A group from the AIDS Healthcare Foundation protests outside Gilead Sciences’ headquarters. Photo courtesy of Jesse Brooks for the AIDS Healthcare Foundation. 

An increasing amount of Americans view the pharmaceutical industry in a negative light, saying they believe that prescription drugs have made the lives of people in the U.S. worse, drug costs are unreasonable, and drugmakers should be required to release information to the public about how they set prices, according to a new survey.

The Kaiser Family Foundation conducted its annual health tracking poll in mid-September among 1,204 Americans.

This year’s poll highlights an increasingly negative public sentiment toward the pharmaceutical industry during a time when more drugmakers have been under fire over the re-pricing of older treatments. Mylan was blasted by lawmakers in September over price hikes of its emergency anaphylaxis treatment, EpiPen. And, in 2015, both Turing Pharmaceuticals and Valeant Pharmaceuticals International were criticized over dramatic price increases of Daraprim, a drug used primarily by AIDS patients, and Nitropress and Isuprel, two heart drugs, respectively.

Seventy-seven percent of respondents in 2016 said prescription drug costs are unreasonable, compared to 72% of survey participants in 2015.

See also: Conflicting polls highlight uncertainty about the public’s opinion of pharma

But the poll also found that fewer respondents — 70% — had seen or heard prescription drug advertisements compared to last year’s 82%. And, subsequently, fewer participants said they talked with their doctor about a specific medicine they had seen advertised this year. The drug industry spent $5.4 billion in 2015 on DTC advertising, according to Kantar Media.

This drop in patient engagement may be the result of different media viewing habits for younger generations, who are less likely to see TV broadcasts during prime time, said Ashley Kirzinger, a senior survey analyst for the Kaiser Family Foundation. Nearly half of respondents (47%) also called for eliminating prescription drug advertisements. That question had not been asked in previous years’ polls.

The American Medical Association voted in support of banning DTC advertising in November. Rep. Rosa DeLauro (D-CT) introduced the Responsibility in Drug Advertising Act in February that would place a three-year hold on nearly all DTC advertising.  

See also: The year’s top pharma marketing controversies

Respondents also questioned the value of new drugs in their lives, with 21% saying that prescription drugs developed over the past 20 years have “generally made the lives of people in the U.S. worse,” compared to only 15% of participants who said so last year. Kirzinger posited that this perspective could be a result of critical news coverage, suggesting that people may be seeing a disproportionate amount of negative stories about drugs, like increasing prices, for example, rather than positive ones, such as how newly approved medicines have changed the standard of care.

PhRMA spokesperson Holly Campbell said in a statement that “surveys on the affordability of medicines highlight challenges patients are facing in accessing their medicines,” a common refrain for the industry when addressing its critics. She also called for pragmatic solutions, including giving patients better information about out-of-pocket costs, as well as “common-sense rules to prevent discrimination and remove barriers to accessing care.”

The ongoing criticism about drug pricing has become an election-year issue. Last week Democratic presidential candidate Hillary Clinton wrote in an op-ed in The New England Journal of Medicine that, if elected, she will directly address the rising costs of drugs. Her plan focuses on streamlining the approval process for biosimilars and generic drugs and ensuring “that drug companies justify their prices, eliminate ‘pay for delay’ practices, and allow Medicare to directly negotiate for better prices.” She also said she would create a consumer response team that would identify excessive price hikes on “long-standing, life-saving treatments.”