Google Ad Policies for Pharmaceutical Companies

• According to Google’s policies, certain content that’s related to healthcare and medicine can be advertised only when the pharmaceutical company has been approved by Google as a “certified healthcare-related advertiser”. Certified companies can target ads in approved countries alone. Companies would also have to abide by country-specific regulations apart from Google’s general ad policies.

• Details on the country-specific restrictions for pharmaceutical companies can be accessed here.

• Google allows pharmaceutical companies to advertise prescription drugs only in the United States, New Zealand, and Canada while over-the-counter drugs can be promoted in over 24 countries, which are the United States, the United Kingdom, Sweden, Spain, South Korea, Slovakia, Russia, Poland, Norway, New Zealand, Netherlands, Mexico, Japan, Italy, India, Hong Kong, Germany, France, Czech Republic, China, Canada, Brazil, Austria, and Australia. Medical professional suppliers and bulk drug manufacturers are allowed to advertise in Canada and the United States alone.
• Google Ads closely monitors any prescription drug that is being promoted by a certified healthcare-related advertiser. A list of the prescription drugs that Google Ads monitors can be accessed here.

• While advertising online pharmacies is restricted in general, Google allows their promotion only in specific countries including the United States, the United Kingdom, Taiwan, Sweden, Slovakia, Portugal, Norway, New Zealand, Netherlands, Mexico, Japan, Hong Kong, Germany, Denmark, Czech Republic, China, Canada, Brazil, Austria, and Australia.

• Google approves the promotion of an online pharmacy after reviewing the content of the ad/app/site along with the services and products it offers. Online pharmacies are also required to be certified by Google in order to promote their products through Google Ads. To qualify for Google’s certification, online pharmacies would have to be “registered with the relevant pharmaceutical authorities in the countries that their ad campaign targets”.

• Google has separate policies for specific products and services such as birth control and clinical trials. While the promotion of birth control products are allowed in many countries such as Canada and the United States, Google does not allow birth control ads in several countries including Yemen, United Arab Emirates, Ukraine, Tunisia, Thailand, Syria, Saudi Arabia, Qatar, Palestinian Territory, Oman, Morocco, Libya, Lebanon, Malaysia, Kuwait, Jordan, Iraq, Iran, Hong Kong, Egypt, Djibouti, China, and Bahrain. Where addiction services are concerned, Google allows the promotion of such services in the United States alone.

• Pharmaceutical manufacturers and companies tend to face challenges mainly with personalized advertising content. Google’s personalized advertising policy states that marketers cannot serve advertisements that fall under the category of sensitive interest such as belief, identity, and personal hardship. Pharmaceutical advertisers who come under this category are restricted from using several features such as in-market audiences, remarketing, demographic targeting, and similar audiences.

Healthcare-Related Advertiser Certification

• Pharmaceutical manufacturers, online pharmacies, and other companies that are seeking to utilize prescription drug terms in their landing pages or ad text would have to first be certified by Google.

• Pharmaceutical companies can apply for the certification by filling out Google’s online form which can be accessed here. Pharmaceuticals would need to ensure they adhere to the country-specific regulations along with additional requirements for the countries where their ad campaigns will be targeted.
• For the certification process, pharmaceutical companies would need their Google Ads customer ID, a copy of their pharmaceutical license with a 'Pharmaceutical Manufacturer Authorization Letter' if applied by an agency, and a website URL.

Restricted Substances

• Google has developed a list of prohibited pharmaceutical drugs and supplements that are not allowed to be advertised regardless of any legal claim. Some unapproved substances include products that contain human chorionic gonadotropin (hCG) and ephedra, drugs that have received regulatory or government warning, and products with misleading claims.

• Pharmacies that advertise unauthorized products will be considered as egregious and may be suspended. Violation of this policy would include, but not limited to, targeting ads in unlicensed locations, promoting unauthorized content, or providing prescription medicine without a prescription. Apart from account suspension, violation of Google Ad policies can lead to ad disapproval, compliance review, and disabling the company’s remarketing list.

Use of Ad Words in Pharmaceutical Ads: Policy Change in February 2010

• "Towards the end" of February 2010, Google implemented a policy change that began to allow certain kinds of pharmaceutical ads to get displayed on Google search results. However, only products or services from VIPPS and CIPA certified pharmacies would be allowed to benefit from such an advertisement. Google AdWords began to accept ads from online pharmacies within the United States that were accredited by the National Association Boards of Pharmacy VIPPS program, as well as from online pharmacies within Canada that were recognized or authorized by the Canadian International Pharmacy Association (CIPA.)
• This policy change allowed pharmacies to only target ads within their countries. Thus, pharmacies were allowed to target ads in any country in which they have accreditation. However, this policy change did not affect online pharmacy policies functioning in countries outside the United States and Canada.

2015 Scanning Electron Microscopy (SEM) Policy for Paid Search Advertisements

• On July 20, 2015, "Google's Black Box Ad Format" was removed for changes that were in the pipeline that affected Google's URL infrastructure. Google's original Black Box Ad Format had the following restrictions.
• The Black Box Ad Format served as health risk disclaimers. It mandated some drug labeling as well as advertising to have the "boxed" or "black box" warnings, which indicated concerns for conditions that may develop or be associated with the drug that could lead to death or serious injuries.
• The black box formats now had to conform to the requirements of Google's standard text ad unit. The standard text ad unit was not required to display the entire FDA-recommended disclaimer, which used to be the last line in the previously used Black Box Ad Format.
• The new disclaimer format required by Google utilized the drug name, the active ingredients in the drug, and details of the side effect of the drugs coming immediately after the top-level domain (TLD), as shown in the attached format.

Google Advertising Policies Begin to Reference/Recognize .Pharmacy TLD in 2016

• In 2016, the National Association of Boards of Pharmacy (NABP) announced that "Google now recognizes the .pharmacy" top-level domain (TLD) as sufficient requirements for pharmacies as well as related entities to advertise online.
• In June 2016, Google's advertising policies relative to health care and medicines began to specifically "reference the .pharmacy TLD as meeting its requirements." This policy change meant that companies with the dot pharmacy (.pharmacy) top-level domain (TLD) would get automatically recognized as safe and legitimate.
• From June 2016, Google's policies were updated to recognize any website URL that ends with .pharmacy to be a safe and legitimate website and would be allowed to advertise online.

Google Ads Ban on Unproven Medical Products/Treatments in 2019

• In 2019, Google announced a new policy that prohibits most stem cell and gene therapies. Gene therapies and stem cells are products of some pharmaceutical companies, "including Novartis, Roche, Catalent, and Thermo Fisher."
• In line with its ethics and to maintain a trustworthy stance, Google decided in 2019 that it would no longer permit ads for "unproven or experimental medical techniques." Under this new healthcare as well as medicines policy, Google has prohibited advertising for treatments that lack scientific proof or have an insufficient biomedical and scientific basis. This policy bans most stem cell therapies and gene therapy and aims to cut down on ads for items like young blood transfusions as well as vampire facials.
• This policy change came as a response to the outcry over online marketing implemented by stem cell clinics that touted unapproved treatments for many ailments from joint pain to Alzheimer's disease. The outcry came as a result of opinions which felt that at best, many of these clinics were a waste of money and at worst, they were extremely dangerous.
• Other items banned by the policy include a list of unapproved substances such as those containing ephedra or human chorionic gonadotropin (hCG), which is used for weight control. Herbal and dietary supplements that contain active pharmaceutical and dangerous ingredients were also denied ad rights under this policy.

Overview

• Google has been forced to incorporate several government regulations into its policies because different countries/regions have taken different approaches to internet regulation.
• This has prompted Google's VP of Global Public Policy and Government Relations to call for “common rules of the road when it comes to the regulation of technology."
• Google believes that "comprehensive privacy legislation" would ensure consistency especially in the United States where "legislation could be fragmented due to various state-level laws."
• While Google has shown compliance for government laws, the company announced on July 2019 that it could not comply with the repressive censorship regulations of the Chinese government.
• Previously, Google had been working on a project dubbed "Project Dragonfly" that aimed to build an online search engine that would comply with the restrictive security measures put in place by the Chinese government.

Current Laws and Regulations

General Data Protection Regulation (GDPR)

• The GDPR was introduced in May 25, 2018, to replace the "1995 EU Data Protection Directive." The GDPR regulates how business operating within the members states of the European Union collect, store, and use personal data.
• According to Google, the company completely overhauled its privacy policy in May 2018 in what it called a “full product update” to reflect the GDPR regulations.
• The redesigned Google privacy policy now contains nine mentions Google users are able to export data as well as several sections explaining to users how they can delete their personal data.
• In line with the GDPR, advertisers and publishers using Google advertising and/or measurement tools globally must adhere to the EU User Consent Policy and it is a requirement that they should seek "consent from EEA users for personalized ads and use of cookies/local storage on their sites and apps."

Office of Foreign Assets Control (OFAC) Sanctions

• Google expects advertisers to comply with trade sanctions imposed by the OFAC. Advertisers have to agree not to cause Google to violate the terms stipulated by the OFAC.
• Accordingly, advertisers must not "use ads for or on behalf of restricted entities or individuals" and cannot use "ads for or on behalf of entities or individuals located in sanctioned countries or regions." Also, Google ad services are not available to restricted individuals or entities or those located in embargoed countries.
• Currently, Crimea, Iran, Cuba, North Korea, Syria, and Sudan are embargoed.
• Google started editing its privacy policy to incorporate the sanctions and regulations by the OPAC in 2012.

Future Laws and Regulations

California Consumer Privacy Act (CCPA)

• CCPA is a newly-introduced data privacy regulation that applies to business entities that seek to collect personal data from California residents.
• The CCPA was first published in October 2019 and will be effective as from January 1, 2020.
• According to Google, after the CCPA takes effect, California residents can opt out of "sale of their personal information" thanks to a link that states "Do Not Sell My Personal Information" that will be provided on the selling party’s home page.
• The CCPA applies to all businesses operating within or targeting individuals or entities within California. It has been incorporated into Google's "service provider terms."

Additional Information

• Apart from complying with trade sanctions, Google monitors advertisements to ensure that they comply with local legal requirements. Google expects advertisements to comply with any legal laws that are in place in the locales that their advertisements target.
• Google provides a tool that can be used by advertisers to determine the legal requirements of their target countries. However, Google cautions that it is the responsibility of the advertiser or publisher to research local policies to ensure that they comply with local laws.

• In 2019, healthcare and pharma search spend in the U.S. will reach $1.34 billion.
• The total digital spend for healthcare and pharmaceutical advertisers in the U.S. is expected to be $3.62 billion in 2019.
• The total spend for digital advertising in the U.S. in 2019 is expected to reach $82.8 billion.
• Healthcare and pharmaceutical digital advertising represents 4% of the total digital advertising market in the U.S.
• Healthcare and pharmaceutical search advertising represents 37% of digital healthcare and pharmaceutical advertising.
• The total global spend for digital advertising in 2019 is expected to reach $354.0 billion.
• Assuming healthcare and pharmaceutical digital advertising represents about the same percentage globally as it does in the U.S., this would mean the global healthcare and pharmaceutical advertising spend would be about $14.16 billion.
• Assuming healthcare and pharmaceutical search spend represents about the same percentage of the healthcare and pharmaceutical digital advertising spend globally as it does in the U.S., this would mean the global healthcare and pharmaceutical search advertising spend would be about $5.24 billion.

Search Strategy

• Total digital spend in the U.S. (all industries): $82.8 billion 
• Total healthcare and pharmaceutical digital spend in the U.S.: $3.62 billion 
• Therefore, healthcare and pharmaceutical digital spend represents 4% of the overall digital advertising market in the U.S. ($3,620,000,000 / $82,800,000,000 = 0.43, rounded to 4%)
• Total healthcare and pharmaceutical search spend in the U.S.: $1.34 billion.
• Therefore, healthcare and pharmaceutical search spend represented 37% of the healthcare and pharmaceutical digital spend in the U.S. ($1,340,000,000 / $3,620,000,000 = 0.370 or 37%)
• Total digital spend globally (all industries): $354 billion.
• Assuming healthcare and pharmaceutical digital advertising represents about the same percentage of the overall digital spend globally as it does in the U.S., this would mean the global healthcare and pharmaceutical advertising market is about $14.16 billion ($354,000,000,000 x 0.04 = $14,160,000,000)
• Then, assuming healthcare and pharmaceutical search advertising represents about the same percentage of healthcare and pharmaceutical digital advertising globally as it does in the U.S., this would mean the global healthcare and pharmaceutical search advertising market is about $5.24 billion ($14,600,000,000 x 0.37 = $5,239,200,000)

Google's Key Advertising Policies

• Companies must comply with Google's Legal Policy if they wish to utilize Google Ads. The policy requires compliance with the local laws of any country they want to target, in advertising. Google has a comprehensive list of the legislative requirements for each country. Some countries prohibit particular products. In other instances, the advertisement needs to be approved by Google. This ensures compliance.

• Local laws are the definitive factor in determining if advertisements can run in a particular country. Prescription drugs can only be advertised in the US, New Zealand, and Canada. New Zealand and the US are the only two countries in the world that allow pharmaceutical companies to advertise directly to the consumer.
•  Canadian laws are lax and full of contradictions. The ban on advertising prescription medicines is not enforced. It is unclear why Google allows advertisements in Canada.
• Google places a geographical restriction on the countries where over the counter medications can be marketed. The policy clearly states these medications can only be advertised in Australia, Austria, Brazil, Canada, China, Czech Republic, France, Germany, Hong Kong, India, Italy, Japan, Mexico, Netherlands, New Zealand, Norway, Poland, Russia, Slovakia, South Korea, Spain, Sweden, United Kingdom, and the US. ·
• Before initiating advertising, pharmaceutical manufacturers need to be certified by Google. The process, when reviewed, does not look overly arduous. It is essentially just confirming that the advertiser is a credible pharmaceutical provider. ·
•  Unapproved substances are a range of different treatment options, many of them lacking evidence to support the claims they make. Unapproved pharmaceuticals and supplements include weight loss products, ephedra products, anabolic steroids, and a list of dietary supplements. Google has placed a total restriction on these items. ·
• Google prohibits the use of targeted advertising in relation to prescription medicine. ·
• How a company structures an advertisement, and the words they use are limited. Google does not allow drug or medical device terminology to appear in the advertisements.

Impact on Opportunities for Pharmaceutical Companies

• With recent changes to their advertising policy and restrictions and obligations placed on those who wish to utilize the service, there are questions about whether the changes to Google's policies will impact on the opportunities available for pharmaceutical companies. The answer is a resounding, no.

• The regional restrictions on advertising are legislative, relating to prescription and over the counter medications. The laws are controlled by the countries. Pharmaceutical companies could not advertise these medications in any other country because of the local laws.

• Google's policy merely ensures compliance with current laws. One could argue, that pharmaceutical companies have increased access, through Google, given they have not been banned from Canadian prescription medication advertising, despite the current laws there.

• When Google's policy is stripped back to the core, it is difficult to see how it will impact the advertising spend and opportunities of pharmaceutical companies.
• The top five companies utilizing digital advertising are Johnson & Johnson, Merck, Abbvie, Novartis, and Pfizer. All of these companies are legitimate businesses and subject to the laws of the jurisdictions they operate in.
• The use of digital advertising, to market products in regions they otherwise legally could not, seems an unlikely risk for these companies. It seems unlikely that they would have contemplated utilizing the service in the way Google has now ruled out. All legal advertising options are still available.
• An analysis of the pharmaceutical spend, both before and after the changes to advertising policy, suggests that the policy has had little impact on pharmaceutical company engagement and uptake of services offered.
• The certification, by Google, of the pharmaceutical companies is inconvenient. When put in real terms, it is not unreasonable. Pharmaceutical companies have to establish credentials whenever they enter a new market, why should the digital marketplace be any different.
• Google is sensitive about complying with local law, having being fined $500 million in 2005 for allowing a Canadian company to sell prescription medications to the US.
• There is a possible suggestion that the rules around the personalization of advertising, limit the way pharmaceutical companies can advertise their products. This is true. If this is the case, an opportunity has been lost because of the rules. Given the personalization rules, predominantly cover sensitive conditions, consideration has to be given as to whether the companies would have targeted that type of approach in the first place. This negates the lost opportunity.

Advertising Spend

• In 2019, pharmaceutical companies in the US will spend $90.5 million on digital advertising (2.8% of the health spend). Growth in digital advertising spends by pharmaceutical companies will grow at a rate of 10.8% in 2019.
• In 2018, US pharmaceutical companies spent $70.95 million on digital advertising.
• Based on these figures, it is clear that the impact of the restrictions on pharmaceutical advertising has had a little impact on the total pharmaceutical digital spend in the US.
• The US, is of course, not representative of the global market, but in the absence of figures to the contrary, it is suggestive of similar behavior patterns internationally. ·
• Pharmaceutical companies still consider television the best way to sell medicines. It is the preferred advertising medium for the pharmaceutical industry with $3.45 billion spent in 2017.
• In describing the advertising of pharmaceutical companies, Lee Baler, senior media director of planning and investment at iCrossing, has said, “There’s not a lot of budget being cut out of TV and going into digital channels. When we look at TV, the reach is still big, but you’re hitting the same audience frequently. We’re looking to see how clients can move money out of TV, but it’s been a slow process.”
• Based on the advertising spend of pharmaceutical companies, and the trends over the last couple of years, it does not appear as if the Google advertising changes have affected the digital advertising spend by pharmaceuticals.

Impact of Future Changes

• Currently, the changes that have been made to Google's advertising policy, for pharmaceuticals, have largely been based around the laws of different countries. On this basis, there is no lost opportunity by Google enforcing legal requirements.

• ·Although not tested and speculative, if Google were to change its policies and incorporate rules that did not have a basis in law, this could have the potential to limit opportunities. The difficulty is, without knowing the substance of such policies, it is difficult to estimate

Research Strategy

Pfizer

•  Pfizer uses digital advertisements and it has collaborated with tech giant IBM to launch a cutting-edge research project that delved into Parkinson’s disease.

• As per the IDC report, digital transformation initiatives in healthcare account for 30% of all innovations, including personalized medicine, telemedicine, and M-Health developments.
• Pfizer has worked on the digital advertisement by embracing IBM’s machine learning capabilities.
•  The pharmaceutical company planned to roll out a system of sensors and mobile devices to provide doctors and researchers with critical disease symptom information in real-time to find valuable connections between symports and other clinical data.
• Pfizer believed that if embraced, digital technologies have the power to change the world positively.

• Pfizer uses social media platforms such as Facebook which showed that the company uses digital mediums such as connected sensors, mobile devices, and machine learning in collaboration with IBM to develop a new approach to Parkinson’s disease care that allows researchers to continuously monitor patients’ day-to-day activities.
• The link is available here.

Novartis

•  Novartis utilizes digital advertisements, in which Amgen and Novartis work on patient support issues with research into migraine's economic, social and emotional effects.
• In 2017, the two pharmaceutical companies also co-launched a digital and social media awareness effort which is called as “Speak Your Migraine.”
• As presented by DTC Perspectives, the leading forum for direct-to-consumer (DTC) advertising thought leaders, “Speak Your Migraine has been given as Best Disease Education Digital or Social Media Award”.

• This ad was created by Novartis which is an online community for people living with migraines, plus their friends, family, and caregivers.
• The link is available here.

•  Novartis Pharma AG created a YouTube channel on Speak Your Migraine for people living with migraine.
• The channel as 380 subscribers and it wants to give migraines affected people a voice that can help one a step out of the shadows and have better conversations about migraines.
• The link is available here.

Helpful Findings

• The world of digital advertising has some stringent requirements that pharmaceutical brands must comply with to advertise their products. But in 2019, digital advertising spend is on pace to exceed traditional media.
• Google continues to take in the lion’s share of digital ad budgets: in 2019, the tech giant is projected to earn 36.2% of digital media spend, compared with just 19.2% for Facebook.
•  1 in 20 searches in Google consists of health and wellness queries.
•  5% of the more than 63,000 searches happen every second on Google and 3,150 Google searches per second are for health and wellness related topics.
• According to CNBC report, Pharma companies are shifting their ad dollars from TV to digital media, and are looking at new ways to reach younger audiences.
• According to eMarketer data, US healthcare and pharma advertisers will boost their digital ad spend by 20% this year, propelling it to $3.62 billion.

Your Research Team Applied The Following Strategy

Strategies Successful Companies Are Using To Drive Sales Through Digital Pharmaceutical Sales

Use of Influencers

• Influencers are individuals who have a significant presence on social media platforms with a large number of followers.
• They make relevant posts on the pages which attract their followers.
• Successful pharmaceutical companies are utilizing the number of followers and the influential status of these individuals to drive sales of their products.
• This digital sales strategy is successful because it provides the opportunity for pharmaceutical companies to reach out with ease to people who may need their products and are followers or related to the followers of these influencers.
• To boost its brand awareness, Amcal teamed up with Jack Perkins, a supercar driver who has diabetes.
• The result of the contract was a 7.2% engagement, and the post by Jack drives gathered about 1,397 likes. 

Use of AI-driven Assistants and Messaging App

• Message apps like Facebook and WhatsApp are interesting marketing strategies used by companies to reach out to their target customers.
• It is an excellent opportunity for pharmaceutical companies to get across to doctors, patients, and customers.
• Like the message apps, pharmaceutical companies utilize chatbots to respond to their clients.
• This strategy is successful because, "using autonomous machine learning chatbots to improve organization efficiency, conduct key tasks and answer client, patient or customer queries, pharmaceutical brands" like Johnsons & Johnsons and MedxNote increase their productivity while enhancing their overall customer experience offerings and sales.

Use of Augmented Reality And Virtual Reality

• AR and VR are increasingly becoming part of our day-to-day life, and this is an opportunity for pharmaceutical companies to get closer to their customers, patients, and partners.
• The use of VR and AR by pharmaceutical brands does not only place companies at the core of their businesses, but it can provide "information and care through virtual clinics and product demonstrations."
• The success in the use of these technologies in pharmaceutical sales can be described using the example of Excedrin. 
• To make people more empathetic to patients with migraine, the “GlaxoSmithKline brand, Excedrin, developed a VR-driven campaign named The Migraine Experience.”
• This campaign increased the company's profits. It had about a 22% increase in sales.
• It also had excellent conversion and engagement rates, with the campaign making about 400 million earned media impressions.

Research Strategy

Google's Policies for Display Marketing for Pharmaceuticals

• In order to advertise, pharmaceutical manufacturers must get certified with Google. During the certification process, the applicant must provide details such as: their Google ads customer ID, pharmaceutical license, country in which they are licensed, and company contact information.
• Display advertisements for healthcare-related content must follow the laws for any country in which they advertise, in addition to Google's own guidelines. For the United States, advertisers must work according to the standards of the Food and Drug administration (FDA), Federal Trade Commission (FTC) and various governing boards.
• Companies advertising with Google must personally assure that their ads meet the proper legal requirements because Google does not review the content's legality.
• Google automatically formats responsive display ads into default dimensions which could change the appearance of the creative assets. Therefore, all display ad variations should be reviewed for legality before their launch.
• Some pharmaceuticals may be advertised through Google in only specific countries, while some content is banned from advertisement altogether. Prescription drugs are eligible for promotion in the United States, Canada, and New Zealand. Google provides an alphabetical list of the prescription medications they currently monitor.
•  DHEA products are only approved for display in the United States while melatonin products are only approved for the United States and Canada. Birth control cannot be used in advertisements in 23 countries in Asia, Africa, and Europe.
• Google's compilation of "Prohibited Pharmaceuticals and Supplements" lists substances that are banned from advertising with no exceptions. Substances that have dangerous properties, make unproven or fraudulent health claims, or were subject to any government warning are among those on the list.

Application

• Prior to advertising on YouTube, pharmaceutical companies must apply for Google's "healthcare products and services certification."
• The application is here and is fairly short, as it usually has 10 or fewer questions.
•  To apply for Google's healthcare products and services certification, applicants will need a Google Ads ID number, the copy of their pharmaceutical license (for agencies applying on behalf of manufacturers), and an optional website URL.
•  Other information that will need to be provided during the application includes the following:
• The organization type (online pharmacy, pharmaceutical manufacturer, governmental or well-established nonprofit health advocacy organization, addiction service provider)
• The country where licensed
•  Agency of manufacturer affirmation
•  Contact name 
•  Contact email 
•  Address (optional) 
•  Phone number 
•  Website URL (optional)
•  Website URL redirect to online pharmacy indication
•  Google Ads customer number 
• If an agency is applying on behalf of a pharmaceutical manufacturer, a Pharmaceutical Manufacturer Authorization Letter and a copy of the pharmaceutical license will need to be submitted as well.

Policies

• Prescription drug ads are currently only allowed in the United States, Canada, and New Zealand.
•  Prescription drug terms are allowed in ad text and on landing pages.
•  Over-the-counter medicines can be advertised in Australia, Austria, Brazil, Canada, China, Czech Republic, France, Germany, Hong Kong, India, Italy, Japan, Mexico, Netherlands, New Zealand, Norway, Poland, Russia, Slovakia, South Korea, Spain, Sweden, the United Kingdom, and the United States.
•  Clinical trial ads can only target people in Australia, Belgium, Canada, China, France, Germany, Indonesia, Ireland, Israel, Italy, Japan, Korea, Malaysia, Netherlands, New Zealand, Philippines, Singapore, Taiwan, Thailand, the United Kingdom, the United States, and Vietnam.
•  Birth control ads are restricted in many countries, but are allowed in the United States, the United Kingdom, and Canada.

Restrictions

• YouTube does not allow advertisements for the following products:
• All items on this list of unapproved pharmaceuticals and supplements.
• Products that contain ephedra.
• Products that contain human chorionic gonadotropin (hCG) for weight loss or in conjunction with anabolic steroids.
• Herbal or dietary products that contain active pharmaceutical or dangerous ingredients.
• Products that have false or misleading health claims, including "claims implying that a product is as effective as prescription drugs or controlled substances."
• Products that have received a governmental regulatory warning or ban.
• Products that have names that are confusingly similar to controlled substances or unapproved pharmaceuticals.
•  DHEA products except in the United States.
•  Metatonin products except in the United States and Canada.
•  HIV tests except in the United States, France, the Netherlands, and the United Kingdom.
•  Speculative and experimental medical treatments. These include "Stem cell therapy, cellular (non-stem) therapy, gene therapy and similar forms of regenerative medicine, platelet rich plasma, biohacking, do-it-yourself (DIY) genetic engineering products, and gene therapy kits."
•  Birth control products in Bahrain, China, Djibouti, Egypt, Hong Kong, Iran, Iraq, Jordan, Kuwait, Malaysia, Lebanon, Libya, Morocco, Oman, Palestinian Territory, Qatar, Saudi Arabia, Syria, Thailand, Tunisia, Ukraine, United Arab Emirates, and Yemen.
•  Addiction services in all countries except the United States and bidding on keywords is only allowed for alcohol and drug addiction.
•  Unauthorized pharmacies are not allowed to advertise on YouTube and accounts may be suspended.
• Pharmacies that sell prescription drugs without a prescription or target locations for which they are not licensed are considered unauthorized pharmacies.
•  Online pharmacy promotion is restricted on YouTube for both prescription and over-the-counter drugs to Australia, Austria, Brazil, Canada, China, Czech Republic, Denmark, Germany, Hong Kong, Japan, Mexico, Netherlands, New Zealand, Norway, Portugal, Slovakia, Sweden, Taiwan, the United Kingdom, and the United States.
• Online pharmacies can only bid on keywords that contain prescription drug terms in Australia, Austria, Canada, Czechia, Denmark, Germany, Japan, New Zealand, Netherlands, Norway, Portugal, Slovakia, the United Kingdom, and the United States.
•  Abortion-related ads in the United States, the United Kingdom, and Ireland are required to be from certified advertisers that either provide abortions or do not provide abortions.

Part 1: Google's Policies for Paid Search

Google Ad Policies for Pharmaceutical Companies

• According to Google’s policies, certain content that’s related to healthcare and medicine can be advertised only when the pharmaceutical company has been approved by Google as a “certified healthcare-related advertiser”. Certified companies can target ads in approved countries alone. Companies would also have to abide by country-specific regulations apart from Google’s general ad policies.
• Details on the country-specific restrictions for pharmaceutical companies can be accessed here.
• Google allows pharmaceutical companies to advertise prescription drugs only in the United States, New Zealand, and Canada, while over-the-counter drugs can be promoted in over 24 countries, which are the United States, the United Kingdom, Sweden, Spain, South Korea, Slovakia, Russia, Poland, Norway, New Zealand, Netherlands, Mexico, Japan, Italy, India, Hong Kong, Germany, France, Czech Republic, China, Canada, Brazil, Austria, and Australia. Medical professional suppliers and bulk drug manufacturers are allowed to advertise in Canada and the United States alone.
•  Google ads closely monitor any prescription drug that is being promoted by a certified healthcare-related advertiser. A list of the prescription drugs that Google ads monitors can be accessed here.
• While advertising online pharmacies is restricted in general, Google allows their promotion only in specific countries including the United States, the United Kingdom, Taiwan, Sweden, Slovakia, Portugal, Norway, New Zealand, Netherlands, Mexico, Japan, Hong Kong, Germany, Denmark, Czech Republic, China, Canada, Brazil, Austria, and Australia.
• Google approves the promotion of an online pharmacy after reviewing the content of the ad/app/site along with the services and products it offers. Online pharmacies are also required to be certified by Google to promote its products through Google ads. To qualify for Google’s certification, online pharmacies would have to be “registered with the relevant pharmaceutical authorities in the countries that their ad campaign targets”.
• Google has separate policies for specific products and services such as birth control and clinical trials. While the promotion of birth control products are allowed in many countries such as Canada and the United States, Google does not allow birth control ads in several countries including Yemen, United Arab Emirates, Ukraine, Tunisia, Thailand, Syria, Saudi Arabia, Qatar, Palestinian Territory, Oman, Morocco, Libya, Lebanon, Malaysia, Kuwait, Jordan, Iraq, Iran, Hong Kong, Egypt, Djibouti, China, and Bahrain. Where addiction services are concerned, Google allows the promotion of such services in the United States alone.
• Pharmaceutical manufacturers and companies tend to face challenges mainly with personalized advertising content. Google’s personalized advertising policy states that marketers cannot serve advertisements that fall under the category of sensitive interest such as belief, identity, and personal hardship. Pharmaceutical advertisers who come under this category are restricted from using several features such as in-market audiences, remarketing, demographic targeting, and similar audiences.

Healthcare-Related Advertiser Certification

• Pharmaceutical manufacturers, online pharmacies, and other companies that are seeking to utilize prescription drug terms in their landing pages or ad text would have to first be certified by Google.
• Pharmaceutical companies can apply for the certification by filling out Google’s online form which can be accessed here. Pharmaceuticals would need to ensure they adhere to the country-specific regulations along with additional requirements for the countries where their ad campaigns will be targeted.
• For the certification process, pharmaceutical companies would need their Google Ads customer ID, a copy of their pharmaceutical license with a 'Pharmaceutical Manufacturer Authorization Letter' if applied by an agency, and a website URL.

Restricted Substances

• Google has developed a list of prohibited pharmaceutical drugs and supplements that are not allowed to be advertised regardless of any legal claim. Some unapproved substances include products that contain human chorionic gonadotropin (hCG) and ephedra, drugs that have received regulatory or government warning, and products with misleading claims.
• Pharmacies that advertise unauthorized products will be considered as egregious and may be suspended. Violation of this policy would include, but not limited to, targeting ads in unlicensed locations, promoting unauthorized content, or providing prescription medicine without a prescription. Apart from account suspension, violation of Google Ad policies can lead to ad disapproval, compliance review, and disabling the company’s remarketing list.

Part 2: Google's Advertising Policies — Historical Changes

Use of Ad Words in Pharmaceutical Ads: Policy Change in February 2010

• "Towards the end" of February 2010, Google implemented a policy change that began to allow certain kinds of pharmaceutical ads to get displayed on Google search results. However, only products or services from VIPPS and CIPA certified pharmacies would be allowed to benefit from such an advertisement. Google AdWords began to accept ads from online pharmacies within the United States that were accredited by the National Association Boards of Pharmacy VIPPS program, as well as from online pharmacies within Canada that were recognized or authorized by the Canadian International Pharmacy Association (CIPA.)
• This policy change allowed pharmacies to only target ads within their countries. Thus, pharmacies were allowed to target ads in any country in which they have accreditation. However, this policy change did not affect online pharmacy policies functioning in countries outside the United States and Canada. 

2015 Scanning Electron Microscopy (SEM) Policy for Paid Search Advertisements

• On July 20, 2015, "Google's Black Box Ad Format" was removed for changes that were in the pipeline that affected Google's URL infrastructure. Google's original Black Box Ad Format had the following restrictions.
• The Black Box Ad Format served as health risk disclaimers. It mandated some drug labeling as well as advertising to have the "boxed" or "black box" warnings, which indicated concerns for conditions that may develop or be associated with the drug that could lead to death or serious injuries.
• The black box formats now had to conform to the requirements of Google's standard text ad unit. The standard text ad unit was not required to display the entire FDA-recommended disclaimer, which used to be the last line in the previously used Black Box Ad Format.
• The new disclaimer format required by Google utilized the drug name, the active ingredients in the drug, and details of the side effect of the drugs coming immediately after the top-level domain (TLD), as shown in the attached format.

Google Advertising Policies Begin to Reference/Recognize .Pharmacy TLD in 2016

• In 2016, the National Association of Boards of Pharmacy (NABP) announced that "Google now recognizes the .pharmacy" top-level domain (TLD) as sufficient requirements for pharmacies as well as related entities to advertise online.
• In June 2016, Google's advertising policies relative to health care and medicines began to specifically "reference the .pharmacy TLD as meeting its requirements." This policy change meant that companies with the dot pharmacy (.pharmacy) top-level domain (TLD) would get automatically recognized as safe and legitimate.
• From June 2016, Google's policies were updated to recognize any website URL that ends with .pharmacy to be a safe and legitimate website and would be allowed to advertise online.

Google Ads Ban on Unproven Medical Products/Treatments in 2019

• In 2019, Google announced a new policy that prohibits most stem cell and gene therapies. Gene therapies and stem cells are products of some pharmaceutical companies, "including Novartis, Roche, Catalent, and Thermo Fisher."
• In line with its ethics and to maintain a trustworthy stance, Google decided in 2019 that it would no longer permit ads for "unproven or experimental medical techniques." Under this new healthcare as well as medicines policy, Google has prohibited advertising for treatments that lack scientific proof or have an insufficient biomedical and scientific basis. This policy bans most stem cell therapies and gene therapy and aims to cut down on ads for items like young blood transfusions as well as vampire facials.
• This policy change came as a response to the outcry over online marketing implemented by stem cell clinics that touted unapproved treatments for many ailments from joint pain to Alzheimer's disease. The outcry came as a result of opinions that felt that at best, many of these clinics were a waste of money and at worst, they were extremely dangerous.
• Other items banned by the policy include a list of unapproved substances such as those containing ephedra or human chorionic gonadotropin (hCG), which is used for weight control. Herbal and dietary supplements that contain active pharmaceutical and dangerous ingredients were also denied ad rights under this policy.

Part 3: Google's Advertising Policies — Governmental Laws

Overview

• Google has been forced to incorporate several government regulations into its policies because different countries/regions have taken different approaches to internet regulation.
• This has prompted Google's VP of Global Public Policy and Government Relations to call for “common rules of the road when it comes to the regulation of technology."
• Google believes that "comprehensive privacy legislation" would ensure consistency especially in the United States where "legislation could be fragmented due to various state-level laws."
• While Google has shown compliance with government laws, the company announced in July 2019 that it could not comply with the repressive censorship regulations of the Chinese government.
• Previously, Google had been working on a project dubbed "Project Dragonfly" that aimed to build an online search engine that would comply with the restrictive security measures put in place by the Chinese government.

Current Laws and Regulations

General Data Protection Regulation (GDPR)

• The GDPR was introduced on May 25, 2018, to replace the "1995 EU Data Protection Directive." The GDPR regulates how businesses operating within the member states of the European Union collect, store, and use personal data.
• According to Google, the company completely overhauled its privacy policy in May 2018 in what it called a “full product update” to reflect the GDPR.
• The redesigned Google privacy policy now contains nine mentions Google users can export data as well as several sections explaining to users how they can delete their data.
• In line with the GDPR, advertisers and publishers using Google advertising and/or measurement tools globally must adhere to the EU User Consent Policy and it is a requirement that they should seek "consent from EEA users for personalized ads and use of cookies/local storage on their sites and apps."

Office of Foreign Assets Control (OFAC) Sanctions

• Google expects advertisers to comply with trade sanctions imposed by the OFAC. Advertisers have to agree not to cause Google to violate the terms stipulated by the OFAC.
• Accordingly, advertisers must not "use ads for or on behalf of restricted entities or individuals" and cannot use "ads for or on behalf of entities or individuals located in sanctioned countries or regions." Also, Google ad services are not available to restricted individuals or entities or those located in embargoed countries.
• Currently, Crimea, Iran, Cuba, North Korea, Syria, and Sudan are embargoed.
• Google started editing its privacy policy to incorporate the sanctions and regulations by the OPAC in 2012.

Future Laws and Regulations

California Consumer Privacy Act (CCPA)

• CCPA is a newly-introduced data privacy regulation that applies to business entities that seek to collect personal data from California residents.
• The CCPA was first published in October 2019 and will be effective from January 1, 2020.
• According to Google, after the CCPA takes effect, California residents can opt-out of the "sale of their personal information" thanks to a link that states "Do Not Sell My Personal Information" that will be provided on the selling party’s home page.
• The CCPA applies to all businesses operating within or targeting individuals or entities within California. It has been incorporated into Google's "service provider terms."

Additional Information

• Apart from complying with trade sanctions, Google monitors advertisements to ensure that they comply with local legal requirements. Google expects advertisements to comply with any legal laws that are in place in the locales that their advertisements target.
• Google provides a tool that can be used by advertisers to determine the legal requirements of their target countries. However, Google cautions that it is the responsibility of the advertiser or publisher to research local policies to ensure that they comply with local laws.

Part 4: Pharma Search Advertising — Market Size

• In 2019, healthcare and pharma search spend in the U.S. will reach $1.34 billion.
• The total digital spends for healthcare and pharmaceutical advertisers in the U.S. is expected to be $3.62 billion in 2019.
• The total spends on digital advertising in the U.S. in 2019 is expected to reach $82.8 billion.
• Healthcare and pharmaceutical digital advertising represent 4% of the total digital advertising market in the U.S. (see calculations in the Research Strategy section).
• Healthcare and pharmaceutical search advertising represent 37% of digital healthcare and pharmaceutical advertising. (see calculations in the Research Strategy section).
• The total global spend on digital advertising in 2019 is expected to reach $354.0 billion.
• Assuming healthcare and pharmaceutical digital advertising represents about the same percentage globally as it does in the U.S., this would mean the global healthcare and pharmaceutical advertising spend would be about $14.16 billion (see calculations in the Research Strategy section).
• Assuming healthcare and pharmaceutical search spend represents about the same percentage of the healthcare and pharmaceutical digital advertising spend globally as it does in the U.S., this would mean the global healthcare and pharmaceutical search advertising spend would be about $5.24 billion (see calculations in the Research Strategy section) (see calculations in the Research Strategy section).

Part 5: Google's Advertising Policies — Impact

Google's Key Advertising Policies

• Companies must comply with Google's Legal Policy if they wish to utilize Google Ads. The policy requires compliance with the local laws of any country they want to target, in advertising. Google has a comprehensive list of the legislative requirements for each country. Some countries prohibit particular products. In other instances, the advertisement needs to be approved by Google. This ensures compliance.
• Local laws are the definitive factor in determining if advertisements can run in a particular country. Prescription drugs can only be advertised in the US, New Zealand, and Canada. New Zealand and the US are the only two countries in the world that allow pharmaceutical companies to advertise directly to the consumer.
•  Canadian laws are lax and full of contradictions. The ban on advertising prescription medicines is not enforced. It is unclear why Google allows advertisements in Canada.
• Google places a geographical restriction on the countries where over the counter medications can be marketed. The policy clearly states these medications can only be advertised in Australia, Austria, Brazil, Canada, China, Czech Republic, France, Germany, Hong Kong, India, Italy, Japan, Mexico, Netherlands, New Zealand, Norway, Poland, Russia, Slovakia, South Korea, Spain, Sweden, United Kingdom, and the US. ·
• Before initiating advertising, pharmaceutical manufacturers need to be certified by Google. The process, when reviewed, does not look overly arduous. It is essentially just confirming that the advertiser is a credible pharmaceutical provider. ·
•  Unapproved substances are a range of different treatment options, many of them lacking evidence to support the claims they make. Unapproved pharmaceuticals and supplements include weight loss products, ephedra products, anabolic steroids, and a list of dietary supplements. Google has placed a total restriction on these items. ·
• Google prohibits the use of targeted advertising for prescription medicine. ·
• How a company structures an advertisement, and the words they use are limited. Google does not allow drug or medical device terminology to appear in the advertisements.

Impact on Opportunities for Pharmaceutical Companies

• With recent changes to their advertising policy and restrictions and obligations placed on those who wish to utilize the service, there are questions about whether the changes to Google's policies will impact on the opportunities available for pharmaceutical companies. The answer is a resounding, no.
• The regional restrictions on advertising are legislative, relating to prescription and over the counter medications. The laws are controlled by the countries. Pharmaceutical companies could not advertise these medications in any other country because of the local laws.
• Google's policy merely ensures compliance with current laws. One could argue, that pharmaceutical companies have increased access, through Google, given they have not been banned from Canadian prescription medication advertising, despite the current laws there.
• When Google's policy is stripped back to the core, it is difficult to see how it will impact the advertising spend and opportunities of pharmaceutical companies.
• The top five companies utilizing digital advertising are Johnson & Johnson, Merck, Abbvie, Novartis, and Pfizer. All of these companies are legitimate businesses and subject to the laws of the jurisdictions they operate in.
• The use of digital advertising, to market products in regions they otherwise legally could not, seems an unlikely risk for these companies. It seems unlikely that they would have contemplated utilizing the service in the way Google has now ruled out. All legal advertising options are still available.
• An analysis of the pharmaceutical spend, both before and after the changes to advertising policy, suggests that the policy has had little impact on pharmaceutical company engagement and uptake of services offered.
• The certification, by Google, of the pharmaceutical companies is inconvenient. When put in real terms, it is not unreasonable. Pharmaceutical companies have to establish credentials whenever they enter a new market, why should the digital marketplace be any different.
• Google is sensitive about complying with local law, having been fined $500 million in 2005 for allowing a Canadian company to sell prescription medications to the US.
• There is a possible suggestion that the rules around the personalization of advertising, limit the way pharmaceutical companies can advertise their products. This is true. If this is the case, an opportunity has been lost because of the rules. Given the personalization rules, predominantly cover sensitive conditions, consideration has to be given whether the companies would have targeted that type of approach in the first place. This negates the lost opportunity.

Advertising Spend

• In 2019, pharmaceutical companies in the US will spend $90.5 million on digital advertising (2.8% of the health spend). Growth in digital advertising spends by pharmaceutical companies will grow at a rate of 10.8% in 2019.
• In 2018, US pharmaceutical companies spent $70.95 million on digital advertising.
• Based on these figures, it is clear that the impact of the restrictions on pharmaceutical advertising has had a little impact on the total pharmaceutical digital spend in the US.
• The US, is of course, not representative of the global market, but in the absence of figures to the contrary, it is suggestive of similar behavior patterns internationally. ·
• Pharmaceutical companies still consider television the best way to sell medicines. It is the preferred advertising medium for the pharmaceutical industry with $3.45 billion spent in 2017.
• In describing the advertising of pharmaceutical companies, Lee Baler, senior media director of planning and investment at iCrossing, has said, “There’s not a lot of budget being cut out of TV and going into digital channels. When we look at TV, the reach is still big, but you’re hitting the same audience frequently. We’re looking to see how clients can move money out of TV, but it’s been a slow process.”
• Based on the advertising spend of pharmaceutical companies, and the trends over the last couple of years, it does not appear as if the Google advertising changes have affected the digital advertising spend by pharmaceuticals.

Impact of Future Changes

• Currently, the changes that have been made to Google's advertising policy, for pharmaceuticals, have largely been based around the laws of different countries. On this basis, there is no lost opportunity by Google enforcing legal requirements.
• ·Although not tested and speculative, if Google were to change its policies and incorporate rules that did not have a basis in law, this could have the potential to limit opportunities. The difficulty is, without knowing the substance of such policies, it is difficult to estimate.

Part 6: Digital Ads — Examples

Pfizer

•   Pfizer uses digital advertisements and it has collaborated with tech giant IBM to launch a cutting-edge research project that delved into Parkinson’s disease.
•  As per the IDC report, digital transformation initiatives in healthcare account for 30% of all innovations, including personalized medicine, telemedicine, and M-Health developments.
• Pfizer has worked on the digital advertisement by embracing IBM’s machine learning capabilities.
•  The pharmaceutical company planned to roll out a system of sensors and mobile devices to provide doctors and researchers with critical disease symptom information in real-time to find valuable connections between symports and other clinical data.
• Pfizer believed that if embraced, digital technologies have the power to change the world positively.

• Pfizer uses social media platforms such as Facebook which showed that the company uses digital mediums such as connected sensors, mobile devices, and machine learning in collaboration with IBM to develop a new approach to Parkinson’s disease care that allows researchers to continuously monitor patients’ day-to-day activities.
• The link is available here.

Novartis

• Novartis utilizes digital advertisements, in which Amgen and Novartis work on patient support issues with research into migraine's economic, social and emotional effects.
• In 2017, the two pharmaceutical companies also co-launched a digital and social media awareness effort which is called “Speak Your Migraine.”
• As presented by DTC Perspectives, the leading forum for direct-to-consumer (DTC) advertising thought leaders, “Speak Your Migraine has been given as Best Disease Education Digital or Social Media Award”.

• This ad was created by Novartis which is an online community for people living with migraines, plus their friends, family, and caregivers.
• The link is available here.
•  Novartis Pharma AG created a YouTube channel on Speak Your Migraine for people living with migraine.
• The channel as 380 subscribers and it wants to give migraines affected people a voice that can help one a step out of the shadows and have better conversations about migraines.
• The link is available here.

Part 7: Strategies — Digital Pharmaceutical Sales

Use of Influencers

• Successful pharmaceutical companies are utilizing the number of followers and the influential status of these individuals to drive sales of their products.
• This digital sales strategy is successful because it provides the opportunity for pharmaceutical companies to reach out with ease to people who may need their products and are followers or related to the followers of these influencers.
• To boost its brand awareness, Amcal teamed up with Jack Perkins, a supercar driver who has diabetes.
• The result of the contract was a 7.2% engagement, and the post by Jack drives gathered about 1,397 likes. 

Use of AI-driven Assistants and Messaging App

• Message apps like Facebook and WhatsApp are interesting marketing strategies used by companies to reach out to their target customers.
• It is an excellent opportunity for pharmaceutical companies to get across to doctors, patients, and customers.
• Like the message apps, pharmaceutical companies utilize chatbots to respond to their clients.
• This strategy is successful because, "using autonomous machine learning chatbots to improve organization efficiency, conduct key tasks and answer client, patient or customer queries, pharmaceutical brands" like Johnsons & Johnsons and MedxNote increase their productivity while enhancing their overall customer experience offerings and sales.

Use of Augmented Reality And Virtual Reality

• AR and VR are increasingly becoming part of our day-to-day life, and this is an opportunity for pharmaceutical companies to get closer to their customers, patients, and partners.
• The use of VR and AR by pharmaceutical brands does not only place companies at the core of their businesses, but it can provide "information and care through virtual clinics and product demonstrations."
• The success in the use of these technologies in pharmaceutical sales can be described using the example of Excedrin. 
• To make people more empathetic to patients with migraine, the “GlaxoSmithKline brand, Excedrin, developed a VR-driven campaign named The Migraine Experience.”
• This campaign increased the company's profits. It had about a 22% increase in sales.
• It also had excellent conversion and engagement rates, with the campaign making about 400 million earned media impressions.

Part 8: Google's Policies for Display Marketing

Google's Policies for Display Marketing for Pharmaceuticals

• To advertise, pharmaceutical manufacturers must get certified with Google. During the certification process, the applicant must provide details such as their Google ads customer ID, pharmaceutical license, the country in which they are licensed, and company contact information.
• Display advertisements for healthcare-related content must follow the laws for any country in which they advertise, in addition to Google's guidelines. For the United States, advertisers must work according to the standards of the Food and Drug Administration (FDA), Federal Trade Commission (FTC) and various governing boards.
• Companies advertising with Google must personally assure that their ads meet the proper legal requirements because Google does not review the content's legality.
• Google automatically formats responsive display ads into default dimensions which could change the appearance of the creative assets. Therefore, all display ad variations should be reviewed for legality before their launch.
• Some pharmaceuticals may be advertised through Google in only specific countries, while some content is banned from advertisements altogether. Prescription drugs are eligible for promotion in the United States, Canada, and New Zealand. Google provides an alphabetical list of the prescription medications they currently monitor.
•  DHEA products are only approved for display in the United States while melatonin products are only approved for the United States and Canada. Birth control cannot be used in advertisements in 23 countries in Asia, Africa, and Europe.
• Google's compilation of "Prohibited Pharmaceuticals and Supplements" lists substances that are banned from advertising with no exceptions. Substances that have dangerous properties, make unproven or fraudulent health claims, or were subject to any government warning are among those on the list.

Part 9: Google's Policies for YouTube Advertising

Application

• Before advertising on YouTube, pharmaceutical companies must apply for Google's "healthcare products and services certification."
• The application is here and is fairly short, as it usually has 10 or fewer questions.
•  To apply for Google's healthcare products and services certification, applicants will need a Google Ads ID number, a copy of their pharmaceutical license (for agencies applying on behalf of manufacturers), and an optional website URL.
•  Other information that will need to be provided during the application includes the following:
• The organization type (online pharmacy, pharmaceutical manufacturer, governmental or well-established nonprofit health advocacy organization, addiction service provider).
• The country where licensed
•  Agency of manufacturer affirmation
•  Contact name 
•  Contact email 
•  Address (optional) 
•  Phone number 
•  Website URL (optional)
•  Website URL redirect to online pharmacy indication
•  Google Ads customer number 
• If an agency is applying on behalf of a pharmaceutical manufacturer, a Pharmaceutical Manufacturer Authorization Letter and a copy of the pharmaceutical license will need to be submitted as well.

Policies

• Prescription drug ads are currently only allowed in the United States, Canada, and New Zealand.
•   Prescription drug terms are allowed in ad text and on landing pages.
•  Over-the-counter medicines can be advertised in Australia, Austria, Brazil, Canada, China, Czech Republic, France, Germany, Hong Kong, India, Italy, Japan, Mexico, Netherlands, New Zealand, Norway, Poland, Russia, Slovakia, South Korea, Spain, Sweden, the United Kingdom, and the United States.
•  Clinical trial ads can only target people in Australia, Belgium, Canada, China, France, Germany, Indonesia, Ireland, Israel, Italy, Japan, Korea, Malaysia, Netherlands, New Zealand, Philippines, Singapore, Taiwan, Thailand, the United Kingdom, the United States, and Vietnam.
•  Birth control ads are restricted in many countries but are allowed in the United States, the United Kingdom, and Canada.

Restrictions

• YouTube does not allow advertisements for the following products:
• All items on this list of unapproved pharmaceuticals and supplements.
• Products that contain ephedra.  
• Products that contain human chorionic gonadotropin (hCG) for weight loss or in conjunction with anabolic steroids.
•  Herbal or dietary products that contain active pharmaceutical or dangerous ingredients.
• Products that have false or misleading health claims, including "claims implying that a product is as effective as prescription drugs or controlled substances."
• Products that have received a governmental regulatory warning or ban.
• Products that have names that are confusingly similar to controlled substances or unapproved pharmaceuticals.
•  DHEA products except in the United States.
•   Melatonin products except in the United States and Canada.
•   HIV tests except in the United States, France, the Netherlands, and the United Kingdom.
•  Speculative and experimental medical treatments. These include "Stem cell therapy, cellular (non-stem) therapy, gene therapy and similar forms of regenerative medicine, platelet-rich plasma, biohacking, do-it-yourself (DIY) genetic engineering products, and gene therapy kits."
•   Birth control products in Bahrain, China, Djibouti, Egypt, Hong Kong, Iran, Iraq, Jordan, Kuwait, Malaysia, Lebanon, Libya, Morocco, Oman, Palestinian Territory, Qatar, Saudi Arabia, Syria, Thailand, Tunisia, Ukraine, United Arab Emirates, and Yemen.
•  Addiction services in all countries except the United States and bidding on keywords is only allowed for alcohol and drug addiction.
•  Unauthorized pharmacies are not allowed to advertise on YouTube and accounts may be suspended.
• Pharmacies that sell prescription drugs without a prescription or target locations for which they are not licensed are considered unauthorized pharmacies.
•  Online pharmacy promotion is restricted on YouTube for both prescription and over-the-counter drugs to Australia, Austria, Brazil, Canada, China, Czech Republic, Denmark, Germany, Hong Kong, Japan, Mexico, Netherlands, New Zealand, Norway, Portugal, Slovakia, Sweden, Taiwan, the United Kingdom, and the United States.
• Online pharmacies can only bid on keywords that contain prescription drug terms in Australia, Austria, Canada, Czech, Denmark, Germany, Japan, New Zealand, Netherlands, Norway, Portugal, Slovakia, the United Kingdom, and the United States.
•  Abortion-related ads in the United States, the United Kingdom, and Ireland are required to be from certified advertisers that either provide abortions or do not provide abortions.

Research Strategy

• Total digital spend in the U.S. (all industries): $82.8 billion.
• Total healthcare and pharmaceutical digital spend in the U.S.: $3.62 billion.
• Therefore, healthcare and pharmaceutical digital spend represents 4% of the overall digital advertising market in the U.S. ($3,620,000,000 / $82,800,000,000 = 0.43, rounded to 4%).
• Total healthcare and pharmaceutical search spend in the U.S.: $1.34 billion.  

• Therefore, healthcare and pharmaceutical search spend represented 37% of the healthcare and pharmaceutical digital spend in the U.S. ($1,340,000,000 / $3,620,000,000 = 0.370 or 37%).

• Total digital spends globally (all industries): $354 billion. 
• Assuming healthcare and pharmaceutical digital advertising represents about the same percentage of the overall digital spend globally as it does in the U.S., this would mean the global healthcare and pharmaceutical advertising market is about $14.16 billion ($354,000,000,000 x 0.04 = $14,160,000,000).
• Then, assuming healthcare and pharmaceutical search advertising represents about the same percentage of healthcare and pharmaceutical digital advertising globally as it does in the U.S., this would mean the global healthcare and pharmaceutical search advertising market is about $5.24 billion ($14,600,000,000 x 0.37 = $5,239,200,000).