If CPMs have been rising all year, you are not imagining it. Costs per thousand impressions are up almost everywhere in 2025. The reason is not only “Meta got more expensive.”
Part of it is the market. Advantage+ consolidates spend into fewer auctions, so competition for the good impressions is fiercer. Reels and Stories have taken the steepest increases. The auction still prices bid × predicted action rate × ad quality — if your ad is slightly less relevant than the next certified brand, you pay a premium.
Those forces hit everyone. They do not explain why two GLP-1 advertisers with similar creative see such different CPMs.
Delivery friction
Some accounts get stickier over time even when CTR and conversion rate look fine. Patterns that show up in health stacks: old policy flags and unresolved Page quality issues that never quite leave. Recycled Pages, domains, or ad accounts that have changed hands. Constant edits and duplication that keep campaigns under review. Weak event data — poor Event Match Quality, pixel drift, unverified domains — which lowers predicted action rate and therefore raises price.
None of those throw a red banner. You just notice that scaling got harder and every impression costs a little more. In a restricted vertical, a cold account adds another layer: Meta already prices health as risk. The market increase and the trust tax stack.
What to fix before you blame the auction
Clean old friction. Archive flagged assets you do not need live. Verify the domain. Stop rebuilding campaigns every week. Raise Event Match Quality, keep Aggregated Event Measurement stable, and send a clean Conversions API for the events that actually mean a patient or a purchase.
Make creative that can live in the placement: short vertical for Reels, native UGC, hooks that get watched. Rotate without detonating the ad set daily. Let Advantage+ campaigns stabilise before large budget jumps. Fewer, stronger campaigns reduce self-competition.
Advertisers who do this well often see CPMs 15–30% lower than their sticky baseline, faster approvals, and spend that stops leaking into dead placements. If creative and tracking are already clean and CPMs are still high, the remaining lever is usually the account Meta is scoring — HiVA, feedback, and whether you are running certified health through infrastructure the platform already trusts.
