BUSI 528 Week 6 Case Study Example

Should a State Ban Prescription Drug Commercials? A Case Study on Advertising, Free Speech and What Patients Actually Learn From Television

The Case

A state senator has introduced a bill to ban television and streaming advertisements for prescription drugs within the state, arguing that the ads drive up costs and push patients toward expensive medicines they may not need. The state hospital association must decide whether to support, oppose or seek changes to the bill. Berkowitz (2017) explains that advertising in health care can inform, persuade or remind, and that promotional choices carry ethical weight because patients often cannot judge the quality of what is being sold.

What Is the Case for a Ban?

Drug advertising has grown dramatically. Schwartz and Woloshin (2019) reviewed U.S. medical marketing from 1997 to 2016 and found that direct-to-consumer prescription drug advertising rose from $1.3 billion to $6 billion, from 79,000 ads to 4.6 million, including 663,000 television commercials, with a shift toward high-cost biologics and cancer immunotherapies. The content of the ads raises concern. Frosch et al. (2007) analyzed drug commercials aired in evening news and prime time and found that 82% made some factual claim, but few described causes (26%), risk factors (26%) or how common the condition was (25%). Emotional appeals appeared in 95% of ads, and no ad mentioned lifestyle change as an alternative to the medication. Advertising of this kind persuades more than it informs.

What Is the Case Against?

Courts treat truthful commercial speech as protected under the First Amendment, so a state ban would likely be challenged and could be struck down. Supporters of advertising also argue that ads prompt some patients to see a clinician about symptoms they had ignored, such as depression or diabetes, and that patients have a right to information about treatments. A ban might also reach beyond drugs, since hospitals, clinics and addiction treatment programs advertise as well. There is a practical problem too: national networks and streaming services do not stop at state lines, so a single state would struggle to enforce a ban on ads that viewers see on national broadcasts or online, and manufacturers might simply shift spending to social media and influencer marketing, which is harder to monitor than a television spot.

Who Else Would Be Affected?

Schwartz and Woloshin (2019) found that health services advertising, much of it by hospitals and cancer centers, grew from $542 million to $2.9 billion over the same period. Hospital association members are advertisers too, so a precedent for banning health care advertising could eventually reach them. Patients would also be affected, both by losing whatever useful information ads provide and by possibly paying less for drugs if marketing costs fell.

What Should Be Done?

The association should oppose an outright ban and support a disclosure bill instead: ads must state the drug's list price, describe its benefit in plain numbers and mention nondrug alternatives where they exist. These rules address the evidence on content without silencing speech. The association should also offer to work with the state medical board on guidance for clinicians, since a patient who asks for an advertised drug deserves a conversation about whether it fits, not an automatic prescription or a dismissive refusal. Finally, the association should commit its own members to the same disclosure standard for hospital advertising, which would give its position credibility with legislators who see hospitals as advertisers too.

Biblical Integration

Paul urged the Philippians to think on whatever is true, honorable, just, pure, lovely and commendable (English Standard Version Bible, 2001/2016, Philippians 4:8). An advertisement that moves a viewer with images while leaving out what the medicine costs and how much it helps falls short of what is true. Hospitals should apply the same standard to their own ads.

Conclusion

A disclosure law answers the problem the evidence identifies, misleading persuasion, while preserving patients' access to information and avoiding a likely constitutional defeat.

References

Berkowitz, E. N. (2017). Essentials of health care marketing (4th ed.). Jones & Bartlett Learning.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Frosch, D. L., Krueger, P. M., Hornik, R. C., Cronholm, P. F., & Barg, F. K. (2007). Creating demand for prescription drugs: A content analysis of television direct-to-consumer advertising. Annals of Family Medicine, 5(1), 6-13. https://doi.org/10.1370/afm.611

Schwartz, L. M., & Woloshin, S. (2019). Medical marketing in the United States, 1997-2016. JAMA, 321(1), 80-96. https://doi.org/10.1001/jama.2018.19320