The FDA on Tues­day re­leased 40 let­ters sent to com­pa­nies as part of its crack­down on phar­ma­ceu­ti­cal ads, re­veal­ing some of its crit­i­cisms on how risks and ben­e­fits of drugs are pre­sent­ed.

The un­ti­tled let­ters con­cen­trat­ed most­ly on tele­vi­sion ads from Pfiz­er, No­var­tis, Bris­tol My­ers Squibb, Ab­b­Vie, Al­ny­lam, Boehringer In­gel­heim, Sanofi, As­traZeneca and oth­ers. Sev­er­al com­pa­nies re­ceived mul­ti­ple let­ters each.

Bris­tol My­ers, for ex­am­ple, re­ceived three un­ti­tled let­ters for "false or mis­lead­ing" TV ads re­lat­ed to their block­buster can­cer drug Op­di­vo and their car­diomy­opa­thy drug Camzyos. In the let­ter, the agency took is­sue with the safe­ty ex­pla­na­tions in each, among oth­er con­cerns.

The FDA is­sued warn­ing let­ters to tele­health com­pa­nies for mak­ing "false or mis­lead­ing" claims about com­pound­ed GLP-1 obe­si­ty drugs.

The let­ters were part of a larg­er group of warn­ings post­ed on Tues­day that were sent to on­line phar­ma­cies, phar­ma­ceu­ti­cal gi­ants, tele­health star­tups and oth­er com­pa­nies as part of the Trump ad­min­is­tra­tion's clam­p­down on drug ad­ver­tis­ing.

Among the tele­health com­pa­nies that re­ceived let­ters were Hims & Hers and Rem­e­dy Meds, which bought fel­low dig­i­tal health plat­form Thir­ty Madi­son for $500 mil­lion. Both sell com­pound­ed ver­sions of pop­u­lar weight loss drugs. While these com­pound­ed drugs are not ap­proved by the FDA, they surged in pop­u­lar­i­ty over the past few years dur­ing the na­tion­wide short­age of GLP-1 drugs. Some tele­health com­pa­nies cap­i­tal­ized on the de­mand, build­ing en­tire busi­ness­es around the al­ter­na­tive ver­sions.

For years, the end of every phar­ma­ceu­ti­cal ad has been a well-worn con­ven­tion: Af­ter smil­ing pa­tients are done walk­ing down the beach, or singing while walk­ing down the beach, a voice reads a sum­ma­ry of side ef­fects and risks that may come with treat­ment.

Un­der the FDA, those brief warn­ings have been a com­pro­mise be­tween reg­u­la­tor and in­dus­try, try­ing to strike a bal­ance be­tween what peo­ple will pay at­ten­tion to dur­ing a brief break in their show or game, and a com­plete pic­ture of the com­plex set of trade-offs that comes with many med­ica­tions.

This week's an­nounce­ment by the FDA that it plans to up­end that pol­i­cy on side ef­fects could com­plete­ly change — or dis­man­tle — that con­ven­tion, and po­ten­tial­ly drug ad­ver­tis­ing as a whole.

The FDA's top drug reg­u­la­tor de­nied a re­port that said he might "aban­don" cer­tain ad­vi­so­ry com­mit­tee meet­ings that of­ten re­view con­tro­ver­sial drug can­di­dates be­fore po­ten­tial ap­proval.

Cen­ter for Drug Eval­u­a­tion and Re­search Di­rec­tor George Tid­marsh said ear­li­er this week that the agency “would like to get away” from as­sem­bling its out­side ex­pert pan­els to ex­am­ine and vote on in­di­vid­ual drugs be­cause “I don’t think they’re need­ed," ac­cord­ing to a KFF Health News sto­ry pub­lished Fri­day. The re­port said FDA lead­ers seek to "aban­don" these ex­pert re­views.

When asked if he would aban­don or elim­i­nate ad­comms that fo­cus on in­di­vid­ual drug ap­pli­ca­tions, Tid­marsh de­nied it, telling End­points News, "Aban­don? I have nev­er said that."

Tid­marsh did not re­spond to a re­quest for more clar­i­ty on his views around ad­comms.

Covid-19 shot mak­ers have not been work­ing close­ly with the CDC’s vac­cine ad­vi­sors and aren’t ex­pect­ed to make sub­stan­tive pre­sen­ta­tions to the pan­el when it con­venes lat­er this week, mul­ti­ple sources fa­mil­iar with the plan­ning told End­points News.

The CD­C's Ad­vi­so­ry Com­mit­tee on Im­mu­niza­tion Prac­tices is sched­uled to meet start­ing Thurs­day to dis­cuss and vote on rec­om­men­da­tions for he­pati­tis B, MM­RV and Covid-19 vac­cines. Sources told End­points that an agen­da item for Fri­day, list­ed as “COVID-19 Vac­cine Man­u­fac­tur­er up­dates,” will be an op­por­tu­ni­ty for the com­pa­nies to re­spond to ear­li­er pre­sen­ta­tions made dur­ing the meet­ing. Com­pa­nies have his­tor­i­cal­ly been al­lot­ted time dur­ing ACIP meet­ings to give de­tailed pre­sen­ta­tions on up­dat­ed vac­cine da­ta.