The six-billion-dollar ask
Drug companies spent $6.0 billion advertising prescription drugs to American consumers in 2016, up from $1.3 billion in 1997.
We have not finished checking this source. No judgement either way. how we score evidence
Caveat on this rating: The mandatory rebuttal, printed beside the guidance annotation per the verified record: Rosenthal et al., NEJM 2002 (doi:10.1056/NEJMsa012075) - "the initial surge in direct-to-consumer advertising preceded the 1997 FDA guidelines... and thus the 1997 guidelines may not have been the most important reason" for the increase. The 1997 draft and 1999 final guidance are rendered as annotations ("the rules changed here"), never as the asserted cause of the spend curve - and DTC advertising was never illegal, so "legalized" appears nowhere in this row.
Both figures are in 2016 dollars. Over those twenty years the number of ads went from 79,000 a year to 4.6 million.
No federal agency tracks this spending, so both figures come from industry ad-trackers, analysed in JAMA.
Significant findings
Be careful which number you are holding. $29.9 billion is all medical marketing, most of it aimed at doctors rather than you. $9.6 billion is all consumer advertising, including disease-awareness campaigns.
Only $6.0 billion is prescription-drug ads to consumers. That is the figure this stop means.
Folklore says a 1997 FDA rule legalised these ads. It did not, and they were never illegal.
Spending had already tripled between 1996 and 2000. The surge came before the guidance, which "may not have been the most important reason" for it (Rosenthal, NEJM 2002).
Worth asking
When a drug-advertising figure reaches you, ask which of the three it is.
When the ad itself reaches you, ask what it cannot answer. What is the absolute benefit, what are the harms, and what are the alternatives? Those are prescriber questions, which is where the ad tells you to go anyway.
Source
Medical Marketing in the United States, 1997-2016 — Schwartz LM, Woloshin S (2019)
Read the source: https://doi.org/10.1001/jama.2018.19320
DOI: 10.1001/jama.2018.19320
How this was scored
- Study design
- not recorded
- Funding
- not recorded
- Published in
- not recorded
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
We have not finished checking this source, so there is no scoring to show yet. “We have not checked this yet” and “this is disputed” are different statements, so no scored band is shown rather than a low one.
Read the full scoring rubric, including what it can't tell you.
Published August 31, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "not yet assessed". We have not finished checking this source. No judgement either way. One caveat travels with that badge: The mandatory rebuttal, printed beside the guidance annotation per the verified record: Rosenthal et al., NEJM 2002 (doi:10.1056/NEJMsa012075) - "the initial surge in direct-to-consumer advertising preceded the 1997 FDA guidelines... and thus the 1997 guidelines may not have been the most important reason" for the increase. The 1997 draft and 1999 final guidance are rendered as annotations ("the rules changed here"), never as the asserted cause of the spend curve - and DTC advertising was never illegal, so "legalized" appears nowhere in this row. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Medical Marketing in the United States, 1997-2016 — Schwartz LM, Woloshin S (2019). DOI: 10.1001/jama.2018.19320. The full source is linked on this page so you can read it yourself.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.