It was just a few years ago that TV advertisements of prescription drugs had dropped off by 20 percent, as drugmakers were also cutting back on other types of direct-to-consumer advertising. Those days are over, though, according to figures provided by Kantar Media, a market research firm.

Drugmakers in 2014 spent $4.5 billion marketing prescription drugs, up from $3.5 billion in 2012. That's also up from the $2.5 billion drugmakers spent in 2000, or $3.39 billion in 2015 dollars when adjusted for inflation.

AD

AD

How about which drugs are being advertised the most to consumers? In 2014, two widely recognized erectile dysfunction drugs that have been on the market for more than a decade — Pfizer's Viagra and and Eli Lilly's Cialis — ranked among the top five, according to Kantar. Pfizer's advertising budget for its "little blue pill" has more than doubled in the past five years to $232 million, and the company notably started marketing directly to women in a new ad campaign that drops the long-running innuendo associated with its groundbreaking product.

Other highly advertised drugs included Humira, a rheumatoid arthritis treatment; Lyrica, a treatment for pain caused by nerve damage; and Eliquis, an anticlotting drug approved in December 2012.

Still, spending on direct-to-consumer ads is just a fraction of what the pharmaceutical industry spends marketing directly to health-care providers to prescribe their products. For instance, when drugmakers' direct-to-consumer marketing dropped to $3.5 billion in 2012, the firms spent $24 billion promoting their wares directly to doctors. That method of advertising is finally starting to become more transparent , thanks to new federal requirements.

The United States is just one of a few countries that allows drug companies to advertise directly to patients, and the practice really escalated in 1997 after the Food and Drug Administration relaxed federal rules. In some ways, it's not surprising that advertising is back on the upswing. The economic recovery is here, millions more have obtained health insurance, and 2012 and 2014 saw high rates of new drug approvals from the FDA.

AD

AD

TV is also playing a greater role in how drug marketers make their pitches directly to patients. In 2011, television accounted for 52.6 percent of pharma's direct-to-consumer advertising dollars — in 2014, it was 61.6 percent. And last month, Super Bowl viewers saw the following ad for a new toe-fungus prescription medication that featured a cartoon toe indeed defeating toe fungus on the football field.

So that means, at least in the meantime, we'll be bombarded with more images of cartoon toes playing football and couples inexplicably sitting in separate bathtubs on the beach, complemented by disturbingly long lists of side effects.