Pharmaceutical Industry Pay‐Per‐Click Advertising Strategies to Influence Public Opinions on Drug Pricing

This analysis characterizes the magnitude, timing, and keyword targeting strategies of the Pharmaceutical Research and Manufacturers of America's (PhRMA) pay-per-click advertising expenditures and their relation to major drug pricing policy developments (2019-2025). Pay-per-click advertising allows advertisers to purchase prominent placement in search engine results, allowing their content to appear above organic results when users search for specific terms. We extracted pay-per-click advertising data from Semrush, a commercial digital marketing intelligence platform, for the domain www.phrma.org from February 2019 through December 2025. We classified keywords into mutually exclusive categories using a specificity-based pattern-matching algorithm and categorized landing-page URLs by content theme using URL string matching. We analyzed monthly spending against a timeline of major legislative and regulatory events. PhRMA spent an estimated $58.8 million across 283,517 keyword instances, generating 17.1 million paid visits to phrma.org and its subdomains. Insurance and health plan keywords dominated spending ($32.4 million; 55.1%), including general and non-health insurance terms. Nearly half of total expenditures (47.5%; $27.9 million) drove traffic to pages classified as criticizing pharmacy benefit managers. Monthly spending showed little linear association with the selected Google Trends index (r = -0.05), but spending surged around well-publicized US legislative and regulatory actions, peaking at $4.8 million in May 2023; March-September 2023 accounted for 36.5% of total spending. Overall, PhRMA pay-per-click spending surges coincided with major US drug pricing policy developments.