Over the last 18 months, we at Holistic Primary Care have been deeply involved in the process of expanding our online presence, and engaging new audiences with our medical content.

Through that process, we’ve had to learn a bit about the arcane arts of search engine optimization and keyword-based online advertising. And recently, as we began using the Google AdSense platform to bring new advertising streams onto our site, we discovered something deeply troubling: the Google AdSense platform does not distinguish between pharmaceutical and dietary supplement ads.

The platform enables online publishers like HPC, and others in the field, to filter the ads that Google posts to our website by selecting from a list of categories which Google provides. We, and other publishers, try to select ad categories that are most related to our website’s content.

In the realm of healthcare, Google’s ad category list includes a single header for “Drugs and Supplements.” It basically lumps these two industries—and two types of ads—together into a single group.

This is extremely problematic for us as publishers of content related to holistic medicine, and also for you as a marketer of non-pharmaceutical products.

Why? Because by grouping supplements and pharmaceuticals into a single category, Google is unwittingly—and we believe unintentionally—creating a bias that favors pharmaceutical ads.
We discovered this problem earlier this summer, when we began to deploy the AdSense system on our site. Within weeks, we began to see pharma ads—for cancer drugs, psychiatric drugs, immunomodulatory drugs—popping up on the site. Most were only vaguely relevant to the editorial content next to which they appeared.

Fortunately, we work with a sharp IT partner, who has the knowledge and skills to dig deeply into the analytics, and the workings of Google’s algorithms.

He and his team figured out that because Google lumps “Supplements” and “Drugs” together, the drug companies (or shell websites created by them) are able to buy up keywords relevant to holistic medicine (and, to be fair, nearly all healthcare related topics) and stack the odds that their ads will show up when readers seek information on healthcare alternatives.

For example, an online reader searching Google for articles on “probiotics after antibiotics” will likely find her way to HPC’s article on this topic. But the ad next to that article could be an ad for a Proton Pump Inhibitor, or an anti-inflammatory drug for Crohn’s Disease. We have seen this happen many times on our site. 

Google’s system does allow publishers and website hosts to block individual ads. But this can be very time-consuming; it obliges us to monitor our content and our ads constantly, and then spend time and energy tracking down the sources of each undesired ad and applying the appropriate coding to block each one individually.

This can quickly become a game of whack-a-mole, because the pharmaceutical companies can easily create new websites on domain names that seem totally unrelated and independent, through which they can then buy advertising keywords and deploy the parent company’s ads.

Industry Impact
In addition to being a hassle for us as publishers, we believe Google’s current setup has significant negative impact for any company that advertises dietary supplements or natural products through AdSense.

Putting it most simply, the drug companies can outspend you, and Google’s system is set up in such a way that drug ads are likely to show up where your ads ought to be appearing.
The grouping of pharmaceutical and dietary supplement ads into a single AdSense category is problematic for several reasons:

1. Websites wishing to be open to ads from supplement or natural product companies must by default be open to pharma ads. Short of individually blocking each unwanted ad that pops up on our site, we as website hosts have no easy way to ensure that only ads from supplement and nutrition companies will appear on our website. 
2. The current categorization creates inherent bias in favor of pharma. Google’s categorization schema gives an unfair competitive advantage to pharma companies, while disfavoring supplement advertisers. Drug companies have vastly bigger marketing budgets and greater online strategic capabilities. They can easily outspend supplement companies, ensuring their ads are linked to keywords representing holistic, natural, and functional medicine. Because of this, drug ads frequently pop up next to content about non-pharma healthcare alternatives.
3. It is unfair to online readers. Under Google’s current system, people seeking online information about holistic healthcare and functional medicine are routinely exposed to ads for the very types of products for which they are seeking alternatives. AdSense placement of drug ads on sites featuring content about holistic, integrative, or functional medicine means that the ads and editorial content are mismatched from a reader’s perspective.
4. Google’s lack of distinction between drug and supplement ads runs counter to intent of federal regulations. The Dietary Supplement Health and Education Act (DSHEA) makes it clear that supplements and prescription drugs are two entirely distinct product categories that must not be mixed or misconstrued. Over the last 24 years since passage of DSHEA, FDA has unequivocally reinforced that position. In saying this, we are not implying that AdSense is in violation of the law; we’ve spoken with industry attorneys who informed us that Google is not bound by DSHEA, and that its ad categorization scheme is not illegal. But the system’s combining of drug and supplement ads is definitely not in alignment with the intent of DSHEA or the FDA’s enforcement of it.
5. It is unfair to online publishers using Google’s AdSense platform. Websites wishing to display supplement ads but not pharma ads must expend time and human resources monitoring, tracking, and blocking the unwanted drug ads individually, because they cannot be blocked as a category. The combined pharma-supplement category also makes it difficult for publishers to determine what percentage of total AdSense revenue comes from Pharma vs Supplement ads, unless they go deeply into the analytics and track every single AdSense placement. This is time and labor-intensive.

Taking Action
As a publishing company with a deep commitment to natural nutrition-based medicine and freedom for healthcare alternatives, we at Holistic Primary Care are deeply concerned about this issue.

We are working to find the appropriate person within Google’s administration that has authority over the company’s ad categorization schema. We plan to contact this individual and urge Google to make a simple change to the AdSense platform that would create two distinct and non-overlapping categories, one for Pharmaceuticals, and a separate one for Dietary Supplements.

Such a change would:

• Serve online health information-seekers by creating greater alignment between the types of content they are seeking and the types of ads that appear in connection with said content;
• Serve online health information publishers by making it easier for them to monitor, to distinguish between, and to make informed choices about the types of ads displayed on their websites;
• Eliminate inherent and probably unintentional bias that favors the drug industry and disfavors supplement industry advertisers;
• Serve Google itself by bringing AdSense into alignment with a federal law that makes a clear distinction between pharmaceuticals and dietary supplements; and by creating two separate revenue-generating categories out of the existing single category.
• Engage companies and websites not currently using AdSense because they do not like the current framework for ad categorization.

If you share our concern about this problem, please be in touch. You can reach me via e-mail at: Erik@holisticprimarycare.net. I believe that if we, as an industry, can come together with a unified voice we can convince Google to reconsider and revise its existing ad categorization structure. It is certainly worth a shot!

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Erik Goldman
Holistic Primary Care

Erik Goldman is co-founder and editor of Holistic Primary Care: News for Health & Healing, a quarterly medical publication reaching about 60,000 physicians and other healthcare professionals nationwide. He is also co-producer of the Practitioner Channel Forum, the nation’s leading conference focused on opportunities and challenges in the practitioner segment of the dietary supplement industry.