JustCare

Tag: Ads

  • If confirmed as head of HHS, RFK Jr. could end Pharma’s direct to consumer ads

    If confirmed as head of HHS, RFK Jr. could end Pharma’s direct to consumer ads

    If Congress confirms RFK Jr. to head the US Department of Health and Human Services (HHS), it might keep us from receiving needed vaccines, endangering our own health and the public health. But, it could also spell the end of direct-to-consumer marketing of prescription drugs, reports Andrea Park for Fierce Pharma. And, that’s good news for Americans, as the ads, much like the Medicare Advantage ads, can be extremely deceptive.

    When he was running for president several months ago, RFK Jr. declared that he would ban pharmaceutical company advertisements on TV through an executive order. President-elect Trump could follow his lead. Of course, the pharmaceutical companies will challenge this act, claiming it abridges their first amendment right to free speech, and they could prevail. That said, not until 1983 did pharmaceutical companies begin advertising their drugs to consumers on TV. Before that, they marketed their drugs exclusively to doctors and pharmacists.

    Today, Pharma spends buckets marketing their prescription drugs. And, for good reason. Their return on investment is tremendous, as much as five times for some drugs.

    The United States and New Zealand are the only two countries in the world that permit direct-to-consumer marketing of prescription drugs.

    It’s still unclear whether RFK Jr. will take on Pharma’s ads or direct his attention to US food policies. But, Trump’s pick to head the Food and Drug Administration (FDA), which is under HHS control, could also act to end Pharma consumer ads. Dr. Martin Makary published a study ten years ago finding that “Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed.”

    Here’s more from Just Care:

  • Don’t trust TV drug ads

    Don’t trust TV drug ads

    Elisabeth Rosenthal writes for KFF Health News about why you should not trust drug ads on TV. Ignore the celebrity endorsements by Lady Gaga and others; they won’t tell you about a better less expensive drug. If our government were not in the pocket of the pharmaceutical corporations, it would ban all direct to consumer drug advertising as every country other than the US and New Zealand do.

    Pharmaceutical companies spend huge amounts of money to sway you to buy their drugs because their ads work really well, even when the ads promote drugs that are of little value. Indeed, pharmaceutical companies now spend more than $1 billion a month on these ads. They are among the biggest spenders of TV ads.

    The Clinton Administration is responsible for allowing these ads, which had been banned. The FDA thought it could somehow keep the drug companies from misleading people by saying ads could not be misleading and had to list side effects. Really?

    Rosenthal reports on University of Colorado professor Michael DiStefano’s recent study of best-selling drugs, which found that the pharmaceutical companies spent more on ads targeted to individuals, featuring drugs with fewer benefits, than on ads for doctors. DiStefano is concerned: “I worry that direct-to-consumer advertising can be used to drive demand for marginally effective drugs or for drugs with more affordable or more cost-effective alternatives.”

    Thankfully, five of the ten drugs that will have Medicare negotiated prices beginning in 2026, are drugs that the pharmaceutical corporations spent the most advertising to patients.

    The government’s legal challenges to PhRMA’s misleading ads, even by the former Trump Administration, are not easy to win. PhRMA claimed that a requirement to disclose a drug’s list price in an ad violated first amendment rights and prevailed.

    New FDA requirements sound great, but they are so vague and subjective as to be meaningless; moreover, the FDA cannot enforce them effectively. As of November 2023, PhRMA consumer ads must provide a “non-misleading net impression about the advertised drug.” Drug ads should be “clear, conspicuous, and neutral.”  “Audio or visual elements that might interfere with the consumer’s understanding” is not permitted and and anything in writing must be “easy to read.”

    The FDA does not require the pharmaceutical corporations to submit ads for approval before releasing them. The drug companies are expected to self-police. And, the FDA does not have the money or the power to hold pharmaceutical companies to account when they misled. Each year over the last five years, the FDA sent out an average of six “warning letters.” And, it’s not at all clear that the companies receiving those letters did anything about their misleading ads.

    The FDA now has a Bad Ad Program for physicians, The program trains them on misleading ads and gives them a hotline to call to report misleading ads: 855-RX-BADAD. Given the FDA’s limited resources and power, it’s hard to imagine that will do any good. The FTC apparently does not have the power to protect consumers from false and misleading drug ads.

    For the public health, Congress should ban these ads altogether.

    Here’s more from Just Care:

  • Insurers will continue misleading people, notwithstanding new Medicare Advantage marketing rules

    Insurers will continue misleading people, notwithstanding new Medicare Advantage marketing rules

    Rachel Roubein writes for the Washington Post on the new rules the government has put in place to protect older adults and people with disabilities from misleading marketing by corporate health insurers offering Medicare Advantage plans. While the rules are a step in the right direction, you can bet your bottom dollar that they will make little difference. Insurers will continue to mislead people, as will their sales agents.

    The corporate health insurers offering Medicare Advantage plans will have to adopt a new marketing look. But, there’s no way that they will tell people about restrictions on their access to care in Medicare Advantage plans; restrictions that people do not face in traditional Medicare. Nor are the insurers going to explain that people are likely to spend more out of pocket if they need costly health care services and are enrolled in a Medicare Advantage plan than they would in traditional Medicare.

    Since the advent of Medicare Advantage, the insurance company ads have been terribly deceptive.  And, the insurance companies’ sales agents often steer people to plans from which they receive the highest commissions rather than to Original Medicare, even when Original Medicare best meets people’s needs. Complaints about deceptive marketing are rampant.

    The new government rules are intended to keep corporate health insurers from deceiving people into believing their Medicare options are more limited than they are, or that they will get extra benefits that are actually not available to them. That’s good. It’s just not enough.

    Moreover, there are no meaningful penalties on the insurers if they violate the marketing rules. CMS does not exercise its right to penalize Medicare Advantage plans in meaningful ways, let alone cancel contracts with the bad actors. And, a lot of the information people need to distinguish the good MA plans from the bad actors, such is denial rates, delay rates and disenrollment rates, is not available. 

    The new marketing rules do nothing to help people make an informed Medicare choice.  People can’t understand critical differences among their options, such as whether a plan has a high denial rate or has a poor network of providers. All people have to go by is unclear, inaccurate and misleading information.

    Best advice: If you can’t afford to spend $5,000 out of pocket—the typical amount people must spend for in-network care alone if they need critical care in a Medicare Advantage plan—you should consider enrolling in traditional Medicare. If you don’t have Medicaid or retiree benefits that provide Medicare supplemental coverage, you should also consider buying supplemental coverage. You can get low-cost Medicare supplemental (Medigap) coverage with an out-of-pocket cap. Or, you can get comprehensive Medicare supplemental coverage for about $2,500 a year. With Medigap plan G, you’ll have almost all your costs covered. No matter which supplemental insurance you choose, in traditional Medicare you will be able to see the doctors you want to see without needing approval from an insurance company that profits more when it denies coverage for your care. That’s what too often happens in Medicare Advantage.

    Here’s more from Just Care:

  • Dems launch attack ads against Senators Cruz and Scott for proposing to take away Medicare

    Dems launch attack ads against Senators Cruz and Scott for proposing to take away Medicare

    Axios reports that the Democratic Senatorial Campaign Committee has launched attack ads against Senator Ted Cruz of Texas and Senator Rick Scott of Florida for planning to take away Medicare. Cruz and Scott are the two Republican Senators whose seats are at risk in the 2024 election. And, when it comes to Medicare and Social Security, they can’t be trusted.

    Both Scott and Cruz have called for the end of Medicare in one form or another, as have most Republicans. For a long while, one of their goals has been to privatize Medicare and allocate a fixed amount of money to each person with Medicare that they can spend on their health care, “premium support”. Premium support policies would mean higher costs for older adults and less comprehensive Medicare coverage. People with Medicare who developed costly or complex conditions would likely either have to forgo care or pay for it themselves.

    The Democrats’ digital ads are designed to appeal to older Americans and call out Senators Cruz and Scott for being a “threat to Medicare.” The ads also attack Republicans more broadly for their positions on Medicare.

    Senator Scott has called for federal legislation that would have Medicare and Social Security go away after five years. In his words, “All federal legislation sunsets in five years. If a law is worth keeping, Congress could pass it again.” Given how difficult it is to pass any legislation in Congress, Scott’s policy proposal is a sure recipe to end Medicare and Social Security.

    It’s worth noting that Medicare Advantage plans already put Medicare on a dangerous trajectory, both from a sustainability perspective and from a coverage perspective. The HHS Office of the Inspector General has now twice reported that Medicare Advantage plans often inappropriately delay and deny care that Traditional Medicare would have covered. And countless agencies and organizations have found overpayments to Medicare Advantage plans are today more than $70 billion a year and growing, endangering the Medicare Trust Fund.

    Here’s more from Just Care:

  • Medicare Advantage ads will continue to mislead despite new rules

    Medicare Advantage ads will continue to mislead despite new rules

    Whether or not you are Medicare eligible, you have likely seen countless TV and print ads by health insurance companies offering you what sounds like a free lunch if you sign up for a Medicare Advantage plan. The ads are often profoundly misleading and don’t begin to help people understand the tradeoffs they are making, at times gambling away their health security, because many Medicare Advantage plans engage in widespread inappropriate delays and denials of care. New government advertising rules are designed to eliminate some of the misleading elements in Medicare Advantage ads, but not nearly enough of them.

    Joe Namath and other superstars will continue to be able to promote Medicare Advantage plans without warning you of the risks you could be taking if you sign up for some of these plans. But, as of September 30 of this year, the Medicare Advantage plans will no longer be able to use Medicare’s logo in their ads in ways that suggest that they are Medicare or the federal government.

    Medicare Advantage plans are the corporate health insurance alternative to traditional Medicare, which is offered directly through the federal government. While traditional Medicare provides coverage to people for care from almost all doctors and hospitals and defers to the opinions of treating physicians when determining whether care is reasonable and necessary, Medicare Advantage plans restrict access to most physicians and hospitals and often come between their enrollees and their treating physicians, second-guessing people’s care needs and denying care inappropriately to maximize their profits.

    Because the government pays Medicare Advantage plans upfront, regardless of the cost of the care they deliver, the less care they cover, the more profits they earn. Prior authorization requirements, which all Medicare Advantage plans impose, allow them to delay costly care, also helping to maximize their profits.

    But, a combination of relentless marketing by the Medicare Advantage plans and the additional costs in traditional Medicare for supplemental coverage and prescription drug coverage lead many people to opt for a Medicare Advantage plan. In fairness, it’s hard to understand the risks of Medicare Advantage and how it is so fundamentally different from traditional Medicare when it comes to having your care needs met. And, as long you’re healthy, you can save money in a Medicare Advantage plan. Of course, health insurance should be there when you will need costly care, as the vast majority of us will at some point.

    The new government rule does not allow for “overly general ads about the Medicare Advantage program that often tend to confuse and mislead individuals,” according to Xavier Becerra, the Secretary of the Department of Health and Human Services. The rule appears to forbid ads that do not name one specific Medicare Advantage plan. Health insurers also can only use the name Medicare in limited instances and cannot feature a Medicare card.

    When Medicare Advantage ads contain a toll-free number, some people think they are calling the federal government and not an insurance company or its agents. Now, companies won’t be able to have ads that promote benefits unless they are available to people where the ads are being aired.

    Here’s more from Just Care: 

  • Medical and health misinformation abounds

    Medical and health misinformation abounds

    Medical and health misinformation abounds, and it’s not going away. The government should do more to address some of the misinformation. But, as with all advertising and promotion, you need to assume that what you are hearing or seeing or reading might not be true, before acting on the information. Try to find independent sources you can trust.

    There are a few trustworthy sources for determining whether a drug, vitamin supplement or medical device or medical service is safe and effective. For good information on health care and policy, I go to cochrane.org. Cochrane is a non-profit independent organization that studies all the available reliable data to determine what’s working or not working. For example, if you go to cochrane.org to look up different vitamin supplements, you’ll learn a lot about the lack of evidence that most of these supplements work.

    If the question is whether a medical device is safe and effective, you can begin by looking on the Food and Drug Administration’s web site to see whether it has been recalled. Unfortunately, that won’t tell you the whole story because the FDA has not recalled some medical devices it has approved that can cause serious harm.

    Similarly, there are lots of prescription drugs that are FDA-approved that may not be safe and effective.

    Stat News reports on FDA action–truly inaction–to address a lot of misinformation. Some researchers argue the FDA must do more to police health information and ensure drug labels are accurate. At the same time, the researchers recognize that the FDA does not have the tools, resources or power to undertake this work.

    In some cases, the FDA might be infringing on people’s free speech rights under the first amendment of the constitution. Moreover, the internet enables people to make inaccurate claims that reach tens of millions of people. “Counteradvertising,” as it is sometimes called, will never do enough to keep the misinformation from taking hold.

    Here’s more from Just Care:

  • Medicare Advantage ads are improperly embedded in people’s electronic health records

    Medicare Advantage ads are improperly embedded in people’s electronic health records

    Medicare Advantage plans are now advertising on people’s electronic health record portals, reports Cheryl Clark for MedPage Today. The Centers for Medicare and Medicaid Services (CMS), which administers Medicare, says this should not be allowed. But, before I explain what’s happening with these ads, let me list some of the many things some Medicare Advantage plans do that are not allowed and that CMS has not been able to address in a meaningful way.

    1. Medicare Advantage plans inappropriately delay and deny care.
    2. Medicare Advantage plans do not cover care that Traditional Medicare covers, though they are required to.
    3. Medicare Advantage plans fail to share complete and accurate data on the services their enrollees receive with the government.
    4. Medicare Advantage plans fail to keep their provider directories accurate and up to date.
    5. Medicare Advantage plans fail to code the health status of their enrollees accurately.
    6. Medicare Advantage plans mislead people through their advertisements.

    So, it’s no surprise that Medicare Advantage plans will take advantage of every opportunity to promote their health plans. Marketing Medicare Advantage plans through people’s electronic health record seems par for the course. Why shouldn’t FollowMyHealth, the electronic health record portal, accept money from Medicare Advantage plans in exchange for promoting them? It’s not their concern that their users might be misled to think their doctors are promoting Medicare Advantage plans. They’re simply trying to maximize profits.

    CMS has a memo on Medicare Advantage “best practices,” that discourages this type of advertising, even by third parties. But, it’s not clear that it’s illegal or a violation of any contractual obligation.

    CMS also has a proposed rule that would require Medicare Advantage ads to specify the Medicare Advantage plans that offer particular benefits and not to generalize about products in Medicare Advantage. It is not yet finalized.

    As with prescription drug ads, the Medicare Advantage ads should highlight the risks of enrolling in a Medicare Advantage plan. But, they don’t mention, let alone highlight, their limited provider networks, the restricted geographic scope of their coverage, their referral and prior authorization requirements, their high out-of-pocket costs when you need costly care, or that once you are in a Medicare Advantage plan you likely will not be able to move back to traditional Medicare because you are not guaranteed the right to buy supplemental coverage.

    At the very least, CMS should include all these warnings in its Medicare and You Handbook and in all materials it distributes on Medicare Advantage. CMS will never have the tools or the resources to prevent Medicare Advantage plan bad actors from doing everything in their power to maximize their profits, whether it’s misleading prospective enrollees about their benefits, inappropriately delaying and denying care, having inadequate provider networks, not paying hospitals for the services they deliver, or overcharging enrollees for their prescription drugs.

    CMS can keep issuing rules that the bad actors will not follow. Or, if it wants to protect Medicare and Medicare Advantage enrollees and providers, it can start canceling contracts and penalizing Medicare Advantage bad actors in meaningful ways. Are there many bad actor Medicare Advantage plans you might ask? Likely, far more than you’d like to believe.

    Here’s more from Just Care:

  • Medicare Advantage: Tune out the Joe Namath ads

    Medicare Advantage: Tune out the Joe Namath ads

    Joanna Robin reports for The New Republic on the firm behind the Joe Namath TV ads pushing Medicare Advantage and the Medicare “helpline.” As I’ve reported before, you should tune those ads out, just as you do other spam. Fuggetaboudem!

    Benefytt Technologies is behind the Medicare Advantage ads. It owns Together Health, which in turn partners with Humana, Aetna and WellCare to push their Medicare Advantage plans. You should beware the can of worms that Joe Namath does not share with you. He wouldn’t talk to Robin about them. He doesn’t know from Medicare Advantage; he’s simply getting paid to read from a script. 

    Before changing its name to Benefytt Technologies, the company sold short-term health insurance policies under the name Health Insurance Innovations. Robin suggests that its biggest innovation was to charge $500 a month to unsuspecting people for a health insurance policy that failed to cover their basic, let alone their catastrophic, medical needs. 

    Health Insurance Innovations (Benefytt Technologies) was mired in lawsuits. It was also caught in a sea of state and FTC actions for violating its obligations and forced to pay out tens of millions to settle.

    In 2020, it paid a $1.5 million fine for violating Washington state laws 50,000 times.

    Much like the Medicare Advantage plans that the company now pushes, it is always morphing, making it impossible to oversee adequately, let alone to be kept in check and penalized appropriately. As Robin explains, it’s “regulatory Whac-a-Mole.”

    What are you getting when you sign up for one of Benefytt Technologies’ Medicare Advantage plans? I can just about guarantee you that it’s not what you think. I can also guarantee that CMS (Center for Medicare and Medicaid Services) does not have the resources to ensure that these Medicare Advantage plans are doing right by people with Medicare. It also lacks the tools to punish them appropriately and protect you if it catches them violating their contractual obligations.

    Here’s more from Just Care:

  • Drug ads drive up drug spending

    Drug ads drive up drug spending

    A new Government Accountability Office analysis suggests that pharmaceutical companies benefit handsomely from advertising brand-name drugs on television and in other media. People look at the loving couple promoting a drug and then appear to want it for themselves. Of course, when people with Medicare use more drugs, Medicare spends more.Stat News reports that between 2016 and 2018, total Medicare drug spending was $560 billion. Of that money, $324 billion covered the cost of drugs that were advertised. Most of the drugs that were advertised, 463 of 553 were for drugs covered under Medicare Part D.

    Pharmaceutical companies spent about $18 billion on advertising during those three years, an average of $32 million for each drug. The vast majority of that spending was on expensive, brand-name drugs. About $12 billion was directed toward 39 prescription drugs, 19 of which were new to the market.

    Advertising is just one of several tools that the pharmaceutical industry deploys to drive up drug spending. Pharmaceutical companies also raise prices on their drugs, enlist doctors to prescribe their drugs and offer promotions for use of their drugs.

    Senate Judiciary Committee members were incensed by the GAO report’s findings. Republican Charles Grassley of Iowa and Democrat Dick Durban of Illinois both believe that these ads drive up Medicare’s costs. They are not about appropriately educating the public or there would be a lot more generic drug ads. But, Congress has done nothing to prevent prescription drug advertising to consumers, which was against the law 25 years ago.

    To be clear, even the incensed lawmakers have no intention of making drug advertising illegal. Their solution is for pharmaceutical companies to list the price of the drugs they advertise, a Trump administration proposal that seems senseless. There is no set price for a drug in the US. And, most people don’t pay the list price, just the copay.

    New Zealand is the only other nation that permits drug advertising. Every other country bans advertising and for good reason. Drug ads lead people to ask their doctors for drugs that are of no benefit to them. Of course, doctors have the power to say no when asked, but they don’t generally exercise it. That’s a whole other issue.

    Here’s more from Just Care: