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The Rise of the Pharma Influencer

False diagnoses and bad drug recommendations are now just a few hashtags away, new research warns

“Are you struggling with ADHD?” 

“Can’t keep the weight off?” 

“Do you need help taking a shit?” 

If you’re on Instagram or TikTok, you’re likely familiar with influencers hustling every type of drug under the sun. Now, researchers are examining how pharmaceutical companies partner with patients who are willing to share their experiences with their followers and help give the drugs more credibility. 

“This is a growing phenomenon, but there is virtually no research on it and very little regulation,” Erin Willis, an associate professor of advertising, public relations and media design at the University of Colorado, said in a press release. “Is it going to help patients be better informed? Or is it going to get patients to ask their doctors for drugs they don’t really need? We just don’t know, because no one has studied it.”

In order to set “forward a research agenda,” Willis and Marjorie Delbaere, a professor of marketing at the University of Saskatchewan, reviewed 88 existing articles on current industry regulations and practices, and parsed together information about the potential impact on consumers. In doing so, they concluded that influencers are “the next frontier in direct-to-consumer pharmaceutical marketing.”

Direct-to-consumer marketing has been an issue ever since the 1980s when commercials for boner pills and Zoloft first graced our TVs. Willis and Delbaere’s paper argues that this, along with the rise of internet-aided self-diagnosis, has created a culture of patients who tell their doctors what is wrong with them and what drugs they need, as opposed to the other way around. And amazingly, up to 44 percent of doctors oblige these medication requests.

“It’s a lot like what we used to see with doctors and pharmaceutical companies,” Willis explained. “Only now it’s patients using social media to advocate for disease awareness, and in some cases, pharmaceutical medications.”

As for when these ads made the jump from TV to Instagram, Willis and Delbaere think it started in 2015 after a pregnant Kim Kardashian posted about how the drug Diclegis helped treat her morning sickness. “It’s been studied, and there’s no increased risk to the baby. I’m so excited and happy with the results,” she wrote, before the post was removed after the Food and Drug Administration flagged it for failing to disclose risks.  

Seven years later, the Federal Trade Commission has instituted some regulations — e.g., influencers are now required to use hashtags like #ad or #sponcon to inform followers that they’re being paid to post. The FDA has done the same, but Willis warns that such rules can be loosely interpreted and difficult to enforce — especially now that drug companies have pivoted to micro-influencers or “patient advocates,” who have comparatively smaller followings and fly under the radar more easily. 

While Willis is concerned about the claims of some of these influencers, she pointed out that there can be some crowd-sourced oversight — provided, of course, the influencer doesn’t turn off the comments section. “If an influencer recommends a drug, there is an entire community of voices that get to weigh in on it and support it or share their negative experiences,” she said. 

For a forthcoming study, Willis has interviewed dozens of pharma influencers and has found that only a small number are paid to post, whereas others post in exchange for free trips to conferences, or in some instances, to sit on advisory boards. That said, some influencers she’s spoken to are advocates who are posting for free. 

“They all say they’re really doing this so that other patients have information and can have a better life,” she concluded. “There is both value and risk in this growing trend and, like anything, it has the potential to become dangerous if we’re not careful.”