• by Wayne Friedman , 5 hours ago

Not only are billions of dollars of pharmaceutical direct-to-consumer TV/CTV advertising dollars at risk from the Trump Administration’s recent effort to stop DTC advertising, but major “pricing premiums” as well, media research company Guideline finds.

Direct-to-consumer (DTC) cost-per-thousand viewer pricing (CPM) is 35% higher than averages for all advertising categories -- particularly among streaming/connected TV platforms, the Guideline analysis finds.

“Publishers have long enjoyed the premium on CPMs that Pharma ads bring,” according to Sean Wright, chief insights/analytics officer of Guideline. “Two reasons are Pharma companies tend to buy more premium inventory (i.e. live sports, streaming exclusives, broadcast prime time); and have longer creative lengths (90s) in order to meet regulatory requirements to state all side effects of drugs, etc."

Around $14 billion to $16 billion annually is spent overall in TV/CTV direct-to-consumer (DTC)pharmaceutical and related advertising -- roughly 4.2% of estimated total U.S. advertising. CTV represents around 20% of total spend.

In the near term, around $4 billion in DTC ads in the fourth quarter of 2025 is estimated to be at risk.

Wright's analysis offers a warning: “A potential scenario in the mid-to-long term... may have unintended consequences in creating a proliferation of potentially dubious advertising.”

For years, the Food and Drug Administration has demanded that on TV (and more recently, streaming services) pharmaceutical advertising needs to disclose the potential adverse side efforts and contraindications of those medications.

But last week, the FDA sent out “100 cease-and-desist letters” to brands in a move that could have a massive impact on pharmaceutical national TV and streaming advertising marketplace, due to what it says is “misleading” advertising.

The fallout could be severe -- with some minor improvements in other related advertising.

According to the Guideline's Wright analysis, there is “the potential to see more wellness type advertising around supplements and similar products as a way to continue to generate ad revenue which is approximately $670 million per year, which has a 7% annual growth rate over a three-year period.

Guideline offers market intelligence by pooling exclusive billing data from the world's leading agencies and independents.