Is Pharma Advertising on TV Reaching a Breaking Point?
Also, the future creative vs. media turf war
On Sunday night, my 16-year old and I sat down to watch an episode of “Prison Break” (still holds up) on Hulu. During the first ad break, like clockwork, there it was:
A commercial for Xiaflex, a drug aimed at - “Dupuytren contracture,” which is when your hand or fingers start to bend inward over time. According to Mayo Clinic, this condition is most prevalant among men over 50 who are of “Northern European descent” and may have used vibrating tools earlier in their careers.
Well, I am over 50, with Irish blood, and I used to use a mouse connected to my old Dell Latitude at the office.
Still, if this is the power of connected TV targeting and precision, we might all be in trouble. Xiaflex says to date over a quarter of a million people have been prescribed the drug to date - so perhaps blasting ads like this out to tens of millions does drive outcomes?
I promise you I had planned to write this post prior to the above very funny “Saturday Night Live” mock commercial from the other night - but really the timing is perfect. Indeed, the preponderance of pharma ads on TV of late has been a topic of off the record discussion/worry at recent ad industry conferences of late.
To me, the explosion of pharma ads is clearly out of control - if you watch the NFL, or the recent Winter Olympics, these ads are all over linear TV - which to be fair - is the domain of the over 50 crowd.
According to iSpot, pharma airings were up 5.4% on linear in January and February, while ad time jumped 9.6% during that period.
Over the past six months, iSpot found that national linear TV ad spend for pharma brands surged 25.1%.
Again, that’s just linear TV. Still, there’s no escape in streaming.
Last year, pharam impressions surged 88% per EDO, peaking at 17.3 billion in Q3.
Now, according to Samba, “Pharma TV ad spend dropped 12% year-over-year, as brands shift toward precision targeting and audiences now cluster into distinct behavioral groups.”
Still, data from EDO, which focuses on tracking how people respond to TV ads (searches, etc.) seems to bear that out. For example, in Jan 2026, the average ad exposure in streaming was 64% more effective than in linear for the cosmetics category, which includes products like Ebglyss (ads for which I see all the time). It would seem that these brands are reaching the right eczema sufferers.
Yeah, it sure doesn’t feel like that if you actually watch TV. All you have to do is stream anything ad-supported for a few minutes and you’ll be bombarded by ads for Skyrizi and Tremfya, which are aimed ate people with plague psoriasis or moderate to severe Crohn’s disease.
I’m not trying to make light of any of these conditions - nor do I not want people to get the drugs they need. But these are maladies that very few Americans actually have (about three quarters of a million people in the US have Crohn’s disease.
The more that streaming is flooded with these ads - the more they seem to make a mockery of what we all hear are CTV’s strengths: identity, cross device frequency management, uber-precise targeting, TV as a performance vehicle, etc. etc.
Sure, TV companies, I suppose get the pharma cash while the money is good (or until RFK Jr. takes it away)- but you have to wonder what this does for the medium’s development, reputation among brands, and viewers’ attentiveness. If I’m a CMO, I may start to question whether all these CTV leaders and ad tech companies can actually do all they say they can. Especially in a medium already known for having a major frequency problem - at a time when many are wondering whether machines will eventually be better at spending your media budgets than people.
Personally, with this endless parade of pharma spots, I’m and worried about my vision - either from being bombarded by scary commercial - or whether I may actually be experiencing blurred vision, eye pain, or swelling - which are listed as potential serious side effects of Skyrizi.
Operating System vs. Operating System
The more that artificial intelligence-plus-data promises to infiltrate, and ultimately reshape how digital advertising works, the more that the holder of such tech and data promises to wield the power. Will that ultimately be the platforms, the media agencies - or the creatives?
It’s possible that such battle lines are being drawn up, the more that generative AI allows for quick creative decisioning and development. Adobe seems to aspire to play a huge role on the creative/brand side of the equation.
“I think about it as that operating layer. It’s really across the entire operating system across the market or advertising,” said Sam Garfield, Adobe’s Head of Digital Strategy, CMT, Data and AI Platforms on this week’s Next in Media podcast.
Garfield and I talked about how Adobe is looking to weave its way into every aspect of a brand’s digital output - which could put the company on a collision course with the Metas of the world, or the AI-first ad tech intermediaries looking to control the transaction layer in future ad campaigns.
“Think of this math problem,” Garfield said. If you’re a large brand, “you have to create X amount of assets in X times X amount of formats. And that can be video, can be still imagery, that can be 3D times the amount of languages. Most of these companies are global….think about that math formula and how many assets you have to produce just to maintain kind of the status quo. And so there has to be some level of automation in that process and efficiency that’s going to push us into that next stage. And we’re there - we’re laying that foundation.”
Ok, that’s the production side of things. The next step would putting all those assets into action. Is that Adobe’s role, or someone else’s? “We’re going to look back in three to five years and go, ‘okay, we’re there now.’ And we can talk about what being there means,” Garfield said.
“Today we’re mostly reactive on the creative side. So we push it out route. We really don’t know how it’s going to perform. Then we find out and maybe we make an adjustment. Maybe we don’t. [in the future] there’s going to be a lot of pre-scored content intelligence.”
That sets up an interesting potential tug of war. For more, listen to the full episode here: