WASHINGTON — President Trump wants to force drug companies to disclose their prices in TV ads — and that’s going to hit five companies much harder than any others: Pfizer, AbbVie, Eli Lilly, Amgen, and Allergan.

Just a few dozen drug companies run any TV ads at all, and those five companies alone were responsible for more than half of the drug ads customers saw on TV in the last 12 months, according to a STAT analysis of data provided by analytics company iSpot.tv. Pfizer, for example, ran 37 unique ads in the last 12 months — racking up an advertising bill of over $600 million, according to iSpot’s estimate.

The list sheds light on the ultimate impact of the proposed policy, which Health and Human Services Secretary Alex Azar unveiled Monday and which would affect any drug covered by Medicare or Medicaid that cost more than $35 per month.

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No one knows how much the change will cost large companies that run lots of ads. Overall, HHS maintains, the change will cost next to nothing, but it concedes that “relatively large entities are likely to experience proportionally higher costs.” HHS estimates that even in the most expensive year of implementation, the change will only cost each company, on average, $2,900.

Drug companies, at least so far, haven’t said much about how big a burden the policy would be — if anything, their reactions have focused far more on First Amendment issues they might raise in future litigation.

But it’s clear the change would be painful. The more ads a company runs, the more time and money spent revising those ads. Each ad would need to be updated every time the list price for that drug changes. Companies also often run multiple ads for each drug they’re marketing.

Pfizer, for example, ran nine different ads in the last 12 months for its drug for nerve pain, Lyrica, according to iSpot, which analyzes ad spend based on data from smart TVs. And that tally doesn’t take into account the shorter 15- and 30-second spots companies cut from their longer ads.

And the costs don’t stop there. If a drug company is scared off from taking a price hike that it’ll ultimately be forced to include in an ad, that’s lost profit.

Price hikes contributed to a huge chunk of sales growth for the top-selling drugs – many of which are also the drugs most frequently advertised, STAT recently reported.

Leerink analyst Geoffrey Porges found, for example, that price hikes for Lyrica, Pfizer’s most advertised drug, contributed 90 percent of the drug’s increased sales from 2014 to 2017.

Pfizer, AbbVie, Eli Lilly, and Amgen didn’t comment for this article. But PhRMA, which counts all five companies as members, is already proposing a voluntary alternative that would give patients some information about drug prices, without requiring ads be updated each time a price changes. A statement from Allergan highlighted its work with PhRMA on that voluntarily initiative.

Below, STAT walks through how many ads each of the companies is running — and an estimate of how much each is spending.

1. Pfizer

Pfizer has continually topped the list for biggest TV ad spender, according to multiple data sets analyzed by STAT. It currently advertises for seven drugs.

Pfizer has spent the most promoting Lyrica. The company ran nine unique ads for the drug in the last 12 months, spending over $200 million according to iSpot, which estimates how much a company spends on its ads based on when and where an ad runs.

But Lyrica isn’t the only drug Pfizer is throwing lots of ad money at. The company runs multiple ads for five other drugs: an arthritis product known as Xeljanz; a blood thinner called Eliquis that is co-marketed with Bristol-Myers Squibb; a breast cancer treatment, Ibrance; an eczema drug, Eucrisa; and a pneumonia vaccine, Prevnar 13. The company also ran one ad for Viagra.

2. AbbVie

AbbVie only runs TV ads for its blockbuster Humira. But it has a spate of ads to promote the drug, including different ads for different indications. Humira is approved by the Food and Drug Administration to treat arthritis, Crohn’s disease, and psoriasis. In total, the company has run 18 different ads for Humira in the last 12 months, costing an estimated $288 million, according to iSpot.

3. Eli Lilly

In the last 12 months, Eli Lilly has run 14 ads for three different drugs: the diabetes treatments Trulicity and Jardiance, the latter of which is co-marketed with Boehringer Ingelheim, and the psoriasis drug Taltz. iSpot estimates the company spent $276 million on those ads.

4. Amgen

Amgen ran 16 unique ads in the last 12 months. The majority of those ads promote the rheumatoid arthritis drug Enbrel, the cholesterol drug Repatha, and a chemotherapy treatment called Neulasta. However, the company also ran two ads for Prolia, which can treat osteoporosis. Despite the high tally of unique ads, Amgen spent $145 million on them — less than Pfizer, AbbVie and Lilly, according to iSpot’s estimates.

5. Allergan

Like Amgen, Allegan’s spending is dwarfed by some of its competitors, but it runs some of the most ads. Allergan ran 15 ads in the last 12 months for five different drugs — a list that iSpot estimates cost the company nearly $160 million. The company’s most-publicized drugs were Botox and Linzess, which treats irritable bowel syndrome and is co-marketed with Ironwood Pharmaceuticals.

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  • One thing that has been left out of this pricing conversation is the fact that DTC marketing is allowed at all. Just the few examples given in the article represents approximately $1B which would either reduce cost or could go to R&D. Physicians should be making prescribing decisions, something which is supported by the fact that the US is one of only two countries on the planet that allow DTC.

  • Rather than falsely manipulating the issue over alleged constitutional rights of drug manufacturers under written by benefit of the business tax write-off they receive at the expense of the public, here’s a novel idea to protect the public’s rights: cease all advertising of prescription drug products in non-clinical media.

    Drugs should be treated no different than the poison the tobacco industry used to push to the public.

    The public does not benefit in any legitimate manner receiving such loaded ads. Funny, how long has it taken clinically educated NPs and PAs to be allowed to make clinical decisions, when at the same time, Big Pharma promotes ads to push the public to demand those drugs from their physician provider…

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