Drug advertising in Brazil

DOI: 10.14393/SN-v36-2024-72114x Received: 17 January, 2024 | Accepted: 15 April, 2024 | Published: 04 July, 2024 Papers Drug advertising in Brazil João Henrique Santana Stacciarini1 Keywords Marketing Pharmaceutical sector Pharmaceutical companies Abstract Researchers from various scientific fields have been dedicated to investigating the multiple characteristics of the pharmaceutical sector. Aiming to contribute to this debate and provide a basis for discussion, this study set out to analyze the history and current context of drug advertising in Brazil. Through an extensive collection of data and information, it was noted that the pharmaceutical sector is among the largest investors in marketing in the country. In the last few years, three or four pharmaceutical companies have appeared on the list of the ten biggest advertisers in Brazil, some of which have invested more than R$1 billion in a single year. A brief historical review of pharmaceutical marketing in the country has revealed the presence of several deceptive advertisements since the beginning of the 20th century. These included cases in which harmful substances, such as cocaine, were promoted as remedies for various illnesses and ineffective medicines were presented with unfounded promises of cures for diseases. Nowadays, advertising and marketing strategies have become increasingly complex and sophisticated. Multi-million dollar studies and sponsorships have ensured the insertion of advertising on several platforms, especially television and the Internet. The emergence of digital marketing strategies, driven by improved algorithms, social networks and influencers, along with advertising campaigns that are potentially harmful to public and collective health, highlight a challenging scenario. 1 1 Universidade Federal de Goiás -UFG, Goiânia, GO, Brazil. joaostacciarini@hotmail.com Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI INTRODUCTION Throughout the last century, pharmaceutical industry has experienced substantial growth, establishing itself as one of the largest in the modern economy (Stacciarini, 2023). In 2022, the global revenue generated by companies in this sector reached approximately 1.48 trillion dollars (Statista, 2023b). Such expansion stems from a variety of factors, ranging from scientific advances, socio-cultural and economic transformations, as well as the development of strategies to increase the sale of medicines (Stacciarini, 2023). Among these, pharmaceutical marketing stands out for its emblematic nature. After all, is it possible to harmonize commercial objectives with the ethical use of medicines, in the face of pharmaceutical companies' relentless pursuit of growth and profit maximization? Or is drug marketing, as in other sectors, just a tactic to stimulate sales and guarantee higher corporate profits? In a society where consumption is the central economic driver (Stacciarini et al., 2020), marketing is becoming more and more influential (Dantas, 2010; Rabello; Camargo Júnior, 2012). Viewed from an economic perspective, the justification for developing, producing on a large scale, obtaining sales authorization and keeping a product on the market is intrinsically linked to its ability to convince consumers of their needs, thereby completing the cycle of sales and profitability. In this context, advertising has emerged as a key element in the success of these large companies, sometimes even preceding the production phase (Santos, 2000). A notable example is the US company Amazon, which in 2022 invested approximately 20 billion dollars in marketing (Johnson, 2023), the equivalent of around 54.8 million dollars a day, with the aim of promoting the "importance" of its products globally. In the pharmaceutical sector, medicines should require special treatment, as they are not just consumer products. Marketing in this sector faces a unique challenge: balancing competition and corporate profit, characteristic of any business, with the principles of health and wellbeing for society. However, this distinction is often not clear-cut. In several countries, including Brazil, pharmaceutical companies are criticized for allocating significant amounts of funds to advertising (Angell, 2005; Gagnon; Lexchin, 2008). Drug advertising in Brazil Based on these initial considerations, the goal of this paper is to present - to the best of our knowledge, in an unprecedented way - how companies in the Brazilian pharmaceutical sector have risen to be among the main investors in marketing in the country in recent years and, moreover, to explore the evolution and diversified set of strategies they have undertaken to promote their "products". METHODOLOGY A methodological approach was adopted to carry out this research, which has involved extensive data and information collection and analysis, with a specific focus on the national perspective (Brazil). The interpretation and subsequent discussion of these findings were enriched by dialog with a range of scientific bibliographical sources, including academic articles, books and systematic reviews. In order to retrieve and analyze old commercials from the pharmaceutical sector, the research used the Hemeroteca Digital Brasileira da Fundação Biblioteca Nacional (BNDigital, 2023), which is an institutional website of the Brazilian government dedicated to preserving digital collections from various institutions. Websites and archives of national television stations such as Record (2020), Sistema Brasileiro de Televisão (Brazilian Television System - SBT) (2021) and Globo (2022) were also consulted to obtain more recent marketing materials. Pharmaceutical company platforms aimed at communicating with shareholders and customers were consulted to obtain a comprehensive set of data and information on these companies' finances and market strategies (Cimed, 2022; Genomma, 2022; Hypera, 2022; EMS, 2023). The data gathered through Kantar IBOPE (Ibope, 2023) was crucial for mapping and analyzing the growth of investments in television marketing in the Brazilian pharmaceutical sector. In addition, information from the consultancy Meio & Mensagem (M&M, 2022), which specializes in marketing and communication market analysis, has helped to identify and evaluate the pharmaceutical companies that have been among the biggest investors in television marketing in Brazil in recent years. 2 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI Drug advertising in Brazil THE HISTORY OF DRUG MARKETING IN BRAZIL The use of marketing strategies to sell pharmaceuticals has a long and diverse history, and is not a concept that is exclusive to or originated in Brazil (Delorme et al., 2010; Lee et al., 2015; Applequist; Ball, 2018). However, in Brazil, the promotion of medicines also has an extensive history, with records dating back to the beginning of the 20th century (Bueno; Taitelbaum, 2008). Originally, in the absence of mass communication channels such as television and radio, drug advertisements were broadcast in newspapers, magazines and posters on public transportation means. This historical panorama overlaps with the period in which Brazil began its republican era. The country was experiencing a process of intense urbanization, with many migrating from the countryside to the cities (Schiffer, 1999). During this phase, access to public health services was scarce and knowledge of medicine was restricted to a minority of the population. It was in the midst of a nation whose political, state and legal infrastructure was still being formed that the first pharmaceutical companies emerged in the country, along with an increase in the import of pharmaceutical substances from abroad (Temporão, 1986). However, many of these new production and sales opportunities were linked to the unfounded promises of cures for many diseases, such as syphilis, for which "medicines" were offered with claims of therapeutic efficacy even before the discovery of penicillin (Figure 1). The lack of formal education and inadequate government regulation, which was often aligned with industrial interests, led to the dissemination of a misleading model for advertising and selling medicines. In this environment of misinformation and lack of medical and government support, dangerous products such as cocaine were advertised (Figure 1) and marketed as medicines (for coughs, pain and inflammation). Medicines advertisements were also reflective of the cultural values and norms of the time. Advertisements promoted natural conditions, such as "thinness" and stereotyped "female behavior" as serious medicals problems requiring intervention and treatment with "new" drugs (Figure 1). Headache pills were marketed as crucial tools for increasing the physical and mental energy of the "modern" individual, establishing a link between the use of these products and both personal and professional success. At the same time, women were often portrayed as "inquisitive" figures in the advertisements, encouraged to integrate medicines into their daily routines as "solutions". Figure 1 - Historical advertisements reveal long-standing drug marketing practices in Brazil, including questionable pharmaceutical products and the medicalization of socio-cultural issues. Source: BNDigital (2023). Elaborated by the author (2023). 3 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI Through the years, pharmaceutical marketing tactics for the Brazilian public have evolved considerably. Nowadays, television and the internet, with their vast reach and social penetration, have replaced the old methods (posters and printed newspapers) to become the main platforms for publicizing medicines. DRUG MARKETING TODAY The pharmaceutical sector's presence on Brazilian television, which used to be limited to commercial breaks, has expanded significantly in recent years, becoming part of the main content on the networks. Drug manufacturers and pharmacy chains, acting as fixed or sporadic sponsors, have invested large sums in television figures and media groups. This approach makes it easier to promote their products and messages in a way that is integrated into the programs, especially during peak viewing times. Seeking to increase the visibility and credibility of these products, it is common for hosts and media personalities to identify themselves as "successful users" of these medications (Stacciarini, 2023, p. 71). In 2021, SBT spent six million dollars (Mattos, 2021) to obtain the exclusive rights to broadcast the South American Football Championship, known as the "Copa América". Throughout the event, including the muchanticipated final between Brazil and Argentina at the Maracanã stadium, a significant amount of advertising from pharmaceutical companies was featured. The advertisement highlight of the final took place during the break in the first half of the game. The cameras focused on the channel's main narrator, who, taking advantage of the high audience, merchandised a medicine from the Brazilian pharmaceutical company EMS (SBT, 2021). As well as promoting the "Sominex sedative" (EMS), SBT also aired a commercial for "Pague Menos", a drugstore chain, in the same interval. When the match resumed, electronic panels around the pitch showed advertisements for the pharmaceutical company "Cimed" and again for "Pague Menos", both official sponsors of the Brazilian national soccer team (CBF, 2023). Even though the financial details of Cimed's merchandising, mentioned above, have not been revealed, information from Meio & Mensagem (M&M, 2022), a consultant specializing in marketing and communication market analysis in Brazil, reveals that EMS spent approximately 497 million reais on television advertising in Drug advertising in Brazil 2020. This investment placed the company in ninth position among the country's largest advertisers (Table 1). On its website, EMS points out that it has the "largest portfolio of medicines in Brazil", with around 500 products covering 96% of therapeutic categories. The company also claims to have the capacity to produce 1 billion boxes of medicines a year (EMS, 2023). The pharmaceutical company Cimed, meanwhile, emphasizes that sponsoring the Brazilian national soccer team has been a goal achieved and maintained since 2016 (Cimed, 2022). The company reports that 65% of its production is based on "Over the Counter (OTC)" drugs, sold without a prescription, and therefore considers marketing to be essential to boost its sales (Cimed, 2022). Cimed also sponsors other sports in the country, including volleyball, basketball and motor racing. In 2021, the company also began sponsoring "Real E-Sports" in the "Brazilian Free Fire League", one of today's most popular electronic games (Cimed, 2022). The pharmaceutical company's substantial investment in marketing seems to be paying off. In its 2022 report, Cimed reported an increase in sales three times greater than the sector average and claims to be the national sales leader in the OTC (Over-the-Counter) medicines segment. Additionally, the company reports having experienced an annual growth of about 25% from 2018 to 2020, reaching annual gross sales of more than R$2 billion and a net profit of R$320 million (Cimed, 2022). Despite appearing straightforward and with genuine scripts, many pharmaceutical advertisements require extensive research, investment and sophisticated techniques in their production. One example is the campaign for the drug "Next", aimed at cold and flu symptoms. This campaign was developed with an advanced regional segmentation strategy, relying on a behavioral study carried out by IQVIA, a multinational health research company, and on an analysis by the Brazilian company called "Climatempo" on the impact of climate on flu patterns in different regions of Brazil (Genomma, 2022). As a result, in April 2020, several versions of the commercials were launched on Brazilian television (Record, 2020). Based on the research, one version was produced for national circulation and sixteen regional versions (Genomma, 2022). The national one featured a TV news anchor from each region of the country, while the local ones had presenters from regional newspapers. This method was used to intensify the cultural and regional impact, 4 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI Drug advertising in Brazil creating a familiarity with the pitch and addressing specific local issues related to the flu, linking them to the need for the advertised drug. To fund this elaborate production, which encompasses everything from research and marketing to journalists, recording studios, editing and distribution on national and regional broadcasters, a considerable investment was required. It is no coincidence that "Genomma Lab", a Mexican pharmaceutical laboratory and manufacturer of the drug Next, allocated more than R$1 billion for television advertising in Brazil in 2020, the year the commercial aired (Table 1). This amount placed the company as the secondlargest investor in advertising in the country that year, according to M&M (2022). A similar example of major investment in marketing comes from Hypera Pharma, a Brazilian pharmaceutical conglomerate that encompasses several laboratories and brands. Between 2017 and 2020, the company invested more than R$3.2 billion in television advertising in Brazil (M&M, 2022). In its quest for visibility through soccer, the country's most popular sport, Hypera Pharma acquired the naming rights to the Corinthians Arena in September 2020. The stadium was renamed "Neo Química Arena", a reference to one of the group's laboratories. The agreement, worth 300 million reais, will be paid out over twenty years (Laier, 2020). In May 2021, Neo Química also put its brand on the club's uniform, with a contract worth R$20 million a year until 2025 (UOL, 2021). With these agreements, areas of the stadium were renamed after drugs produced by the pharmaceutical company, such as Doril, Benegrip, Buscopan, Neosaldina, Epocler and Engov (Stacciarini; Stacciarini, 2022, p. 254). In addition, Hypera Pharma has maintained for five consecutive years (2018-2022) a sponsorship on Rede Globo's soccer broadcasts, one of the most expensive on Brazilian TV. The 2022 renewal cost the company R$307 million (Sacchitiello, 2021b), allowing merchandising of the drugs "Engov" and "Estonazil" during the broadcasts (Figure 2). In 2022, Hypera Pharma also invested R$11.8 million (Sacchitiello, 2021a) in a sponsorship of reality TV show "Big Brother Brasil". In this case, the company associated the names of medicines with segments of the program, such as the "Engov After Party" and the "Neosaldina knockout round", with product packaging decorating the sets. Figure 2 - Merchandising of Hypera Pharma's medicines on top-rated Brazilian television programs. Source: Globo (2022); Hypera (2022). Elaborated by the author (2023). Hypera Pharma's significant investment in television advertising in Brazil is strategic and has returned remarkable profits for the company. In recent years, Hypera Pharma has shown growth in several economic indicators, including direct-to-consumer sales, net profit, profit from continuing operations and net revenue (Hypera, 2022). In 2022, the company recorded a net profit of R$1.33 billion, an increase of 2.7% from the previous year 5 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI Drug advertising in Brazil (Carvalho; Rocha, 2022). In addition, the company has the highest revenue among pharmaceutical companies in Brazil (Stacciarini, 2023, p. 35). These examples are part of a wider trend of increased investment in advertising by the pharmaceutical sector in Brazil. According to data from Kantar IBOPE, a media analysis company that is part of the multinational WPP Group, there has been a 176.9% growth in the total invested in promoting pharmaceutical products (Figure 3) on Brazilian television in just seven years (Ibope, 2023). Figure 3 - Evolution of investment in television marketing by the pharmaceutical sector in Brazil (2012-2018) 12 10,8 10,3 10 Billions of reais (R$) 8,4 8,2 8 6 6 4,2 4 3,9 2 0 2018 2017 2016 2015 2014 2013 2012 Source: Ibope (2023). Elaborated by the author (2023). Besides the pharmaceutical sector's collective investment (illustrated in Figure 3), several companies within the sector have stood out individually for the significant resources allocated to their advertising campaigns. Table 1, based on data from Meio & Mensagem (M&M, 2022), revealed that in the last four years with available data (2017-2020), the pharmaceutical sector has managed to position three to four of its companies among the ten largest advertisers in Brazil. Some of these advertising investments have surpassed those of traditional Brazilian retail companies, such as beer, soft drink and household appliance manufacturers, as well as financial institutions with a wide national reach and telephone operators that serve thousands of cities and millions of users across the country. 6 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI Drug advertising in Brazil Table 1 - Significant presence of pharmaceutical companies in the ranking of the biggest investors in television marketing in Brazil between 2017 and 2020. 2020 2019 Millions Position / Name Millions (R$) Position / Name (R$) 1º Unilever 1,530 1º Genomma Lab 848 2º Genomma Lab 1,005 2º Unilever 810 3º Sky 888 3º Vivo 420 4º Bradesco 624 4º Divcom Pharma 408 5º Banco do Brasil 616 5º Hypera Pharma 384 6º Via Varejo 607 6º Banco do Brasil 350 7º Vivo 505 7º Coca-Cola 315 8º B2W 499 8º Bradesco 312 9º EMS 497 9º Lojas Marabraz 306 10º Hypera Pharma 476 10º Claro 293 2018 Position / Name 1º 2º 3º 4º 5º 6º 7º 8º 9º 10º Genomma Lab Hypera Pharma Unilever Ultrafarma Via Varejo Ambev Divcom Pharma Claro Vivo Caixa 2017 Millions (R$) 1.110 970 506 457 452 446 437 418 398 378 Position / Name 1º 2º 3º 4º 5º 6º 7º 8º 9º 10º Hypera Pharma Genomma Lab Unilever Ambev Procter & Gamble Divcom Pharma Claro Caixa Ultrafarma Via Varejo Millions (R$) 1.387 1.156 657 540 539 535 504 493 469 444 Pharmaceutical companies. Source: M&M (2022). Elaborated by the author (2023). The complete analysis of the period described in the table shows that "Genomma Lab" and "Hypera Pharma" stood out as the first and third largest investors in marketing over these four years. The Mexican pharmaceutical laboratory Genomma Lab devoted around R$4.1 billion to advertising, an amount that earned the company first place on two occasions and second place on two others. Hypera Pharma, a Brazilian pharmaceutical company, led the ranking in 2017 and remained in the top ten in the following years, with a total investment of approximately R$3.2 billion in the period. These figures reinforce the perception that the pharmaceutical sector sees advertising as a vital tool for boosting sales and increasing profits. The substantial investment in marketing by these companies reflects a clear strategy to reinforce the presence and consumption of their products (medicines) on the market, thus leveraging their financial results. INTERNET, ARTIFICIAL INTELLIGENCE (AI) AND EVOLUTION IN QUALITATIVE PHARMACEUTICAL MARKETING Along with quantitative growth, the development of technologies associated with computing and the internet, such as artificial intelligence, has led to advances in qualitative marketing. This progress translates into increasingly customized, precise and targeted strategies. Just as it was with the popularization of radio and TV, where viewers were inevitably exposed to a plethora of advertisements, the internet is now full of strategically designed and targeted advertising to reach the most appropriate consumers. Artificial Intelligence (AI) algorithms work as effective tools for analyzing and correlating large amounts of data and information, in a much more advanced and accurate way than human capabilities (Lee, 2018). Every search on online search engines, clicks on news, views on 7 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI Drug advertising in Brazil media channels, interactions on social networks and visits to online stores are monitored. The more people use the internet, the more sophisticated the analytical computing skills become to identify our patterns of preferences and recommend content, products and services that are in line with our consumer tendencies. Empowered by these technologies and driven by an environment where access to the internet is increasingly common, "digital pharmaceutical marketing" has been progressively integrated into our daily routine (Liang; Mackey, 2011). Searching for a simple symptom, such as a headache, on search engines like "Google" or looking for videos of doctors discussing such symptoms on video-sharing platforms like "Youtube", quickly turns us into targets for discreet or explicit drug advertisements (Figure 4), which appear on our social networks, news sites, music platforms, among others, within the next few days. Figure 4 - Drug advertisements are increasingly popular on online platforms. Source: Instagram (2022). Elaborated by the author (2023). The qualitative revolution promoted by algorithms and artificial intelligence also allows targeted promotion of medications based on a series of variables, such as age, gender, economic status, level of education, geographical location, among others (Lee, 2018). For example, using social media data, a company can target ads for menstrual cramps to women, painkillers to young workers, flu remedies to mothers with young children, sexual stimulants to middleaged men, vitamins to the elderly, and so on. The growth in visibility provided by the advance and diversification of social networks has also paved the way for an increasing number of "internet personalities", such as digital influencers, bloggers and content creators, who are being paid to promote content, directly encouraging their "followers" to buy certain products (Stacciarini, 2023, p. 85 - 87). In Brazil, this phenomenon is intensified by the fact that its population is one of the most engaged in social networks globally. According to research, the country is the fifth largest in terms of active users, with 165.5 million (Statista, 2023a), and ranks second in terms of average daily time spent on these platforms, with an average of 3 hours and 42 minutes a day, equivalent to 56 days a year (Sortlist, 2022). Within the pharmaceutical sector, this new form of online "merchandising" has allowed many internet users, recognized as "celebrities" to different degrees, to receive payment for posting photos or videos promoting pharmaceutical companies and their products (Stacciarini, 2023, p. 85 - 87). Often, these personalities emphasize the advantages of these products and position themselves as satisfied consumers of certain drugs. This marketing approach in the pharmaceutical sector is not limited to the Brazilian context, but is also present in many other countries. One notorious example has involved American influencer and celebrity Kim Kardashian, who is among the personalities with the most followers on Instagram (2022). In August 2015, Kim was forced to delete a post on her social network where, during her pregnancy, she advertised and recommended a remedy for morning sickness from the Canadian pharmaceutical company Duchesnay (Sullivan, 2015). The Food and Drug Administration (FDA), the federal agency of the US Department of Health responsible for approving and overseeing drugs, had argued that the advertisement was misleading, as it highlighted the effectiveness of the drug without mentioning 8 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI the risks associated with its use, as well as failing to inform that it was not indicated for women with sensitivities to certain drugs (Wasserman, 2015). At the time, Kim Kardashian had around 42 million followers on Instagram and 34 million on Twitter (UOL, 2015). Statistics and analyses highlight the profound and expanding impact of online advertising, creating a complex market scenario characterized by substantial financial movements and extensive influence on the public. Exaggerations, which were previously associated with more traditional media such as radio and TV, now seem to be amplified in a fragmented environment such as the Internet. This situation is particularly concerning in delicate sectors such as pharmaceuticals, which involve critical public and individual health issues. Additionally, many collaborations and agreements between companies and digital influencers take place informally, leaving the public unaware of the payments or benefits linked to the promotional content. This practice places internet users in a vulnerable position, making them more likely not to realize the true intentions behind a drug or pharmaceutical company recommendation. CONCLUSIONS This research investigated the use of drug advertising in Brazil. The debate began by exposing the role of advertising in the reproduction of corporate profits in the contemporary context. Although medicines are not common consumer goods, susceptible to the logic of consumerism, pharmaceutical companies invest heavily in marketing aimed at consumers. In Brazil, it was discovered that the pharmaceutical sector stands out as one of the biggest investors in marketing, with several companies leading the ranking of individual spending on advertising. A brief historical review of pharmaceutical marketing in the country has revealed the presence of several deceptive advertisements since the beginning of the 20th century, including cases in which harmful substances, such as cocaine, have been promoted as remedies for various ailments, and ineffective drugs have been disseminated with unfounded promises of cures for diseases. Drug advertising in Brazil While in the past, posters, leaflets, radio and printed newspapers were the main means of advertising, today television and the internet are dominating the scene. It was revealed that between 2012 and 2018, investment in pharmaceutical advertising on Brazilian television rose by 176.9%. In the last four years with available data (2017-2020), between three and four pharmaceutical companies were among the top ten advertisers in Brazil, surpassing even traditional retail companies. As the internet has advanced, pharmaceutical marketing has undergone qualitative changes, incorporating algorithms and artificial intelligence. A simple search for a symptom on search engines such as Google can lead to drug advertisements. In addition, celebrities, acting as digital influencers, are now endorsing medicines, often positioning themselves as successful users of the promoted products. Although the regulation of drug advertising in Brazil dates back to the 1930s, under the government of Getúlio Vargas, and several entities and laws have been established to modernize supervision (Brasil, 1931; 1976; 1999; 2008), inspection and punishment are still restricted. Frequently, inspection takes place only after the infraction has occurred, exposing the population to risks; the fines imposed are small compared to the companies' profits and advertising investments, and the mandatory warning "if symptoms persist, a doctor should be consulted" encourages self-medication, suggesting seeking a doctor only after using the medication (Fagundes et al., 2007; Soares, 2008; Nascimento, 2009; Araújo et al., 2012). The analyses and observations of this research indicated a clear incompatibility between the current advertising approach for medicines, which is exaggerated and distorted, and the responsible use of pharmaceuticals. Billion-dollar investments in marketing contribute to higher drug prices and encourage self-medication. The downplaying of side effects in advertisements prioritizes consumption over the dissemination of pertinent information, often replacing the advice of health professionals. These findings and reflections stress the complexity of pharmaceutical marketing, the power of its main companies and the sometimes questionable business model adopted in the pursuit of increasing sales and maximizing profits, often at the expense of public health and collective well-being. 9 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513 STACCIARINI REFERENCES ANGELL, M. The Truth about the Drug Companies: how they deceive us and what to do about it. (2005). New York City, United States: Random House Trade, 2005. 319 p. APPLEQUIST, J.; BALL, J. G. An Updated Analysis of Direct-to-Consumer Television Advertisements for Prescription Drugs. 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Available: https://www.fiercepharma.com/regulatory/upd ated-kim-kardashian-instagram-post-landsduchesnay-fda-hot-water. Accessed on: oct. 06, 2023. AUTHORS CONTRIBUTION João Henrique Santana Stacciarini: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Visualization, Writing - original draft, Writing review & editing. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Soc. Nat. | Uberlândia, MG | v.36 | e72114| 2024 | ISSN 1982-4513