ArticleOnline journal of public health informatics2026
Tweets Surrounding Pharmaceutical Drug Brands With Top Direct-to-Consumer TV-Advertising Budgets: Social Media Listening Study.
Article in Online journal of public health informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
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Abstract
Background: Direct-to-consumer (DTC) pharmaceutical advertising allocates billions annually in the United States; however, the analysis of conversations on social media about DTC drugs remains sparse. Twitter (subsequently rebranded X) is serving as a forum for pharmaceutical companies, their constituents, and social media health influencers to discuss topics related to DTC drugs with high advertising budgets. Objective: This study aims to examine user-generated topics discussed for the highest-budgeted DTC pharmaceutical drugs and to identify the agenda-setting themes and uses and gratifications that emerged. Methods: This social media listening study used Brandwatch to analyze Twitter conversations (August 2021-August 2023) surrounding top-budgeted DTC brands from 2020 to 2022. A dataset of 44,700 mentions from 26,800 unique authors was analyzed for content, sentiment, and thematic relevance using agenda-setting and uses and gratifications frameworks. Results: Four dominant themes emerged: (1) patient experiences/testimonials, (2) drug pricing/insurance concerns, (3) pharmaceutical news, and (4) advertising commentary. The content shows a range of potentially agenda-setting topics, including pharmaceutical companies, their DTC drugs, patient experiences, costs, insurance, and advertising commentary. The uses and gratifications we found included information, entertainment, economic benefits, and social benefits, with information being the most prevalent. Conclusions: Our study provides an important glimpse into what is being discussed on Twitter by, with, and about pharmaceutical drugs that spend billions on advertising each year [1]. Although more tweets were neutral than positive or negative, the overall sentiment of the top terms was negative. The predominance of negative sentiment in our findings suggests that many social media users express apprehensions or criticisms about these drugs, highlighting the need for improved communication, transparency, and engagement strategies. Further implications are also discussed surrounding public policy and industry practice. Suggested future research directions include NodeXL network analysis and qualitative inquiry into user motivations.
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