expenses related to DTC advertising of both prescription and compounded medications.

Meanwhile, the American Medical Association (AMA) has repeatedly called for a ban on DTC advertising, citing its role in driving up healthcare costs and encouraging patients to seek unnecessary treatments.

There is a strong return on investment for DTC drug advertising, with some estimates ranging from 100% to as high as 500%, depending on the product. According to Intron, pharmaceutical companies would experience a decline in drug sales if a DTC ban were enacted, despite potential savings on marketing costs.

Companies like AbbVie, which heavily promotes Skyrizi and Rinvoq, would be among the most impacted, according to Intro. AbbVie was among the top advertisers in 2024, spending $2 billion on DTC ads mostly for its blockbuster anti-inflammatories. The two drugs generated $5 billion in revenue in the first quarter of 2025.

Eli Lilly and Novo Nordisk have also been spending heavily on their GLP-1 diabetes and obesity treatments.

While the FDA currently oversees DTC drug advertising to ensure it is not false or misleading, critics argue that enforcement is too lenient and reactive. In recent years, the agency has begun exploring ways to strengthen oversight, especially as advertising expands into newer digital formats like TikTok and YouTube.

While a complete ban appears unlikely, RFK Jr.’s approach could force pharmaceutical companies to rethink their marketing strategies. This may result in a shift toward disease-awareness campaigns, healthcare provider-focused outreach and more discreet digital engagement tactics, such as partnerships with influencers and targeted content for specific patient populations.

Moreover, major pharmaceutical companies are increasingly turning to DTC platforms to boost sales. In 2024, Pfizer launched PfizerForAll, a platform offering treatments for common conditions such as migraines, COVID-19 and the flu.

Around the same time, Eli Lilly introduced LillyDirect, giving patients access to medications for diabetes, migraines and obesity. For Lilly, the platform provides a strategic channel to sell its GLP-1 drugs, Mounjaro and Zepbound, in lower-cost vial formats through telehealth, targeting patients who pay out of pocket.

Novo Nordisk followed suit in early 2025 with its own DTC platform, NovoCare, offering similar access to its GLP-1 therapies in more affordable vial presentations. The company also partnered with telehealth provider Hims & Hers this year to offer its GLP-1 weight loss treatment Wegovy at a discounted price.