The New Reality of Direct-to-Consumer Drug Marketing

ProCare Rx Team • December 2, 2025

The New Reality of Direct-to-Consumer Drug Marketing

Direct-to-consumer (DTC) drug advertising has grown fast, and it is changing how employees think about their medications. In the U.S., the top 10 pharmaceutical companies spent an estimated $13.8 billion on advertising and promotions in 2023 alone, with much of it targeting consumers directly.

For benefits leaders, this trend matters. It affects pharmacy spend, member expectations, and the way new drugs enter the market.

What’s Driving the Surge

Three forces are fueling this shift:

1. Digital reach.
People spend more time online and on social media than ever. This makes it easier for drug makers to reach individuals directly.

2. Consumer trust in online health information.
Studies show that many adults turn to the internet or social feeds for health info before talking with a doctor.

3. Higher awareness of new therapies.
While awareness can be positive, the rise in DTC ads often promotes high-cost brand-name drugs, even when lower-cost or equally effective options exist. For example, a study found that since 1996 annual DTC advertising budgets in the U.S. grew from about $1.3 billion to around $6 billion by 2016.

Why It Matters to Employers

Growing DTC marketing leads to:

Higher pharmacy costs, as demand increases for branded drugs.
Pressure to expand formularies to include drugs that members ask for—even when they may not be preferred.
Confusion and misinformation, because members may believe something is the “best” choice based on an ad, not clinical evidence.
Equity gaps, since DTC ads and digital access tend to favor people who are tech-savvy and higher income.

How PBMs Help Counter the Trend

Pharmacy benefit managers now play a bigger role in balancing value, access, and member expectations. They use:

Data and analytics to detect when DTC marketing is driving unusual prescribing trends.
Evidence-based formularies that protect against unnecessary cost.
Member education and counseling that explains therapeutic alternatives and cost implications.
Clinical review tools like prior authorization and step-therapy to ensure medications are appropriate before heavy cost is incurred.

These strategies help keep decisions grounded in clinical value instead of marketing influence.

What Benefits Leaders Can Do

Here are three practical next steps:

Partner with a PBM that actively monitors DTC trends and supports member education.
Ensure communication materials help members understand generics and lower-cost options, not just the brand-name drugs they hear about on TV.
Focus on value, outcomes, and equitable access, not just formulary expansion or rebate chasing.

DTC marketing isn’t going away. By staying informed and proactive, benefits leaders can help members make choices based on what truly supports their health and the organization’s financial goals.

Sources

America’s Health Insurance Plans (AHIP) , New Reports Spotlight Drugmakers’ DTC Ad “Spending Spree” https://www.ahip.org/news/articles/new-reports-spotlight-drugmakers-dtc-ad-spending-spree

Johns Hopkins Bloomberg School of Public Health, Spending on Consumer Advertising for Top-Selling Prescription Drugs in U.S. Favors Those With Low Added Benefit
https://publichealth.jhu.edu/2023/spending-on-consumer-advertising-for-top-selling-prescription-drugs-in-us-favors-those-with-low-added-benefit

Journal of General Internal Medicine, Dangers and Opportunities of Direct-to-Consumer Advertising https://pmc.ncbi.nlm.nih.gov/articles/PMC5910355

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About ProCare Rx
ProCare Rx is a privately held, independent pharmacy benefit manager (PBM) that has empowered healthcare and self-insured organizations since 1988. We provide fully integrated, in-house solutions—including claims adjudication, clinical program design, pharmacy network access, cost containment, and data analytics—all supported in the U.S. Our flexible, transparent model serves self-insured employers, third-party administrators (TPA), brokers, health plans, health systems, managed care organizations (MCO), unions, workers’ compensation programs, Medicare, Medicaid, hospices, and other PBMs. With a proprietary technology platform, commitment to ethical operations, and a focus on lowest net cost, ProCare Rx delivers long-term value, clinical performance, and trusted pharmacy benefit partnerships.

Media Contact:
Marc Cohen, VP, Marketing and Sales
marketing@ProCareRx.com

The Next Wave of PBM Reform: What It Means for Employers and Plan Sponsors

By ProCare Rx Team • November 4, 2025

The Next Wave of PBM Reform

PBM 101, Part 2: Choosing the Right PBM in a Time of Rising Costs and Changing Rules

By ProCare Rx Team • October 1, 2025

Drug costs continue to surge, regulatory winds are shifting, and employers are bracing for steeper expenses ahead. Now more than ever, your choice of PBM partner can be a major differentiator or a liability. Why This Moment Matters Cost growth expectations are steep. Employers are forecasting higher health care costs in 2026, with pharmacy spend as a central contributor. Some projections suggest pharmacy alone may rise by double digits next year, far outpacing general medical cost trends. Reform pressure is building. PBM practices are under increasing scrutiny. Policymakers, physician groups, and pharmacy organizations are pushing for reforms that would delink PBM profits from drug list prices, increase transparency, and ensure savings flow to plan sponsors and patients. PBMs themselves are already floating proposals to adjust their practices ahead of possible legislation. Regulation is becoming inconsistent and complex. While federal courts and Congress weigh in, states continue to pass new PBM laws. For multi-state employers, this means navigating a patchwork of rules that can be confusing, sometimes conflicting, and potentially at odds with fiduciary obligations. What to Look for in a PBM Partner Given this evolving landscape, employers should place extra emphasis on: Regulatory agility and compliance support Your PBM must help you navigate both federal and state-level requirements, protecting your plan against compliance risk. True cost transparency and incentive alignment Demand clarity on how your PBM is compensated. Incentives should be aligned with your plan, not tied to higher drug list prices or opaque rebate arrangements. Formulary integrity and clinical governance With expensive therapies hitting the market, your PBM should balance cost savings with clinical appropriateness, ensuring members receive the right drug, not just the cheapest option. Benefit design flexibility Rising costs require innovative plan designs such as specialty carve-outs, differential cost-sharing, or utilization management. Your PBM should be a partner in shaping these strategies, not a barrier. Member experience and adoption tools With members facing higher cost-sharing and more complex therapies, digital tools, adherence programs, and proactive engagement are essential for better outcomes. Proven performance and benchmarking In this climate, results matter. Your PBM should demonstrate measurable cost savings and clinical outcomes year over year, benchmarked against peers. The Bottom Line Plan sponsors are entering a pivotal moment. The forces shaping pharmacy benefits include cost escalation, regulatory change, and clinical complexity. The status quo will not be enough. Choosing a PBM partner with regulatory foresight, aligned incentives, clinical integrity, and member-centric tools can help employers navigate this era, mitigate risk, and deliver sustainable value to their workforce. Sources Reuters – Pharma middlemen propose regulatory changes to avoid Trump administration rules Pharmacy Times – Pharmacy policy updates for September 2025 Bloomberg Law – Drug benefit compliance is a state-by-state test for sponsors NASPA – Over 100 pharmacy organizations urge PBM reform AMA – Advocacy update spotlight on PBMs Healthcare Dive – Employers expect 9% higher health costs in 2026 WorldatWork – Business Group on Health predicts 9% higher healthcare costs in 2026 PwC – Behind the numbers: Rising drug spend ProCare Rx PBM 101 video script

The New Pharma Playbook: Trends Employers and Health Plans Can’t Ignore

By ProCare Rx • September 29, 2025

The world of pharma is evolving quickly, with direct-to-consumer (DTC) marketing and new patient engagement strategies changing how therapies are launched, prescribed, and accessed. Join John Drakulich for an insightful conversation on The New Pharma Playbook and what these shifts mean for employers, health plans, pharmacies, and patients. Hosted by ProCare Rx , this webinar takes a closer look at how DTC marketing influences prescribing behavior, patient decision-making, and overall drug costs, and how transparent PBM strategies can help plan sponsors navigate these challenges while prioritizing member care. Attendees will walk away with practical insights into how PBMs like ProCare Rx are driving innovation, improving access, and keeping costs under control in a changing marketplace.