In Pharma, Anything Older Than Two Years Is Ancient History –

If you’re still citing 2021–2022 benchmarks to plan your DTC pharma budgets, you’re making decisions with yesterday’s map. In just 24 months, TV inventory changed, streaming exploded, rules tightened, cookies unraveled, and patient economics shifted. Here’s what’s new—and why any DTC data older than two years belongs in the recycling bin.

1) The spend and mix have shifted—fast

Pharma poured more than $10.1B into Rx advertising in 2024, with the top 10 drugs alone at $3.3B across channels. On TV, the top-10 brands spent $2.13B in 2024, up from $1.94B in 2023. And in 1H 2025, national TV spend hit $2.97B, up 12% YoY—fueled in part by GLP-1s. MediaRadarFierce Pharma+1EMARKETER

The category mix inside that spend also changed. Wegovy, Zepbound and other GLP-1s were among the heaviest TV investors in 2024–2025, with Wegovy alone topping ~$40M in June 2025 TV spend. Month to month, GLP-1s have swung rankings—and budgets. Fierce Pharma+1

Bottom line: Pre-2023 spend ratios won’t predict 2024–2025 behavior for your category.

2) Streaming inventory (and risk) look nothing like 2022

Prime Video turned on ads on January 29, 2024, adding a massive new addressable TV surface area. Streaming’s share of pharma impressions is still smaller than linear, but it’s now a must-buy for incremental reach and frequency control. streamtvinsider.comPCWorld

With that growth comes risk: invalid traffic (IVT) on open-programmatic CTV has been measured between ~19% and 24% across 2024–Q4 2024 reports. If your CTV measurement didn’t account for this in 2024–2025, your lift and reach numbers could be inflated. Pixalate+1

Bottom line: Your 2022 “CTV benchmarks” are obsolete; the marketplace and fraud profile are different now.

3) The rulebook changed—and so must your creative

FDA finalized the DTC TV/radio “major statement” rule—clear, conspicuous, and neutral risk info—effective Nov. 20, 2024. If your ad testing predates this compliance date, your attention and recall benchmarks won’t translate. Federal Register

HIPAA tracking guidance also evolved. HHS OCR updated its tracking-tech bulletin in March 2024, and a federal court vacated key parts in June 2024—but scrutiny remains. If you’re still operating on 2022 interpretations (or using pixels the same way), you’re out of date on both risk and permissible measurement. American Hospital AssociationHHS.gov

Bottom line: Creative, disclosures, and digital instrumentation from 2022 don’t reflect the 2024–2025 compliance reality.

4) The cookie crumble took a turn

Many teams planned for third-party cookie deprecation in 2024. Then the UK CMA said Google wouldn’t proceed with cookie deprecation “as originally envisaged,” and Google pivoted toward user-choice controls instead. Planning and attribution frameworks that assumed a 2024 cookie cutoff now need revisiting. Salesforce Bengroas.ai

Bottom line: If your 2023–2024 roadmap assumed a hard cookie end-date, re-validate your targeting and MMM inputs.

5) Patient affordability rules reset demand curves

Starting January 1, 2025, Medicare Part D out-of-pocket costs are capped at $2,000/year, with ~11 million beneficiaries expected to hit the cap. That changes price sensitivity, adherence, and abandonment assumptions—especially for specialty categories. KFFCenters for Medicare & Medicaid Services

Bottom line: Pre-cap adherence and elasticity data are the wrong priors for 2025 planning.

6) Consumers still see the ads—and act on them

In January 2025, 97% of U.S. adults reported seeing Rx ads, 53% almost daily. 18% spoke to a doctor because of an ad; among those, 50% received the requested Rx, and 56% discussed cost. 74% say they pay close attention to side-effect disclosures. This is current consumer behavior, not a 2018 snapshot. KFF Files

Bottom line: Fresh polling proves DTC still triggers clinical conversations—measure those 2025 pathways, not 2016 ones.

What to do now (practical moves)

1. Adopt a “Two-Year Rule.” Refuse to base plans on DTC data older than 24 months. Update your category baselines with 2024–2025 iSpot/Kantar/MediaRadar reads and keep them rolling quarterly. Fierce PharmaMediaRadar
2. Rebuild TV/CTV mix models. Incorporate Prime Video inventory and platform-specific performance. Adjust for CTV IVT and run publisher whitelists; require MRC-accredited SIVT filtering. streamtvinsider.comPixalate
3. Re-test the creative to the FDA’s 2024 standard. Shorter cuts, dual-message variants, and explicit risk clarity. Any lift study from pre-Nov 2024 should be treated as directional only. Federal Register
4. Shift measurement to durable signals.
   • Use retail media clean rooms (e.g., CVS Media Exchange) for closed-loop Rx outcomes and audience refinement. Commonwealth FundModern Retail
   • Where appropriate, pair TV exposure with claims data through validated partners (e.g., iSpot + IQVIA Digital) to quantify incremental scripts. iSpot
   • Run geo-based experiments and MMMs that explicitly model the 2025 Part D cap impact. KFF
5. Plan for policy volatility. Legislative chatter about restricting DTC pops up regularly; ensure you have non-branded disease education, HCP activation, and owned-channel content ready if rules tighten. Financial Times

Healthcare and media moved more in 24 months than they did in the prior five years. Budgets, channels, creative rules, cookies, and patient out-of-pocket dynamics are all different now. Treat any DTC dataset older than two years as a red flag—and rebuild your plan with 2024–2025 sources, methods, and assumptions.

Sources: iSpot/Kantar/MediaRadar trend reports and coverage; FDA final rule (Nov 2023) with Nov 20, 2024compliance; HHS/OCR tracking-tech updates and court action (2024); CMA + industry updates on Google cookie policy (2024–2025); CMS/KFF on the 2025 Part D $2,000 cap; KFF Jan 2025 DTC ad polling. Fierce Pharma+1Federal RegisterAmerican Hospital AssociationHHS.govSalesforce BenKFFCenters for Medicare & Medicaid ServicesKFF Files

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