Commercialization, marketing and social media

A ban on pharma’s TV ads may finally be on the way.

Sens. Bernie Sanders, I-Vt., and Angus King, I-Maine, recently introduced the End Prescription Drug Ads Now Act that would end pharma’s ability to advertise directly to consumers. 

If enacted, the bill would fulfill a goal of HHS Secretary Robert F. Kennedy Jr., who targeted TV advertisements when he was running for president and maintained that position after joining the Trump administration. But Sanders and King’s bill goes even further than banning TV ads — it prohibits “prescription drug advertising on television, radio, print, digital platforms and social media,” according to a press release.

The U.S. is one of only two countries that allows DTC pharma advertising (New Zealand is the other). And it’s not just Trump administration officials and a handful of lawmakers who want to do away with pharma ads. Nearly 60% of Americans support banning TV pharma ads, according to an Axios-Ipsos poll from late 2024.

Overall, the industry spent over $10 billion on DTC advertising last year, Bloomberg reported, while pharma and healthcare ad spending jumped 7% over 2023, according to analysis by MediaRadar. Wiping the marketing clean of DTC advertising would create an unprecedented upset for the industry.

Bill details

The bill, in simplest terms, would no longer allow pharma companies to promote their drugs across traditional and digital media, including the ads currently on the market. 

In a press release, Sanders expressed concern for misleading information about drugs in advertisements, stating that “studies” have shown about half of drug ads have false or misleading information.

In particular, Sanders called out Eli Lilly for spending $205 million on advertising in 2010 for its antidepressant drug Cymbalta, which brought in $3.2 billion in sales that year, despite the FDA finding the ads “made unsupported and misleading claims of effectiveness and minimized its safety risks.” 

The bill will likely face legal challenges from the pharma industry. But a ban enacted through legislation is more likely to hold up in court than a policy change by the FDA. An attempt by the agency to prohibit pharma ads was shot down by a court in 2012, for example, on the grounds that they’re protected by First Amendment rights, Politico reported.

It’s not just an outright ban that has lawmakers’ attention. Another bill introduced in April aims to crack down on pharma companies writing off DTC advertising as normal business expenses. Dubbed the No Handouts for Drug Advertisements Act, the bill would end tax deductions for expenses related to DTC ads for prescription and compounded drugs.

Biggest spenders

DTC ads are almost exclusively leveraged for brand name drugs, with two-thirds of that spending concentrated on just 39 drugs between 2016 and 2018, according to a Government Accountability Office report. 

Some of the biggest spenders are shelling out millions to get their brands in front of American audiences. Collectively, pharma spent more than $5 billion on just TV ads last year. One of the top pharma advertisers from 2024 was AbbVie, which spent $2 billion on DTC ads in 2024, mostly for its anti-inflammatory biologics Skyrizi and Rinvoq, according to Bloomberg. Together, the drugs brought in more than $5 billion in revenue during the first three months of 2025.

The proposed ban also comes as some Big Pharma companies are aiming to expand their sales through DTC platforms. Last year, Pfizer launched PfizerForAll, which is focused on drugs for common ailments like migraine, COVID-19 and flu, and Eli Lilly opened its doors to patients seeking treatments for diabetes, migraine and obesity through LillyDirect.

For Lilly, the DTC outlet allows the obesity leader to sell its GLP-1 medications, Mounjaro and Zepbound, in cheaper vial doses via telehealth for patients paying out of pocket. Novo Nordisk also jumped into the DTC game earlier this year with a similar platform, NovoCare, with access to its GLP-1 medications, also in less expensive vial doses.

In fact, GLP-1s have lifted the industry’s overall marketing spend, which is “skyrocketing among drugmakers and healthcare companies,” for obesity and diabetes ads, eMarketer found. Novo spent $263 million on DTC ads for Wegovy and $208 million for Ozempic in 2023, according to Sanders.

Companies offering compounded GLP-1s also spent millions on marketing the drugs before they were banned by the FDA this spring, including Hims & Hers, which shelled out for a Super Bowl ad spot in February.

It’s unclear if the bill has enough support to get passed, but four other Democratic senators have joined as co-sponsors, Sanders said.

Nikolaus Friedreich is “definitely dead.” And he has been since 1882.

At least, that’s what his gravestone says at the beginning of “Friedreich’s Back,” a marketing campaign for the drug Skyclarys, Biogen’s treatment for the ultra-rare genetic condition, Friedreich ataxia.

But when Friedreich’s corpse reaches a hand up out of the ground, zombie-movie style, the ad takes a turn. He sits up — wearing his burial finest, covered in dirt, with a pale, post-death pallor — and looks around the quiet graveyard. He’s not only shocked to discover that he’s dead, but is amazed that a disease has been named after him: Friedreich ataxia, which he discovered.

“Oh my God!” he cries in a German accent, still-waist deep in his grave. “They named a disease after me! Oh, no!”

What comes next is a darkly funny, nine-episode web series that follows Friedreich as he becomes Biogen’s newest intern, working with a Skyclarys scientist and struggling to navigate the modern world.

On the surface, this approach to drug marketing t sounds like a risk. Maybe even absurd. FA is an ultra-rare disease, affecting about 5,000 people in the U.S. and 15,000 people worldwide, and it’s terminal. The progressive disease damages the nervous system and impacts muscle control, triggering an average lifespan of just 37 years old. There’s really nothing funny about it.

But the campaign’s numbers tell a different story. All told, “Friedreich’s Back” racked up more than 2 million social views within its first three weeks of dropping, according to 21GRAMS, the ad agency behind the “Friedreich’s Back” campaign. After just three months, the videos hit 10 million views on Meta and TikTok, which is roughly 600 times the size of the entire patient population. It also drove more than 5,000 conversions to the Skyclarys website during that time, which is astonishing considering the total U.S. patient population is just 5,000. And the campaign took home the Gold Lion award at the Cannes Lion Festival of Creativity in France.

The campaign’s success and resonance is a testament to the industry’s oft-discussed ethos of incorporating patient voices and experiences into pharma strategies. It also showcases the power of laughter even — and maybe especially — in the face of tragedy.

The spark for the campaign came from Fiona Cauley, a standup comedian and FA patient whose act often centers around her experience with the disease.

“The critical insight came when I heard [Cauley] say, ‘I laugh because I've cried enough,’” said Sundip Raval, vice president and head of marketing of rare disease for Biogen. “That was, for me, the moment the penny dropped … We started asking each other, ‘Could we use humor and laughter as a way to bring a community together and discuss the toughest of topics?’”

In talking with patients, the company further discovered that many appreciated and used dark humor to cope with and make light of living with a progressive and deadly neurodegenerative disease.

“The more people we spoke to in the community, it started to become more clear they wanted to laugh. And this was a way of connecting,” Raval said.

Suddenly the “risk” of using humor in a campaign for a drug that treats a terminal disease didn’t seem too risky anymore.

“We knew what they liked, we knew what they wanted, and we knew what kind of content that they loved,” Raval said.

Laughter as a KPI

There’s data to back up the power of humor in advertising. 21GRAMS released a white paper arguing that humor is not only underused in pharma advertising but that laughter can actually be a KPI. Research showed that the overwhelming consumer response to pharma ads is either “neutrality” or “sadness,” which doesn’t elicit either connection or action. Humor, on the other hand, forges connection, captures attention, drives action and is more memorable.

Despite these insights, there’s not a lot of humor in pharma advertising, said Christopher Charles, executive creative director at 21GRAMS.

“And when there is, we're going to be honest, it's not the greatest,” Charles said. “They're really missing the mark because they think they're funny. And that's the worst — when you think you're funny and you're not.”

Charles and Cauley, along with Bill Nye the Science Guy, took to the main stage at Cannes last week to talk about the campaign and the power of using humor in pharma advertising, making Biogen the only pharma campaign presented on the main stage.

In addition to being funny, campaigns like Biogen’s need to be based on a deep connection with the patient community.

“We have done deep ethnographic research where we get to sit side by side with these people for an extended period of time. So we understand what their daily lives are like and what motivates them, what inspires them, what brings them hope and joy, as a way to connect,” Raval said.

Biogen also worked closely with Friedreich’s Ataxia Research Alliance to ensure that the spot hit the right note.

“They too, saw this as a hopeful and inspiring way to bring light to a difficult situation,” Raval said.

Moving ahead in rare disease

Biogen acquired Reata Pharmaceuticals in September 2023, along with Skyclarys, shortly after the drug became the first and only FDA-approved FA treatment for adults and adolescents aged 16 years and older.

Now, it’s part of Biogen’s rare disease portfolio, which also includes programs and commercial assets in ultra-rare forms of ALS and spinal muscular atrophy, Raval said. The company initiated a phase 3 pediatric study of Skyclarys last week for the treatment of FA in kids aged 2-15.

Raval said Biogen is “very happy” with the campaign’s impact and ROI. Although it was a different kind of campaign targeted at a small patient population, “the investment in this campaign wasn't something that was atypical,” he said. “It's sort of in line with the investments we would make.”

The campaign, its success and the presentation at Cannes was a win for Biogen, which suffered a setback when it was forced to scrap its controversial but once-promising Alzheimer’s drug Aduhelm. And while future campaigns like this will ultimately be driven by patients, Raval said he can see similar efforts being made by Biogen down the road.

“It really comes down to [the question]: If the community is asking for content like this, is the community fundamentally looking for this?,” he said. “The saying, ‘laughter is the best medicine,’ exists for a reason. So I think there's a high likelihood you'll see more of this.”

Sponsored content

By Quest Diagnostics

Online retailers aren’t the only businesses that must worry about last-mile delivery. Pharmaceutical companies need to get their therapies into the hands of the right patients, which means connecting with the physicians who treat them. The sooner that happens, the sooner patients can benefit from innovative and alternative treatments.

Medical education and published research are important tools, of course. However, they rely on a resource most doctors have too little of: time. A more targeted, efficient approach can help pharma companies optimize their sales and marketing strategies by identifying and connecting with the right prescribing physicians.

“Most physicians say they want to learn about new treatments and procedures; they simply don’t have time to learn when novel or alternative therapies reach the market,” says Parag More, executive director, healthcare analytics solutions (clinical trials) at Quest Diagnostics. “A recent Doximity report found that more than two-thirds of physicians feel overwhelmed by how much information they need to keep up with.”

Quest Diagnostics, which handles 2.5 million lab orders per day, leverages its extensive data to help pharma companies pinpoint the right physicians and to raise awareness of new therapies. The service leverages timely lab data to engage treating physicians when it matters the most. 

How Quest Helps to Identify Physicians

Quest combines its near real-time lab data with optional Electronic Health Record (EHR), claims, and prescription data. That lets it more precisely identify who is suitable for a therapy or a drug based on eligibility requirements. Key data points include:

• Quest lab data, including test results, diagnoses, and demographics.
• EHR data, including biometrics, comorbidities, and treatment response.
• Claims data, including diagnoses, procedures, and healthcare use.
• Prescription (Rx) data, including prescription details and current and past medications.

By analyzing all this data, Quest can pinpoint physicians currently treating patients who meet eligibility requirements for a new therapy. Pharma companies can then receive daily, weekly, or monthly alerts of the National Provider Identifiers (NPIs) of physicians treating their target patient profile.

“Lab data is typically available within 5 to 10 days — much faster than the 30 to 90 days that claims and EHR data can take to post,” More says. “Our in-house lab data enables faster physician engagement, ensuring outreach efforts align with critical decision-making moments in patient care.”

Narrowing the Search

Another key advantage of lab data is that it allows for more granular searching, such as for patients with specific genes. With breast cancer, for example, lab data can identify more than 40 specific genes, including BRCA 1 and BRCA 2, facilitating more precise searches.

Quest’s ability to dive deep into data may be especially valuable to pharma companies commercializing treatments for rare diseases.

Nearly 30 million people in the U.S. and more than 300 million globally are affected by rare diseases. The limited patient population makes it difficult for pharma companies to pinpoint eligible patients and their treating physicians.

Moreover, the treatment window is often narrow, which means patients must be identified and treated quickly to maximize chances of success. Since EHR and claims data can be delayed by months, that data alone isn’t sufficient.

“Lab data is often the first information a physician and patient get in diagnosing a rare disease, and it’s available within days after a test is completed,” More says. “Quest enables sales teams to quickly connect with physicians who are treating the right patients right now.”

A Rare-Disease Case Study

Recently, a leading pharma company developed a therapy for a blood disorder that affects just 4 out of 100,000 people each year. The disorder can be managed if treated quickly, but diagnosis requires a combination of clinical suspicion, lab findings, and sometimes confirmatory testing.

“To market the therapy, the company was basically trying to find some very small needles in a very large haystack — and time was of the essence,” More says.

Working with the company, Quest developed two search parameters: 1) test orders related to diagnosis of the disorder and 2) test results that fell within values the company had determined were relevant. During a 12-month period, Quest identified and provided NPI information on more than 35,000 physicians who had ordered the relevant tests and on more than 650 physicians who had a patient with a concerning test result.

“We’re proud to help fuel success stories like that,” More says. “Data really does make a difference.”

Learn more about how Quest Diagnostics can help identify the physicians treating patients who are eligible for a drug or therapy.

Disclaimer: The use of genetic data varies on a case-by-case basis and is subject to state-level regulations

The “ice bucket challenge” is back. 

After debuting more than 10 years ago, the viral internet trend that inspired millions of people to douse friends and family with ice water and bring awareness about ALS returned recently, this time with a focus on mental health.

The initial movement brought in donations of more than $115 million for ALS research in the summer of 2014 while underscoring the power of social media and R&D fundraising opportunities for the pharma industry. The ice bucket challenge didn’t promote development for any specific drug, but it highlighted how social media can be leveraged and create conversations through unconventional or unbranded marketing tactics. 

Social media could become an even more important marketing source if direct-to-consumer rules shift under HHS Secretary Robert F. Kennedy, who has called for a ban on pharma TV ads. 

Pharma is big business for TV and streaming services, with the top 10 industry spenders collectively plunking down roughly $3 billion in advertising spots in 2023. Because HHS doesn’t have the authority to ban TV ads, Kennedy would need legislation from Congress to accomplish this goal, but the FDA’s recent marketing regulator resignations may help pave the way, Politico’s AgencyIQ reported in April.

TV ad spending has also ramped up, bringing the issue closer to the front line. The top 10 biggest pharma advertisers spent nearly 30% more on TV ads during the first quarter this year compared to the same period in 2024, according to iSpot.TV. 

In absence of TV ads, pharma companies may redirect their advertising dollars to social media, where more than half of Americans are finding their health information, according to a 2024 study. If the pharma industry pushes further onto social media platforms, it will have to contend with complex requirements and navigate different pitfalls and opportunities.

The regulatory landscape

Pharma doesn’t leverage social media platforms the same way other industries do because of the unique regulatory hurdles they face. For some companies, social media is still a relatively small target compared to traditional marketing outlets.

“A lot of pharma companies still look at social media as a bit of a Pandora's box,” said Ian Baer, founder of marketing intelligence agency Sooth. “While many regulations exist in many industries, there are few that box you in quite the way the FDA has in terms of marketing guidelines.”

Social media creates a two-way dialogue between the industry and patients, and if someone reports an adverse event, pharma companies are required to tell the FDA. Because of the resources needed for that additional reporting, not all pharma companies view social media investments as being worth the return. 

“In some cases, it's literally a matter of [whether] they have the customer service and legal resources … and marketing resources to deal with what could come out of any two-way conversation,” Baer said.

Those constraints can also make it more challenging to create content specifically for social media, where trend cycles happen quickly and often unpredictably.

“One of the challenges … in the pharma space is that they need to be smarter, because they can't rapidly turn around content without that kind of review and rigor,” said Stephanie Trunzo, CEO of Merge, a full-service marketing company that has worked with Big Pharma companies such as Roche. “So [it’s about] building up the right stable of content in advance, pre-reviewing certain kinds of content so that it's ready to use and release.” 

To streamline the content creation process, pharma companies sometimes use the same marketing across all platforms. Pfizer, for example, has run a similar commercial for Nurtec ODT featuring Lady Gaga talking about her struggles with migraines across TV, print and platforms such as TikTok. That model of using the same “bulletproof” TV ad for social media is a common marketing strategy, according to Baer, but it may miss opportunities to create deeper engagement.

“It's certainly an efficient strategy, but it is not leveraging each of those platforms for their strengths or their audiences,” Trunzo stated.

Boosting education

Many pharma companies are leveraging TikTok, Facebook, Instagram and other spaces for educational content and disease awareness without promoting a specific drug. These campaigns can engage patients while avoiding some of the reporting requirements that arise when drug names are mentioned. For instance, pharma companies must submit ads promoting a drug to the FDA, and include efficacy and risk information. But campaigns focused on disease awareness are exempt from the rule and can include a call to action that compels patients to speak with healthcare professionals, for example.

“The way that pharma companies are thinking about social media ... [is about] making a bigger change that the industry needs overall, which is education,” Trunzo said. “Where I see this working and succeeding is when the pharma companies are using these channels to influence the end users’ understanding of what could be extremely challenging and complex content, and turning it more into empowering information they can use to make decisions.”

Campaigns focused on disease awareness can also lean on social media influencers to speak about their own experience with a disease or using a drug, which also isn’t subject to FDA reporting requirements. Influencers are often successful marketers because they offer followers authenticity, which may be more convincing than a traditional advertisement. While most influencers aren’t “getting their hands dirty” by talking about drug efficacy, sharing their experience with a drug or health condition can have an impact.

“It requires extreme caution to get it right, but there are things that healthcare influencers can say and do in social media that drug manufacturers cannot,” Baer said. “You'll see alignments between pharma companies and especially smaller level influencers, where they're leaning on that influencer to say and do things that the drug company never could.”

But social media can also be a double-edged sword in healthcare when misinformation is involved, such as vaccine skepticism during the COVID-19 pandemic, which spread rapidly and became politicized online. 

“The reality for pharma companies is people trust social influencers more than they trust brands,” Baer said. “They don't trust social media platforms to tell them the truth. They don't trust brands to tell them the truth. And it's very challenging to navigate. That's why, when we speak to healthcare marketers, we encourage them to build bonds with the right influencers.”

While the pharma industry’s growth on social media has been slower than other industries, that could change as consumer behavior continues to swing in favor of influencer marketing. And as patients make health decisions based on online information, pharma companies have more opportunities to expand their reach. 

“It is still early days for DTC [marketing] for pharma … specifically in social channel usage,” Trunzo said. “The shift to [recognizing] that individuals make these decisions and giving them information is a route [pharma] should be taking, versus only making sure a consumer is getting education through their doctor. ”

Megablockbusters are on the rise in pharma. More drugs are surpassing the $10 billion sales threshold than ever before, according to a recent analysis by PharmCube, and 12 reached or maintained that status last year alone.

Once dominated by oncology and immunology drugs, the megablockbuster club has recently expanded to include super-selling cardiometabolic medications like GLP-1s. 

The exact road drugs take to hit the megablockbuster mark can vary. In the case of oncology drugs like Keytruda, which raked in nearly $30 billion in revenue last year, diversification has been key. The cancer drug won its 40th approval for an endometrial cancer indication a year ago, and now comprises about half of Merck & Co.’s overall revenue.

Other drugs hit the $10 billion mark by sticking to their niche, PharmCube noted. For example, Vertex Pharmaceutical’s cystic fibrosis medication Trikafta/Kaftrio is “irreplaceable” in the disease, according to PharmCube. The combo therapy topped $10 billion in revenue last year for the first time since its approval in 2019.

In general, the megablockbuster trend is skewing toward drugs that reach a wider range of patients, such as checkpoint inhibitors like Keytruda and GLP-1 weight loss and diabetes medications.

“The era of single-therapy dominance is fading, replaced by a dynamic battlefield where metabolism, immunology and cancer drugs vie for supremacy,” PharmCube found.

As the industry winds shift toward megablockbusters — and the reigning top sellers continue to outdo their own revenue records — the evolving market winners reveal how drugmakers can reach new heights.

GLP-1 market relevance

The two leaders of the weight loss market, Eli Lilly and Novo Nordisk, have created a new arena for megablockbusters in just a few years.

Sales of its GLP-1 suite of products skyrocketed Eli Lilly into becoming the most valuable pharma company in the world while the popularity and growing indications for Zepbound have buoyed investor value.

“By [capitalizing] on the GLP-1 revolution, Lilly didn’t just elevate its market position — it transformed investor perceptions. Its market value doubled in two years, propelling it to the industry’s upper echelon,” PharmCube found.

Mounjaro reached nearly $12 billion in revenue last year, while Jardiance, Lilly’s diabetes medication co-owned with Boehringer Ingelheim, topped $10 billion for the year. Combined, Lilly’s Mounjaro, for diabetes, and Zepbound, for obesity, raked in $16.5 billion last year.

Novo Nordisk’s Ozempic was the second best-selling drug in 2024, with more than $17 billion in revenue and only outpaced by Keytruda. But combined, Novo’s suite of GLP-1 products — Ozempic, Wegovy and Rybelsus — reached $29 billion in revenue last year, “closing in on Keytruda,” according to PharmCube.

Both pharma giants are developing next-generation cardiometabolic drugs, as well, for a chance at treatments that work better, are more convenient or have fewer side effects. Novo and Lilly have already proven the evolution in GLP-1s can pay off. Novo’s first GLP-1 product, liraglutide, known as Victoza, hasn’t been as successful as semaglutide products Ozempic and Wegovy. And Lilly’s injectable diabetes GLP-1 dulaglutide, known as Trulicity, came years before its tirzepatide offerings that helped the company thrive in the obesity space.

“Each new generation outperforms its predecessor, extending the diabetes giants' legacies,” the analysis stated.

Oncology and immunology’s stronghold

The best-selling drug of 2024, Keytruda, has kept its dominant spot for years through diversification of indications, even as a patent cliff approaches and generic competition emerges. It’s a strategy that’s also being deployed by Bristol Myers Squibb for its immunotherapy Opdivo, which reached more than $10 billion in revenue last year. Since its launch 10 years ago, Opdivo has snagged more cancer indications, including a handful this year in combination with other drugs.

It’s a move that will help BMS keep one of its flagship therapies as a best-seller for years to come.

The other way drugmakers hold onto to their megablockbuster status is by finding the next contender in their pipeline.

“Product succession is an eternal theme in pharma innovation as the most direct answer to patent cliffs,” PharmCube said.

AbbVie’s Humira is the prime example, and the company’s top successor Skyrizi topped $11 billion in revenue last year. 

Not all pharmas have deployed these strategies as successfully. 

In 2024, Johnson & Johnson became the first pharma with two megablockbusters: its immunology drug Stelara and an oncology therapy Darzalex. But Stelara, which became a megablockbuster in 2023, will leave a revenue gap that J&J has yet to fill as biosimilar competition heats up. Darzalex is helping fill that void with nearly $12 billion in revenue in 2024, but the balance of the portfolios will remain a “tug-of-war” for J&J.

When Novartis announced it was teaming up with the NFL this year, the company called it the first-ever corporate pharmaceutical partnership with the league. But it wasn’t exactly the only matchup between the industry and the professional football world. 

The NFL has inked several deals with pharma companies, starting with a 2003 sponsorship agreement that co-promoted a Bayer and GSK drug that was under FDA review. 

Yet, instead of marketing one drug, Novartis said this new partnership is “unprecedented” and a “first-in-category” because it aims to tap into football fans’ passion for the game so they make a commitment toward their own health through existing NFL initiatives.

“Our approach goes beyond a focus on a single product or therapeutics to emphasize long-term, proactive behaviors that drive improved health outcomes,” said Gail Horwood, U.S. chief marketing and customer experience officer for innovative medicines at Novartis.

It’s also part of Novartis’ broader ongoing strategy to experiment with marketing at live events. And the NFL’s reach is enormous — up to 70,000 spectators attend games while more than 17 million watch each TV broadcast, according to Horwood.

“We’ve seen that sports events have a significant impact especially in terms of driving viewers to seek out more information,” Horwood said. “Knowing that public awareness is a critical component of managing personal health, partnering with the NFL allows us to amplify important health messaging, at scale, and strengthen our connection with patients — ultimately empowering fans everywhere to make proactive health decisions.”

Broadening marketing strategies

The partnership comes as the pharma industry braces for potential new advertising restrictions. HHS Secretary Robert F. Kennnedy Jr. has proposed banning TV drug advertisements , and while questions remain over whether he has the authority to implement such a measure, doing so would deeply impact how pharma markets its products in the U.S. Between January and October 2024, pharma companies spent over $5 billion on TV ads, according to Ad Week.

Kennedy has long blasted pharma TV ads, noting that the U.S. is one of only two countries — the other is New Zealand —  where it’s legal. 

Kennedy’s not alone in seeking advertising reform. Sen. Dick Durbin, D-Ill., wants to require pharma companies to disclose prescription drug prices in advertisements through the Drug-price Transparency for Consumers Act, which he sponsored. But so far, neither Kennedy nor federal regulators have made an official move to ban pharma commercials. 

With the airwaves still open, Novartis’ NFL deal exemplifies how pharma companies can diversify marketing plans. 

The NFL already has several ongoing campaigns that raise funds for cancer screenings, host educational events and enable players to show support for specific health causes by donating their cleats. Novartis said it will start the partnership by strengthening the NFL’s Crucial Catch initiative, focused on cancer awareness, detection and risk reduction.

“Collaborations like our partnership with the NFL offer us dynamic and impactful ways to engage with patients, leveraging existing initiatives driven by the league like Crucial Catch, the [Player] Health and Safety Summit and My Cause My Cleats,” Horwood said. “These channels provide an opportunity to reach a broad audience in an authentic way, allowing us to focus on education and health advocacy rather than relying solely on traditional advertising channels.”

Novartis will also have a presence at key NFL events, including the 2025 NFL Draft, Super Bowl and more. 

Pharma’s Super Bowl history

Pharma has only recently begun running ads during the Super Bowl, and the commercials haven’t always been a touchdown. Pharma ads from this year had mixed results among viewers and sparked some backlash — one from Pfizer was criticized over high healthcare costs in general,  and an ad by the wellness direct-to-patient platform Hims & Hers was panned over potentially misleading claims, Ad Week reported.

Astellas Pharma marketed its first-in-class menopause treatment Veozah at the Super Bowl in 2024 for the second consecutive year, likely shelling out millions for the TV spot. The ad for a drug that treats hot flashes underscored the changing dynamics of NFL viewership as more women now watch football.

Novartis aired its first-ever Super Bowl ad in February to promote breast cancer screening in what it called the “Your Attention, Please” campaign. The minute-long ad was set to upbeat music and depicted women in sports, fashion, art and everyday situations — but focused on their chests to make the statement that breasts get a lot of attention, but not always for health reasons. The unique ad saw strong engagement from viewers and directed them to a website with more information on cancer screenings and risk factors.

“The commercial and overarching campaign resonated strongly with viewers, receiving positive feedback and driving more than 1 million visits to the campaign website where patients could learn more about evaluating their breast cancer risk and screening options,” Horwood said. 

Novartis’ blockbuster breast cancer drug Kisqali, a kinase inhibitor, received an expanded approval for earlier lines of care last year. The drug was the fourth-best-selling product for Novartis in 2024, bringing in more than $3 billion in sales. 

Novartis plans to continue promoting early detection for cancer and other diseases through the new NFL partnership. And the company will continue to refine its “bold” approach in messaging that it set in the Super Bowl commercial going forward, Horwood said.

By teaming up with the biggest sports league in the U.S., Novartis is betting the audience will connect with the company in a meaningful way. 

“Sports cut across barriers — whether geographic, cultural or socioeconomic — which is critical for advancing better health outcomes,” Horwood said.

Imagine a game of “telephone,” in which a whispered phrase shifts as it works through a crowd.

Now, imagine that each person in the game is financially incentivized along the line to drastically change the phrase for their own benefit. That’s what drug pricing currently looks like, said Wayne Winegarden, director of the Pacific Research Institute’s Center for Medical Economics and Innovation — through a lack of transparency in the system, prices can become unpredictable and grow out of control.

Would full transparency from drugmakers, insurers, pharmacy benefit managers and hospitals make that system fairer and less likely to result in higher-than-expected costs? The answer is also complicated, Winegarden said.

“The problem is that there are so many different prices, and everyone’s negotiating different prices, and it undermines the whole purpose of pricing, which is to convey information about scarcity and value,” Winegarden said. “When you don’t have a mechanism to accurately incorporate that information in a price, your market is going to malfunction — and that’s what’s going on in healthcare.”

The issue of transparency is a major pillar of the Trump administration’s strategy to lower healthcare prices. The president signed an executive order this year calling on federal agencies like the Departments of the Treasury, Labor and Health and Human Services to “rapidly implement and enforce the Trump healthcare price transparency regulations, which were slow walked by the prior administration,” according to a White House fact sheet.

While the executive order is short on details, it signals an effort to enforce actions from the first Trump administration mandating public pricing disclosures from hospitals and insurers. 

Because of those previous policies, some pricing became less obfuscated in the process, but many pharmacies largely reported average sales price, which can be a misleading figure, said Chris O’Dell, senior vice president of market solutions at Turquoise Health, a platform that consolidates pricing information for employers and other healthcare consumers.

“In the simplest terms, for a patient, what that means is that today you can see all the prices in healthcare, whether that’s a drug administered by a doctor or if you’re picking up a prescription from a pharmacy,” O’Dell said, noting that while the average sales price requirements are still in place, they haven’t had the teeth necessary for full transparency. “What this executive order is saying is that we're going to enforce that pharmacy requirement.”

The complexity of the industry’s labyrinthine pricing structure will make complete transparency difficult to achieve, experts agree, but drugmakers in particular should celebrate a move toward better visibility, O’Dell said.

“The opaque system that we've gotten to is that the drug value chain is driven more by the rebate and discount you get than by the actual price of the drug,” O’Dell said. “Manufacturers should love price transparency, and for the most part they do.”

Changing care landscape

Amid the pricing transparency push, the drug landscape has shifted to more effective and specialized treatments like biologics and cell and gene therapies that come with a different financial calculus, Winegarden said.

“Drugs are changing dramatically,” Winegarden said. “With something like gene therapies, which offers a whole new set of opportunities, there’s also a whole new issue in terms of costs.”

But for patients and doctors, as well as insurers and employers choosing benefits, decision-making requires trustworthy information.

“The people who should be making the decisions are patients and doctors, but they really have no idea what those prices are or what they mean,” Winegarden said. “Markets need to settle on an equilibrium price that is both transparent and meaningful.”

Beyond an executive order, lawmakers have the chance to change how pharmacy benefit managers make pricing decisions public, Winegarden said. But although reform has bipartisan support, it has faltered in Congress.

“We all agree [PBM reform] should be done, but, you know, in this type of environment, it's hard to get some of these necessary reforms on the table,” Winegarden said. “We really don't have time for the silliness on The Hill — there are serious issues that need to be addressed, and we really need to get to the business of legislating.”

Short of further laws and regulations, some market solutions have emerged, like Turquoise’s pricing transparency platform, and a similar app from a company called Peek, that aggregates and consolidates drug pricing for patients and their employers.

“Historically, employers use the PBM and don't get involved with the manufacturer,” said Michael Navin, Peek’s CEO and founder. “We're trying to create that connectivity so there can be direct pricing, direct relationships.”

Navin has seen firsthand the kinds of hoops drugmakers jump through to hit the right price point, which is sometimes changed drastically by rebates and other fees.

“We were helping out a brand launch last year, and the CEO wanted to make $200 on this drug — so the price was $970, and that shouldn't happen,” Navin said. “The current state has led to so many pricing games, and so many pricing hurdles and strategies that it's gotten far afield.”

Drugmakers like UCB, which recently released a transparency and pricing report, support reform for PBMs as a means to better control what people pay for their drugs. Another battle pharmas are fighting is alleged hospital manipulation of the 340B program that requires manufacturers to sell drugs at a discounted rate to low-income hospitals and has become a haven for some of these pricing games, said Winegarden.

“You get into these industry pissing matches, and whether you win or not, nobody comes out smelling good,” Winegarden said.

Reversing the spiral

While platforms like Turquoise or Peek offer some transparency to drug pricing, the effort also needs to be untethered from the spiral that leads to more pieces of the pie being chipped away, Navin said.

“I started working on the payer side of pharma in 1999, and I saw all sorts of iterations happening, but the PBMs were fairly easy to deal with,” Navin said, pointing to more straightforward formularies and smaller rebates. “Now the rebates are 70%, 80%, 90%, and they won’t even look at drugs that are under $1,000 because they can’t make any money — and the manufacturer refuses to up their price to meet the demand of the PBM because they want to give a fair price to the patient, so there’s this dichotomy that leads to higher costs, limited access or both.”

The ultimate goal for platforms like Peek, Navin said, is to work directly with manufacturers and other sellers. For example, Peek works with Cost Plus Drugs, the startup launched by billionaire entrepreneur Mark Cuban, as one of its providers. Cost Plus Drugs then partners with “pass-through” PBMs, which passes all rebates, fees and discounts on to the plan sponsor.

“If you look at the 26 pass-through PBMs Cost Plus is partnered with, they make money from the services they provide and are very transparent in how they do so,” Cuban wrote to PharmaVoice in an email. “PBMs that offer these services are very valuable. They are the link between the pharmacy, manufacturers and sponsor — most importantly they are completely transparent on all business points.”

Most of all, while attempts at reform are not aimed at curbing profits for actual services provided, the goal is to consolidate that information so they’re available to the public in a way that isn’t overly complicated and opaque.

“Pricing gets very opaque because it means the more discounts and rebates you give, the more hungry everyone becomes who gets a piece of those,” O’Dell said. “And the opaque system that we've gotten to is that the drug value chain is driven more by the rebate and discount you get than by the actual price of the drug.”

As regulators and commercial payers tighten the screws on pharma’s profits, companies need to get the ball rolling early to position drugs for a competitive market. 

Convincing payers and doctors that breakthroughs and first-in-class therapies are worth the investment can be tricky, and many drugmakers are beginning to think about coverage and reimbursement strategy as early as phase 1, according to a recent report from Norstella.

“A thoughtful market access strategy early in the development process is key to launch success in this world of personalized medicine, especially for competitive launches, where there are many different classes of treatment available,” said Catherine Humphries, senior consultant in advisory services at MMIT, a Norstella company, in an email to PharmaVoice.

Many companies find that making a successful case requires newer tools such as real-world data and AI analyses because clinical performance alone might not always be enough.

“Increasingly, payers are asking manufacturers to provide evidence of a brand’s superiority beyond mere trial results,” Humphries said. 

Real-world patient data can highlight cost savings and improved outcomes, showing that patients who receive the drug need fewer emergency room visits or have better symptom control, for example.

A tough market

Pharma companies have lost some of their pricing power due to factors like Medicare’s newfound drug negotiation position, which the industry has been fighting in court. Pharmacy benefit managers have also been accused of jacking up drug prices, drawing fire from the Federal Trade Commission. 

In an increasingly competitive landscape, commercial payers can force drug discounts that leave drugmakers out in the cold, Humphries said. These add to existing financial stressors like rising R&D costs and shrinking patient pools as medicines become more targeted. 

“[Pharmas] face an evolving environment that requires more emphasis on efficiency of decision-making and cost savings at every step possible,” Humphries said.

To thrive in this environment, Humphries said pharmas need an “agile brand strategy response” to navigate the thicket of payers, group purchasing organizations, integrated delivery networks, oncology pathways and healthcare providers.

Evidence of a drug's value must be compelling enough to woo payers and doctors along with value analysis committees and health technology assessment organizations, which requires a more creative approach, Humphries said.

Companies can demonstrate additional value to insurers by becoming a critical resource and offering educational support for prescribers and patients. For example, the rise of biosimilars in U.S. markets demonstrates the importance of that support, Humphries said.

“In the inflammatory space, biosimilar manufacturers are providing patient support programs similar to those of the reference brands, which helps payer decision-makers feel more confident that their members’ service level will remain high if switched to a biosimilar,” Humphries said. 

Manufacturers in rare diseases and cancer subtypes are mining real-world data and lab test results to identify specialists who need education for challenging diagnoses. 

AI can also help companies quickly assess the competitive landscape to determine other ways to make their product appealing to doctors and patients. 

“Being able to launch a treatment for rare diseases that features convenient dosing, or that treats additional patient populations, can give your brand a real advantage at launch,” Humphries said.

The earlier companies start positioning a drug for a successful launch, the better.

“By the time a drug receives regulatory approval, a clear strategy should be in place to best meet the demand of payers, who will look for increasingly robust evidence that extends beyond clinical trials and into value for spend,” Humphries said. “A comprehensive strategy will include determining how to present payers, providers, value analysis committees and health technology assessment organizations with compelling evidence of the product’s value.”