Health-care industry: $30 billion per year spent on marketing

From an article in JAMA:

From 1997 through 2016, spending on medical marketing of drugs, disease awareness campaigns, health services, and laboratory testing increased from $17.7 to $29.9 billion. The most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9%) of total spending in 1997 to $9.6 billion (32.0%) of total spending in 2016. DTC prescription drug advertising increased from $1.3 billion (79 000 ads) to $6 billion (4.6 million ads [including 663 000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies...

Health care spending in the United States is the highest in the world, totaling $3.3 trillion—17.8% of the gross domestic product in 2016. To capture market share and to expand the potential market, drug manufacturers, companies that manufacture clinical and home-based laboratory tests, and health care organizations use an array of promotional activities to sell their products and services. These activities seek to shape public and clinician perceptions about the benefits and harms of health care, prescription drugs, laboratory tests, and specific diseases and their definitions. Medical marketing influences behaviors and choices that can have important health consequences and also may adversely influence efforts to control unsustainable health care spending...

In 1997, DTC advertising spending for laboratory testing was almost exclusively for pregnancy/fertility tests, HIV tests, and glucose monitors, whereas by 2016, 64% of DTC advertising spending was for genetic tests... The most familiar DTC genetic testing involves consumers purchasing kits for ancestry, paternity, traits (eg, unibrow), wellness (eg, sleep), carrier status (eg, cystic fibrosis), and disease risk prediction (eg, Alzheimer disease) from the company, Amazon, or retailers such as pharmacies and big box stores. Some testing is marketed as a fun activity (eg, spitting parties), a thoughtful gift (eg, Christmas and Valentine’s day), or as adventurous (LivingDNA—Start Your Ancestry Adventure Today).

State attorneys general, who regulate nonprofit organizations, have not initiated any action against deceptive consumer advertising for health services...

Drug company advertisements increasingly offer coupons, rebates, or discounts to defray out-of-pocket costs particularly for expensive drugs and drugs with generic competition. These strategies have been criticized for encouraging use of expensive drugs despite lower-cost options, undermining insurance design, diminishing competitive pressure to lower prices, and ultimately shifting higher costs back to payers...

Disease awareness campaigns have used several approaches to promote conditions: memorable destigmatizing acronyms (eg, ED for erectile dysfunction), quizzes to define the disease and allow self-diagnosis, and encouragement to “ask your doctor” (often including question scripts) about symptoms, disease, and treatment...

More recently, some advertisements for cancer centers have emphasized hope and fear without mentioning treatment harms or quantifying benefit; some advertisements have used survivor testimonials falsely implying patients live longer or have better outcomes when treated at those centers...

The most heavily promoted drugs to physicians are less likely first-line treatments recommended in national guidelines compared with the most-prescribed or top-selling drugs, facts generally not evident in medical journal advertisements...

LOTS more information at the article, available full-text without a paywall at this link.