Quick Take: Drug Advertising’s Big Loophole

A 25-second ad, five claims, and about five seconds of small print

A few notes on a big loophole in prescription drug advertising that regulators know about and still haven’t closed.

Count the claims in this 25-second TV ad from the telehealth company Ro.

“Fastest-working GLP-1.” “Half the price.” “FDA-approved.” “Lose 20% of your weight.” A formula that “hits not one but two hormones.”

Then find the side effects.

Look closely or you will miss them. At the bottom of the screen, for about five seconds, small type says GLP-1 medications “may have serious side effects” and “Do not use if you or your family have a history of a type of thyroid cancer called MTC or MEN 2.” The ad then refers viewers to their doctor for the rest.

There is no list of side effects. The claims are spoken and repeated to drive the pitch. The risk is a couple of lines of small print you have to read if you see them.

I’m including one of the television spots here for those of you living outside the U.S., who are spared the deluge of pharmaceutical TV ads that we in America have to sit through.

I wrote the book on how this industry works. PHARMA, my history of the American drug business, came out in 2020. When I debated profits and the drug industry at Oxford last year, I presented a fact that still stops most people: America is one of only two countries that allow drug companies to advertise prescription drugs directly to consumers. The other is New Zealand. I’ve been a critic for a long time and I think DTC advertising should end.

Start with how odd it is. Only a doctor can prescribe these drugs. But since 1997, when the broadcast rules were loosened, companies have spent billions to create demand among people who cannot buy the product directly, hoping they will contact their physician and ask for it by name.

There was a trade-off in the rules. If an ad names a drug and says what it treats, the company must give viewers the major risks, and they have to be in the spoken part of the ad, not just in print. That’s why pharma ads end with the fast, mumbled list of side effects. The exceptions are narrow. A company can name a drug without saying what it’s for, though not if the drug carries a boxed warning. Or it can discuss the condition without naming the drug. Either way, it is exempt from warning the public about adverse effects.

Telehealth companies drove a truck through that second exception. Sell the “service.” Say “GLP-1” instead of the brand. When the voiceover never names the drug, the company, not the regulators, decides how much risk to show. Ro chose a few lines of small print for a few seconds.

Look at what this ad does anyway. It touts a number, a speed claim, a price claim, and a description of how the drug works. It leans on “FDA-approved” as a trust badge. The FDA-approved labels for these drugs carry the FDA’s most serious warning, a boxed warning often called a black box, about thyroid C-cell tumors found in rodents. Whether that risk exists in humans is unknown. The ad’s small print alludes to it. It never lists the common side effects, which the labels give as nausea, vomiting, diarrhea, and constipation. Nor does it name the serious ones the labels list: pancreatitis, gallbladder disease, kidney injury from dehydration, severe stomach problems, serious allergic reactions, and low blood sugar.

Compare the economics. Novo Nordisk’s Wegovy pill ad needed 90 seconds in this year’s Super Bowl, partly because nearly half of it was the required side-effect language. Ro’s 30-second Super Bowl ad, also starring Serena Williams, handled risk differently: a box of small print for about five seconds near the end. It points viewers to a website, mentions a type of thyroid cancer, and says that in rodents these drugs cause thyroid tumors and the impact in humans isn’t known. That’s more than the 25-second spot above offers, but none of it is spoken.

This is not small money. Hims & Hers, which has sold compounded GLP-1s, spent $815 million on advertising in 2025, up from $390 million in 2023, according to its own 10-K.

To be precise, this Ro spot is for FDA-approved drugs, not compounded ones. So this isn’t only a compounder problem. It’s a telehealth problem. Compounded versions, which have never been evaluated by the FDA for safety or effectiveness, raise the same question.

Telehealth companies also spend real money on celebrities. Tennis icon Serena Williams stars in this ad. Charles Barkley has appeared in others for Ro. The company says Williams is a paid partner and discloses a family investment in the company. That’s fair. But every one of those stars is there to make the drug look easy, and none of them is there to tell you the risks.

Washington knows about this. Before the 2025 Super Bowl, Senators Durbin and Marshall warned that the Hims & Hers ad “risks misleading patients by omitting any safety or side effect information.” Since September 2025 the FDA has sent waves of warning letters to telehealth companies over their marketing of compounded GLP-1s, and this spring it asked Congress for more power to go after DTC ads that lack fair balance. The TV loophole itself is still open.

My preferred fix is to end direct-to-consumer advertising altogether. The AMA called for a ban in 2015. But the industry has lobbied heavily to keep it and has a lot of friends on both sides of the aisle. So here is the floor:

If an ad describes a drug’s results, speed, mechanism, or price, it is a drug ad. Naming Ro instead of the drug shouldn’t matter. It carries the same fair-balance risk disclosure, including the major risks said out loud.

Ads touching compounded drugs must say plainly that the FDA hasn’t approved them.

Risk information must be as audible and readable as the promise, not buried in fine print.

An ad should not be able to borrow the FDA’s approval and skip the FDA’s warnings. Tell viewers the risks out loud or take the ad off the air.