Pharma ads on social media are less regulated than you think

We’ve all seen those prescription drug TV ads that end by listing every possible side effect and risk. Those disclaimers at least made most of us aware that prescription drugs aren’t perfect cure-alls that come without risks. But advertising has changed. Today’s pharma ads are increasingly happening on TikTok, targeting younger consumers with posts that look more like regular content than paid promotions. 

What was once a controlled advertising space run by a few major cable networks has become a sprawling network of millions of social media promoters who don’t have to follow the same rules as traditional ads. As social media becomes more decentralized, advertising has followed suit – but FDA oversight is lagging behind.

The FDA doesn’t regulate social media influencers promoting pharma

The FDA is tasked with ensuring that prescription drug advertisements are accurate and that both benefits and risks are disclosed. However, the FDA’s authority is limited when it comes to content from social media influencers and telehealth companies. Its authority is restricted to regulating what drug manufacturers say in their ads. If there is no established financial relationship between an influencer or a telehealth firm and a drug manufacturer, then the FDA’s rules do not clearly apply. 

This means social media influencers aren’t required to disclose if they’re being paid for content, aren’t required to include side effects and risks, and may promote drugs for off-label uses not approved by the FDA.

This issue affects young consumers more than anyone. Nearly 90% of teens and young adults on social media use it to seek out health information, making platforms like TikTok powerful hotspots for potentially dangerous and misleading content. Right now, the only ones with the power to remove an ad with misleading content are the social media companies that make money off the fact those ads are running on their platforms. We can’t leave regulation of these ads to the social media companies.

Pharma advertising is a problem

Americans see more ads for drugs than almost anyone in the world. The pharmaceutical industry spends more than $1 billion every month on marketing in the U.S. alone. In fact, the U.S. is one of only 2 nations globally where direct-to-consumer marketing for prescription drugs is even allowed (The other is New Zealand).

Influencers are promoting drugs like Ozempic — a Type 2 diabetes medication — for unapproved uses, such as weight loss for patients who don’t meet approved criteria, while skipping over critical details like potential side effects. Those seeking a “quick fix” without any medical necessity could face serious long-term health consequences, while patients with legitimate conditions may receive substandard care — or may not receive the drugs they need due to shortages driven by off-label promotion.

Medical decisions are a big deal, and consumers deserve accurate and complete information. In ads, drugs are presented as an easy route to feeling better — glossing over the cost and the risks of overmedication. Lifestyle changes may increase our overall well-being more than taking a new drug, but ads won’t tell you that.

How algorithms can make the problem worse

It’s easier to trust influencers because of their relatability — they seem more like real people than salespeople. Young people scrolling through TikTok may think they’re getting genuine advice from influencers, when in reality, they’re being exposed to hidden ads that promote drugs which may not work as advertised. These hidden promotions blur the lines between personal experience and paid endorsement. Traditional advertising rules are ill-equipped to handle this false authenticity.

Since platforms like TikTok tailor content to every user’s individual preferences, every user scrolls through a unique feed, making it difficult for the FDA to identify problematic drug promotions across the platform, let alone regulate them. The sheer number of social media creators far outpaces the number of TV and radio stations the FDA has to monitor. In order to do this, the FDA needs more resources. 

Since platforms prioritize engagement over accuracy, the risks of commodifying drugs become even more dangerous. What algorithms amplify is not necessarily true, nor helpful, nor safe. The only objective is keeping users engaged. This is precisely why regulation is imperative. Human health is not the algorithm’s concern — so it’s up to us to step in.

Protecting Patients from Deceptive Drug Ads Online Act

The Protecting Patients from Deceptive Drug Ads Online Act, a new bipartisan bill sponsored by senators Richard Durbin (D-Illinois) and Mike Braun (R-Indiana), aims to extend the FDA’s regulatory and enforcement power to cover online drug promotions. If passed, this legislation would:

• Allow the FDA to send warning letters and fine influencers and telehealth companies for online paid promotions that omit facts regarding prescription drugs, contain false statements, or fail to disclose risks and side effects.
• Require drug manufacturers and telehealth companies to report payments made to influencers to the Open Payments Database, just as healthcare providers are already required to report payments they receive. 
• Direct the FDA to monitor the rapidly-changing social media landscape, including viral trends, personalized algorithms and comment sections.
• Establish a task force in coordination with the Financial Trade Commission (FTC) to monitor prescription drug advertisements.

As how we access information continues to evolve, so too must the regulations that protect us. It’s time for the FDA to step up and ensure that when it comes to our health, transparency and truth still prevail — no matter the platform.