EXPERT REACTION: TGA cracks down on social media marketing of health products

Influencers have become an important marketing tool because they are perceived by many to be genuine and credible sources of information about product quality. However, the incentives that influencers receive from the companies that supply the products or services they promote are rarely disclosed and influencers may have little basis or few credentials for some of the claims made. Consumers of the products can therefore be misled. The government is cracking down on this by banning paid/incentivized influencers from spruiking therapeutic goods. This ban on paid influencers may seem heavy-handed, but public health interests have prevailed in this case. It is important to also remember that the ban only applies to therapeutic goods that are not excluded by the legislation or regulation. In other words the ban only relates to goods which implicate public health interests.

Social media is now a major way people get their information, and an important group on social media is so-called influencers, people with substantial followings on social media whose opinions can sway large numbers of these followers into action. When these opinions are about fashion or music no societal harm is done, but when it comes to medical or pharmaceutical opinions there is the potential for harm. People can be encouraged to substitute effective medication for ineffective (or potentially harmful) treatments. The COVID pandemic has highlighted how ineffective or harmful treatments can be promoted on social media.

Until now social media influencers have been largely left alone, but now the Australian Therapeutic Goods Administration (TGA) has stepped in. Any treatment (from skin cream to vitamins) that makes a therapeutic claim is regulated by the TGA, and there are strict rules around the advertising of therapeutic goods. Now the TGA is turning its attention to influencers, who from July 1 will be banned from promoting health products if they are paid or incentivised, including receiving gifted products. While this may seem heavy-handed, advertising therapeutics, even ones as innocuous as sunscreen, requires high ethical standards. For example, the claim that a product “removes toxins” is a therapeutic claim, and too often products that claim to remove toxins do nothing of the sort and can mislead people, who may avoid seeing a health professional if they think they are treating an issue by “removing toxins” with an agent that does no such thing."

This decision from the TGA shows how important it is for Australians to have access to credible, evidence-based information to eat well, live well and age well. We have large workforces of health professionals, like dietitians and GPs, who are certified to practise safely in this space. Influencers sharing unsubstantiated claims in the form of click bait are dangerous, and prevents Australian's from seeking professional help.

The TGA ruling is long overdue. The rise of influencer marketing has been largely unregulated (with only some industry ‘codes’) in Australia for too long.

Unfortunately for the influencers, health and related products/services are where many of them make a lot of their money, so there will be pushback.

Already we have seen some say that they should be paid for things like sunscreen as it is a ‘community service’.

Having researched this space for 10 years, and recently conducting interviews with influencers who have been working in that space for the same length of time, the need for more enforceable guidelines is obvious.

Influencers have enjoyed unparalleled exposure to people’s habits, and healthcare/personal care product preferences are no exception. As a skin product and toxicology expert, I have grown conscious of the downsides of such a culture.

Channel Ten’s documentary Mirror-mirror last year, highlighted how the beauty industry is influenced and what dangers the general population faces. We welcome the decision from TGA to update the Therapeutic Goods Advertising Code cracking down on paid/incentivised promotion. We believe this was necessary and a long time coming.

Unsolicited health advice by non-professional entities can have damaging health impacts. This is of particular importance where formulation and device combinations such as dermaroller and skin products are concerned. This can be incredibly dangerous and is not licenced for home use in most countries.

Influencer marketing has become a major strategy for most beauty and wellness companies. This trend which encourages trust and influence often from people not qualified in the understanding of therapeutic effects and toxicology of products, their excipients, and the associated risk-benefit profile of the overall products, must be kept in check for the benefit of the consumers.

As a fertility and prenatal dietitian, I often see clients who are on a long list of supplements and powders which they have decided to take on the advice of social media influencers. Oftentimes the supplements are doing more harm than good to these clients.

Examples include taking supplements which compete for absorption, taking doses of supplements that add up to being higher than the recommended ‘Upper Limit’ and taking supplements that have not been tested for fertility and pregnancy.

As the industry regulator, the TGA has a responsibility to oversee and govern control of the approval and release of products to consumers that could have a direct impact, both positive or negative, on their health.

Unsubstantiated claims are both a concern for members of the public, who may see these claims as providing ‘evidence’ of effect, as well as being a problem for those industries that rely on approval of the regulator to quality the efficacy of their products. As such, information going to consumers who could be influenced to buy or use products should be of the highest quality, and it is not clear that social media ‘influencers’ can always attest to this high standard.

However, a better relationship between the regulator and its customers would be highly beneficial to ensure that a holistic and patient/consumer-centred approach is taken. Where there may be benefits in products not yet on the market with real and evidenced health outcomes, the regulator should have a fast-track pathway to consider these.

The move by the Theraputic Goods Administration (TGA) to crack down on social media influencers promoting health products is an interesting case in the field of digital ethics. 

In today's social media landscape, social media 'influencers' -- on platforms such as YouTube, Instagram, and TikTok -- can amass a huge following, thanks in part to the asymmetric nature of these social media platforms as well as algorithmic personalisation and recommender systems. In effect, these factors contribute to social media's ethos of 'optimising for engagement'.

Influencers can engage their audience with rich media content which may include product endorsements and giveaways. Due to their extensive potential for engagement, which is well beyond those of a typical non-celebrity social media user, influencers thus have a greater responsibility (or ethical duty) to avoid any (unintended) harm that their product endorsements can cause to their followers. This includes any possibility of harm to one's health as a consequence of endorsing a health-related product, given that influencers may not have the medical expertise to scrutinise said product in its entirety. Hence, TGA's basic advertising rules are a step in the right direction, to guide influencers in 'doing the right thing'.

Presenting this change as a ‘ban’ on influencers advertising health and wellness products is unhelpful and not true. The changes require influencers to stop making therapeutic claims that haven’t been tested and approved. Ending ‘cash for comment’ arrangements is also consistent with standards in place for other types of media. This is a very sensible policy change by the TGA that protects consumers from harmful misinformation.