The data: Between 2022 and 2024, Novo Nordisk spent about $7.5 million to have Ozempic ads run on related search keywords to drive users to its prescription drug brand website, according to a JAMA Network Open study.

• Novo spent the $7.5 million across 15,000 paid keywords related to weight loss, which generated 2.4 million paid visits to Ozempic.com.

Zooming in: A big portion of Novo’s keyword spending went directly to weight loss terms and phrases. Meanwhile, many of the keywords made no mention of Ozempic, while others linked to competitors’ drugs.

• Novo spent around $500,000 on search terms such as “Ozempic for weight loss” and “Ozempic weight loss.”
• But of the 15,000 keywords Novo spent on, 3,500 (23%) did not reference the word Ozempic.
• More than 1,000 keywords included “Trulicity,” and over 600 keywords included “Mounjaro”—both of which are Eli Lilly medications to treat type 2 diabetes.

Why it matters: Pharma companies can bid to advertise on search keywords unrelated to their drugs, as well as product-related keywords their medications aren’t FDA-approved to treat. Ozempic, for instance, is approved to treat type 2 diabetes, but not obesity (though it’s commonly prescribed off-label for weight loss).

In short, some drugmakers might be getting away with pay-per-click drug advertising that promotes their product for off-label use. This is prohibited by the FDA, though the regulator pays more attention to drug ads on TV and the internet broadly than sponsored search ads. Search ads promoting non–FDA-approved uses could have major implications, as consumers most often use search engines (82%) to begin their online health queries, per EMARKETER’s December 2024 Digital Health survey. For example, it could increase the likelihood that consumers start conversations with their doctors and get an off-label prescription, the study’s researchers suggested.

Novo countered that while it bids on keywords, Google and other search engines use tools to match keywords to user queries, per STAT. Novo said it doesn’t pay for exact keywords and terms cited in the study, and noted that it can’t predict every user query.

What it means for pharma marketers: The $7.5 million spent by Novo is a drop in the bucket for a Big Pharma company, and Novo’s competitors and other large drugmakers likely engage in similar activity.

However, drug marketers should anticipate stricter FDA scrutiny as the government intensifies overall oversight of direct-to-consumer pharma ads. Given that pharma companies devote about 56% of their annual digital ad spend to search—the second-highest share of any sector we forecast—marketers should work with search platforms to better align paid keywords with appropriate drug ad placements.