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# Hard to Isolate Drug Ad/Medicare Spend Relationship: GAO
- URL: https://www.fdaweb.com/hard-to-isolate-drug-ad-medicare-spend-relationship-gao/
- Published: 2021-06-17T12:00:00.000Z
- Updated: 2026-09-14T17:03:48.000Z
- Author: David McFarland
- Tags: FDA Policy/General, #legacy-id-D5149566

The Government Accountability Office (GAO) says its study of direct-to-consumer (DTC) drug advertising and Medicare spending on advertised drugs found it is hard to isolate the relationship between drug advertising, use, and spending. The [report](https://www.gao.gov/products/gao-21-380?utm%5Fcampaign=usgao%5Femail&utm%5Fcontent=topic%5Fhealth&utm%5Fmedium=email&utm%5Fsource=govdelivery) looked at drug manufacturer spending on DTC, Medicare spending on advertised drugs, and changes in DTC spending and Medicare use and spending for selected drugs.

Medicare Parts B and D and beneficiaries spent $560 billion on drugs from 2016 through 2018, GAO says, and $324 billion of that (58%) was spent on advertised drugs. Of the 553 advertised drugs, GAO found Medicare Part B spending for 104 of the drugs and Part D spending for 463 of them.

Among the drugs with the highest Medicare spending, some also had the highest DTC spending. Among the top 10 drugs with the highest Medicare Parts B or D expenditures, four were among the top 10 in ad spending in 2018: Bristol-Myers Squibb and Pfizer’s Eliquis (apixaban), Abb Vie’s Humira (adalimumab), Merck’s Keytruda (pembrolizumab), and Viatris’Lyrica (pregabalin).

A GAO review of four advertised drugs found their manufacturers changed their DTC spending during key events, such as increasing spending when a drug was approved for a new indication and decreasing spending when a generic form was approved.

The agency says it also found that DTC advertising may have contributed to increases in Medicare beneficiary use and spending for the four selected drugs from 2010 through 2018\. However, it says, other factors likely contributed to increases in Medicare beneficiary use and spending, including increases in unit prices, physician prescribing decisions, and manufacturer promotions directed at doctors.

Sens. **Dick Durbin** (D-IL) and **Chuck Grassley** (R-IA), who requested the GAO analysis, said they plan to introduce legislation to bring transparency to the drug industry’s “unfair advertising practices by requiring the disclosure of the product’s cost, which will lower drug spending and empower patients.”