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February 17, 2026 0

The violation letters that started last September and continue this year might alter how brands craft DTC advertising. FDA is using a “totality of the evidence” standard to decide if an ad is in violation. That means they are now interpreting individual statements and creative elements together. While each statement might be true, FDA is deciding that when taken together, consumers are misled as to efficacy and risk.

This “totality” rationale gives FDA wide latitude to decide if commonly used DTC scenes of active patients enjoying life contribute to misleading claims. Many letters use these scenes as a reason to find greater efficacy claims than the drug really provides. I find the “totality” standard problematic. One could find almost every ad in violation by parsing each scene. There now seems to be a highly subjective degree of oversight.

While each statement might be true, FDA is deciding that when taken together, consumers are misled as to efficacy and risk.

I understand the new FDA is showing it is tougher on advertisers. We all get it. They are taking the desire to ban DTC on television and doing the next best thing by sending more letters. As an industry we have little choice but to respond with ads more likely to pass muster. It is hard to fight an agency that has been directed by Secretary Kennedy to eliminate what we do. They are trying to end adequate provision, the regulation that allows :60 ads, but that plan will face court challenges.

The good news is almost all the ads cited by OPDP can be fixed with a few copy changes and by toning down some of the happy scenes. That may be disappointing to agency creatives, but the reality is ads can still be interesting enough to get consumer attention. I am sure MLR internal groups are increasingly nervous in their review process and will make it harder to get approval. That means brands will need more time to develop ads, create alternatives, and allow for internal review resulting in changes.

I am not overly concerned with what I have seen from OPDP. Their letters are obviously frustrating and, as I said, too subjective. What was acceptable in the past will no longer be allowed. The reality is DTC is running at record spending levels, so drug makers are adapting to the new regulatory crackdown. A few campaigns that received letters needed dramatic changes, but most were just tweaked to satisfy OPDP concerns. I am hoping FDA is satisfied by being “tougher” and drops further regulatory action relating to adequate provision. The drug industry can do its part by showing it is crafting ads that meet the new requirements.

Bob Ehrlich

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February 10, 2026 0

Direct-to-consumer (DTC) advertising once again took center stage during the Super Bowl. This year, four commercials aired that were directly related to prescription drugs or diagnostic testing—an increasing trend as pharmaceutical companies seek to make big, cultural-impact moments out of major live events.

Historically, drug manufacturers have not heavily invested in Super Bowl advertising. That appears to be changing, as companies recognize the power of this massive national platform to reach both patients and healthcare providers simultaneously.

Novartis led the way with another highly creative disease-education ad—this time focused on prostate cancer screening. Last year, the company ran a widely discussed breast cancer awareness spot. This year’s commercial cleverly played on the concept of “tight ends,” featuring NFL stars Rob Gronkowski, Tony Gonzalez, and George Kittle in relaxed settings. The message: men do not need to fear prostate cancer testing because today’s screening can be done with a simple blood test rather than a digital rectal exam.

Even under rising regulatory pressure, pharma is doubling down on the Super Bowl as a must-have DTC stage.

The second ad came from TG Therapeutics and featured actress Christina Applegate, who has lived with multiple sclerosis (MS) for years. In her characteristically candid style, she bluntly stated that “having MS sucks.” The ad directs viewers to a platform where Applegate will share more content about living with MS, while also raising awareness of TG Therapeutics’ treatment, Briumvi, which is designed to slow disease progression. Applegate has long been open about her MS journey, which has profoundly affected both her career and personal life.

The third ad spotlighted Ro, with tennis legend Serena Williams promoting weight loss using a GLP-1 medication available through the company. Williams has been a compelling spokesperson for a range of brands, and this commercial was particularly well executed and persuasive. Ro markets branded medications directly to consumers while also providing ongoing clinical support through its membership model.

The fourth ad promoted Wegovy, Novo Nordisk’s newly launched weight loss pill. The tone was lighthearted and star-studded, featuring celebrities such as Kenan Thompson, John C. Reilly, and Danny Trejo. Given that the pill only became available in January, the spot functioned largely as an announcement to build awareness.

This is a critical moment for Novo Nordisk, as it currently has a limited window to dominate the emerging oral weight loss market before Eli Lilly introduces its own pill version of Zepbound later this year. Novo Nordisk had also faced potential competition from Hims & Hers, but legal pressure and FDA warnings prompted that company to withdraw its lower-cost alternative.

Overall, it is encouraging to see pharmaceutical companies continue to embrace television advertising—even amid growing regulatory scrutiny. The FDA has signaled its intent to make branded DTC ads more difficult to execute by flagging more commercials as non-compliant and by reconsidering rules that currently allow abbreviated risk disclosures in 60-second spots. While the regulatory landscape remains uncertain, it is clear that drug makers are committed to maintaining their presence in major broadcast advertising.

Bob Ehrlich