If you’ve ever seen a drug commercial, called your doctor about it, and walked out of that appointment with a better treatment plan, you may soon lose that ability. Not because the drug stopped working or the ad was misleading, but because someone in Washington decided you don’t need to know about it.
Buried in the Trump administration’s 2026 Unified Agenda of Regulatory and Deregulatory Actions — under the coyly deceptive name of “Transparency in Direct-to-Consumer Advertising” — is a proposed rule that would require every prescription drug broadcast ad to air its entire catalog of side effects. Don’t let it fool you: this change would make ads so long, so unwieldy, and so expensive that most pharmaceutical companies will stop running them. The ones that survive will confuse and discourage patients. The U.S. Food and Drug Administration’s own analysis estimates annual costs to advertisers exceeding $100 million, a burden oddly out of place in an administration that has delivered $211 billion in deregulatory savings.
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Before you decide whether that’s a good thing, know who wins and who loses with this proposed rule.
The winners
Washington’s health bureaucrats. When patients don’t know a treatment exists, they can’t ask about it or advocate themselves. That power doesn’t go away; it gets scooped up by bureaucrats who are all too happy to make healthcare decisions for you. It doesn’t matter whether it’s Dr. Anthony Fauci or U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr. Patients don’t want people in Washington telling them what they can and cannot hear and see, especially when more information makes them healthier.
Pharmacy Benefit Managers. The three largest PBMs control nearly 80% of U.S. prescription drug claims. PBMs decide which drugs make the formulary and what gets excluded. They decide which cheaper alternatives patients are steered toward instead of the latest and most effective treatments. The less you know, the less you can ask, which is worth a great deal to middlemen who profit most when you stay quiet. If the drug that‘s best suited for your health needs costs the PBM a few extra bucks, you lose and the PBM wins!
Unregulated health marketers. FDA-approved drug ads are regulated. But the celebrities, telemarketers, and “influencers” pitching miracle cures are not. Whether it is the Kardashians, Mr. Beast, or a pop-up ad promoting a too-good-to-be-true supplement, many alternative health marketers face no fair-balance standard, no enforcement letters, and no FDA review and oversight. Silencing the most regulated, most accountable ads pushes patients toward the wild west of health marketing. The proposed rule’s “protection” makes patients less safe, not more.
The losers
Us, the patient. A TV commercial can be the first moment a person realizes the symptom they’ve been managing — the fatigue, brain fog, or pain they’ve normalized — has a name and a treatment. I’ve lived with multiple sclerosis for 33 years. A drug ad led me to a conversation with my doctor that explained a symptom and improved my care. The solution we found wasn’t even the one I saw advertised, but it put me in the room to ask the question. Take away the ad, and I might never have asked. Patient empowerment doesn’t always start in a hospital. Sometimes it starts during a commercial break.
Your doctor. Patients who arrive prepared have better, more informed appointments with their doctor. They’re participants in their own care, not bystanders. Physicians are stretched thin. A patient who has done some homework gives providers more to work with.
Local broadcasters. Pharmaceutical advertising is a meaningful revenue source for local television stations already running on thin margins. Losing it chips away at the local news and weather coverage people nationwide rely on. Choking off this support without a single vote being cast is federal overreach that hurts local businesses and communities.
Other American industries. If the government can use compelled compliance to restrict free speech, it won’t stop at drug ads. Why not crack down on sugary drinks, carbon-emitting vehicles, or ultra-processed fast food? If an industry that makes life-saving products can be regulated into silence, what stops the next “inconvenient” one?
The First Amendment. George Mason refused to sign the Constitution because it had no Bill of Rights. The one he held out for protects the right to hear information and decide for yourself what to do with it. Hundreds of thousands of Americans enlist to defend that. My son did a few weeks ago. He didn’t sign up so Washington could decide which truths we’re allowed to hear.
The bottom line
THE MALPRACTICE MONSTER DEVOURING HEALTHCARE
There is no disagreement that advertising should be clear, honest, and balanced. The administration is right that patients deserve transparency, not obfuscation. No argument there.
But there’s a better way. The FDA should strengthen enforcement against misleading ads and police bad actors. The agency exists to keep our food and medicine safe, and its warning letters are proof that the current system works. It must stay the course, not implement rules that silence everyone to punish the few. Just as the answer to bad speech is more speech, more medical information is better than less.
John “CZ” Czwartacki is the executive director of the Informed Patients Project and has lived with multiple sclerosis for 33 years.