# Prescription Drug Promotion by Social Media Influencers: A Systematic Scoping Review

## TL;DR

This review finds that social media influencers promoting prescription drugs often spread misinformation and face weak regulation, requiring stronger policies and public education to protect health.

## Contribution

The study systematically identifies risks and regulatory gaps in influencer-driven prescription drug promotion, offering actionable recommendations for policy and public health.

## Key findings

- Influencer promotion of prescription drugs is linked to misinformation due to limited expertise and low audience health literacy.
- Regulatory oversight is weak, with inconsistent disclosure practices and limited enforcement.
- Personal narratives used in promotions blur the line between genuine testimony and paid advertising, increasing persuasion risks.

## Abstract

What is known about the risks of prescription drug promotion by social media influencers, and how can current evidence inform future research and effective policy?

In this systematic scoping review of 12 articles published in peer-reviewed journals, social media influencer promotion of prescription drugs was consistently associated with misinformation, weak and outdated regulatory oversight, and audience difficulty in recognizing promotional intent when marketing was embedded in personal narratives.

These findings highlight an urgent need for updated regulatory guidance, stronger and standardized disclosure requirements, enhanced platform accountability, and targeted digital literacy initiatives to mitigate public health risks.

Prescription drug promotion by social media influencers (hereinafter influencers) is a growing phenomenon that raises concerns about misleading advice, insufficient regulatory oversight, and ethically problematic marketing practices. Understanding the scope and risks of influencers’ promotional activities is essential to protect public health.

To systematically review existing research on influencer prescription drug promotion, with a focus on identifying recurring themes, regulatory gaps, and opportunities for intervention.

This systematic scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. The search strategy was developed with a health sciences librarian and preregistered on Open Science Framework. English-language articles from peer-reviewed journals were retrieved from the Medline, Communication & Mass Media Complete, CINAHL Complete, PsycInfo, Web of Science, Business Source Complete, Scopus, and Cochrane Library databases, covering research conducted in diverse online and health care contexts worldwide from 2004 to 2024. Searches used key terms related to influencers, social media, and prescription drugs, completed on March 13, 2024. Included studies underwent thematic analysis. The primary outcomes included concerns related to accuracy (misinformation), transparency (disclosure practices), and persuasiveness (personal and parasocial narratives) of prescription drug promotion by influencers.

Twelve articles met inclusion criteria (8 empirical and 4 theoretical), addressing topics such as contraceptive advertising, performance-enhancing drugs, and broader pharmaceutical promotion. Methods included content analyses, interviews, and experiments. Three recurring themes emerged: (1) misinformation stemming from influencers’ limited expertise in the context of audiences’ low health literacy; (2) weak regulatory oversight and inconsistent disclosure practices; and (3) parasocial narratives that blur distinctions between personal testimony and paid promotion.

This systematic scoping review study of prescription drug promotion by influencers found that such promotion carried risks of inaccurate or misleading advice, often amplified through personal and emotionally resonant narratives in an environment with limited oversight and enforcement. Despite the small and fragmented evidence base, these findings highlight the urgent need for updated regulatory guidance, standardized and enforceable disclosure requirements, stronger platform accountability, and targeted digital literacy initiatives. Policymakers and researchers should act proactively to safeguard public health.

This systematic scoping review examines the existing research on social media influencer promotion of prescription drugs and identifies recurring themes, gaps in regulatory oversight, and opportunities for public health intervention.