The healthcare industry continues to feed its addiction to obscene profits instead of better, more affordable patient care. While Americans are bombarded with relentless direct-to-consumer advertising (DTCA) pushing dubious drugs to an unwary public, health plan sponsors can provide a much-needed antidote.
According to research published by JAMA Network, DTCA increased by nearly 500% between 1997 and 2016, and reached an astronomical $22.3 billion in 2021. Roughly two-thirds was spent on television commercials. What’s worse is that these commercials promoted using higher-cost, lower-benefit drugs over generics and less expensive, equally or more clinically effective alternatives.
JAMA assessed the therapeutic value of the drugs most heavily advertised between 2015 and 2021. Shockingly, drugs categorized as low therapeutic benefit accounted for 71.3% ($15.9B) of TV advertising. The research noted that, “The findings of this study are consistent with prior research that questioned the therapeutic value of drugs heavily promoted to clinicians.”
This can only result in poor outcomes and wasted money for both plan sponsors and covered members.
What’s an Employer to Do?
Policy makers and regulators won’t be taking action on a grand scale anytime soon. Nor is the industry likely to restrict D2C drug advertising despite calls from public health advocates and the American Medical Association to do so. But health plan sponsors can take important steps today to counter misleading advertising and slow the profit frenzy.
Employers can offer a conflict-free health plan with an evidence-based pharmacy plan that uses comparative effectiveness research to determine which drugs are included on the formulary—not advertising or a PBM profit-pumping agenda. This ensures access to high-value drugs that deliver better health results and reduce out-of-pocket costs for the plan and members.
It’s time for employers to modernize their approach to health benefits and stop enabling the corrupt industry practices that prioritize profits over people.