Too Much Information
The commercial begins with an attractive young lady walking through an overgrown hayfield, the camera slowly moving closer to her face; her inflamed red nose says it all, she has a cold. As the actor continues her walk, a voiceover begins to tell the story. “If you are suffering from a cold, [insert name of miracle drug here] will dramatically reduce your symptoms; side effects include loss of hair, itchy skin, ingrown toenail, flatulence, mood changes, depression, insomnia, priapism, hiccups, sudden outburst of anger, stomach pain, loss of memory, lack of empathy, urge to mumble to yourself, increased tendency to lie, a shaking foot, and blurry vision.” Sounds like an amazing cure for the cold, I think I will endure a runny nose—a nod to Jeff Foxworthy who once did a comedy bit along the same lines as my comedic effort.
A check of various sources shows the pharmaceutical industry spends a little more than $1 billion a month in the US on advertising. That’s a hefty sum, chasing big dollars; pharmaceutical sales worldwide were over $1.6 trillion for the year ending 2023. With so much at stake, it is easy to understand why pharmaceutical firms advertise directly to US consumers.
The United States and New Zealand are the only countries in the world that permit direct advertising of pharmaceuticals to patients. I wonder why the US permits this; my guess is, big pharma has great lobbyists. It is not hard to see why the drug companies choose to focus on hawking their drugs to the population. In fact, there is some data to suggest that drugmakers spend more money on promoting drugs to the public that are known to have the least impact on the patient. Said differently, if the drug hasn’t shown, in clinical trials, to have a significant impact, or results that are better than other options, doctors tend to not prescribe it as frequently as other options. If the doctors aren’t likely to prescribe the drug, then you need patients seeking it and actively asking doctors to give them a script. In fact, according to a February 7th, 2023, Forbes article, “nearly two-thirds of the country’s top-selling prescription drugs—92 of the 135 drugs data was available for—were rated as offering patients low added benefit by health agencies in France and Canada.” Foreign agencies were referenced as a source of this data because there isn’t a US agency that conducts comparative studies to measure competing drugs for effectiveness.
Wouldn’t it be interesting if right before they cited the obligatory side effects, drug companies were forced to show you the performance of their drug against others that were indicated for the same problem? If the FDA is so keen to force companies to disclose every conceivable problem you could get from taking the drug, why not require big pharma to tell us if the damn drug works, and how well? I assume we can handle the additional bit of information. After all, we are used to commercials showing us what drug men can take to be more, ugh, vigorous; how we can dance in the street if we take Ozempic to lose weight; and my new favorite, a carrot that appears to deliver an awkward message to men about curves; we likely will never look at a carrot the same way (if you haven’t seen that beauty of an ad, you’re in for a treat).
In my humble view, we can do without advertisements for medications on TV. Frankly, we could probably do without taking so much medicine. I am not a doctor, nor do I want to suggest I have a sound basis for this, but it seems doctors sure do prescribe a lot of medicine and we are eager to take whatever they give us. According to the KFF, (an independent source for health policy research, polling, and news), “more than half of adults 65 and older (54%) report taking four or more prescription drugs compared to one-third of adults 50-64 years old (32%) and about one in ten adults 30-49 (13%) or 18-29 (7%).” As a society, we are gleeful consumers of prescription drugs; not surprisingly, the US is therefore the biggest user of prescribed drugs in the world; we also pay more for our medicines than anyone else in the world, by a wide margin.
Doing business in the US is very good business for big pharma; they are allowed to drive demand directly with the consumers, they don’t have to worry about comparisons to competitors, and Americans have become willing targets who think medicine will solve every conceivable problem; all this adds up to drug companies having the ability to charge us ridiculous prices, and they do.
This topic is like so many of the problems we have in this country, we have allowed massive companies to put their profits ahead of common sense and good stewardship. I really don’t blame the companies; I blame our leaders who should be legislating; they remain asleep at the wheel. Or maybe they are so well greased they don’t want to address the problem; I hope not, but it wouldn’t surprise me.
Drug companies shouldn’t advertise on TV, they shouldn’t be able to use the US population as a profit center, they shouldn’t spend time telling us how much it costs to do R&D and they are the innovators, when their motivations today are less noble than they were when they set out to make the lives of patients better.
Next time you see an advertisement on TV for a medication targeting patients who have a problem, ask yourself what is the value provided by the commercial. Who is the message benefiting? Wouldn’t it be better if a physician decided whether a patient needs the treatment? And if you’re feeling cheeky, imagine the ad agency, racking up the big bucks putting together a 30 second spot that ends with a description of all the bad things that will happen if you buy the product; I am sure there are jokes when they write the script for the side effects.
We are overloaded with information; in this case it appears we are getting the wrong data. The FDA is, I am sure, convinced that by disclosing the downside, they are doing their job, they’re not. If you want to inform me about a product, tell me how I can compare it to other options; tell me what it cost compared to other options. No, I have a better idea, don’t tell me anything; leave the drug commercials on the shelf, in this case any attempt to advertise to the public is too much information.
