Researchers from Johns Hopkins University recently published an article in JAMA that highlights rising concern around the effects of direct-to-consumer advertising (DTC) on health care. Their work shows that DTC advertising might have direct harm on patients. They studied drug characteristics and total advertising expenditures for the 150 top-selling branded prescription drugs in the United States, finding that total promotional spending by the manufacturer was associated with a significantly lower added clinical benefit for the drug. In fact, companies spent nearly 15% more on DTC advertising for drugs that had demonstrated lower added benefit. Even more troubling, each 1.5% increase in spending was associated with a 10% increase in sales. Simply put, pharmaceutical companies spent more money on DTC advertising when medical research found that the drug was less effective, and this spending directly led to more sales for those inferior drugs. The U.S. is one of only two countries in the world that still allows direct-to-consumer advertising. Aside from increased pressure on providers to prescribe particular drugs which may not be the best option, there are other downsides to DTC. The data show that DTC advertising leads to increased drug costs overall, adding to the already skyrocketing costs of medical care in America. Additionally, DTC advertising tends to reduce use of generic medications, which are often equally effective but significantly cheaper for patients.