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Prescription Drug Advertising and Me

No, this isn't a rerun and yes, I wrote about it just six months ago: prescription drug advertising – aka “direct-to-consumer” advertising and no surprise: it hasn't changed since then.

But maybe I have.

Before I get to that, however, consider this: most of us know there are “seasons” for sales of different kinds of products. Holidays are obvious but home appliances get a big push at certain times of the year. Beds and bed linens at other times. Cell phones are big in February. Sneaker sales seem to be everywhere in April. And so on.

I could be wrong – I haven't done a comparative study - but I believe I may have identified summer as the time of year pharmaceutical companies heavily promote their newest drugs.

Have you noticed recently? There are a bunch of commercials about drugs I had never heard of before: Orencia, Verzenio, Neulasta, Toujeo and more.

They sound a lot like the ones we're already accustomed to e.g., Eliquis, Humira, Xarelto, Lyrica, etc. which continue to be aired among these newbies. They are ubiquitous – I once counted seven prescription drug commercials in a one-hour TV show, and three or four is common.

Because people 65 and older are just about the last age group in the U.S. that watches TV and are also the age group that uses the majority of prescription drugs, it's old folks the marketers target and in addition to the billions of dollars big pharma pulls in for their drugs, it is a lucrative source of income for television networks, channels and owners.

”Drug companies spent more than $6 billion [in 2017] on direct-to-consumer ads, according to the consulting firm Kantar Media,” reported the Los Angeles Times in April. “Over 770,000 such ads were aired in 2016, the most recent year for which stats are available. That's up a whopping 65% from 2012.”

Milton Packer is a U.S. physician well known for his clinical research into heart failure.

”Studies report that consumers often place unwarranted trust in these TV prescription drug ads,” Packer wrote at Medpagetoday in May.

“Practitioners report being bombarded by patient requests, and many feel pressured to prescribe drugs that have been requested by patients, even if they believe it is inappropriate to do so. And the conversation often wastes the limited time the physician has allotted to the patient visit.

“Think the situation is bad now?” Packer continues. “A year ago, pharmaceutical companies were seeking FDA permission to use direct-to-consumer advertising to promote off-label use of drugs for nonapproved indications.”

That's not much different from a movie star advising people to not vaccinate their children, is it. Sure, let's tell people they can use a powerful controlled substance for anything they want.

I'm shocked that anyone could or would actually think that up. And it gets worse. This from The New York Times last December about prescription drug commercials in general:

”'The ads, which once focused on treatments for chronic but generally nonfatal conditions, have turned to more serious ailments in the last few years,' said Thomas Lom, a consultant and former senior executive at several health care ad agencies.

“'In the old days, it was allergies and acid reflux and whatnot,' he said. 'Now, it’s cardiology issues. It’s cancer.'”

Did you know that every nation in the whole wide world disallows direct-to-consumer prescription drug advertising except two? New Zealand is one. Can you guess the other? (The U.S., of course. But you knew that.)

A 2016 Harvard poll [pdf] asked Americans if prescription drugs should be advertised on television:

57% adults said they support removing prescription drug advertisements from television

39% said they opposed this change

The researchers report that there were no significant differences in opinion on this question by political party affiliation, income or gender.

Not that anyone in power, let alone the Federal Drug Administration (FDA) which sets the rules for pharmaceutical advertising, will do anything.

Okay. Believe it or not, all the above is background for what I really came here to say today.

It's not just the adverts themselves that disturb me. It is that, as one citation above notes, there are so many of them for the most debilitating and life-threatening diseases that exist (and the ads are always so damned cheerful about it.)

As most of you know, in June 2017, I underwent a 12-hour surgical procedure for pancreatic cancer. That and chemotherapy have been successful and in January the surgeon said there was no evidence of cancer, which my oncologist confirmed in February.

But that doesn't mean I can go back to the life I had before. I am forever stuck now in a “before and after” personal world, and I haven't found a way to ignore the event that divides the two sides of my life.

Although I'm still working out how my belief system has been challenged and I recognize that some of my outlook and attitudes may not be quite as solidly held as they once were, mostly I don't want to hear the word cancer anymore and certainly not the phrase “pancreatic cancer.”

I am not in denial. And I know that statistically, I am more likely to have a new cancer one day than someone with no previous cancer.

But I don't see a reason to think about that unless or until it happens. Unlike the majority of pancreatic cancer patients, I somehow made it through the first year after diagnosis and then some. A miracle, some say.

Living requires forward motion and I dislike the darkness, however fleeting, that shadows me for awhile following each drug commercial. I will never be as health carefree as in my “before” life but television free of drug commercials about dire diseases sure would help a lot.

(I'm not looking for advice today – just ruminating on something I've noticed that some others may recognize. Nor is it about 'don't watch tv' especially when we are living through a golden age of scripted programming - there is a lot of great stuff on TV these days. I'm only reporting something that may or may not be useful to discuss.)


Comments

Even my most far-right friends and family lament the old days when medical (including pharmaceutical) and legal people were barred from direct advertising. I think that we old people are targeted because we are the ones with the preponderance of chronic conditions. Such advertisings are one of the very few things that make me long for the "good old days" (pre-1985 for pharmaceutical ads and pre-1976 for legal ads).

An interesting aspect of the situation is how many ads now target conditions that I cannot for the life of me consider medical. (Curved penis? Really? That's a medical condition? Next they'll be selling implants to even out those of us whose mammary glands are of slightly different sizes!) Then, to top it off, they use a password generator to come up with new names for pharmaceuticals. Bah! Humbug!

I can't bear the drug ads either, Ronni. Hearing about some awful disease that may lie in my future every few minutes takes the pleasure out of watching TV. Yes, I have Netflix and Amazon, but I can find very little that I can relax and enjoy--too much violence and just plain ugliness.

I record the little bit of TV that I watch and fast forward through all the ads. One or two pushes of the thirty second button covers almost all ads.

Agree with all the above! Ironically, even though the elderly have more of these “conditions“ they have less money to spend on these exotic drugs. A couple of refills will send you into the donut hole before the daffodils pop up in the springtime.

The only way I can afford meds at this point in my life is to stay away from the brand names. I have zero co-pay for tier 1 and tier 2 but the moment I am prescribed a brand name I am in big trouble. So all the advertising in the world isn’t changing my mind! Make it stop!

The intense, often false statements, and repetitiveness of the drug ads have driven me away of commercial TV. This is clearly a simple 'me too' Ronni. Re: "only reporting something that may or may not be useful to discuss." Hopefully my comment doesn't fall under the heading of "advice", just a useful idea.

Being of the age with a fixed income like so many are when retired I must keep a tight rein on expenses like Cable TV, Netflix and Amazon.
I have been able to make great use of the video offerings of the public Libraries in Portland. In a city this size you can have up to 3 library cards with the adjacent counties. They offer so much more than only books now at no charge.

E-books and audio books.
Magazines that don't expire from RB Digital.
Streaming movies, music, comics, TV and more from Hoopla.

I can display any of them on my computer. Since fatigue is "the elephant in my living room" after some medical issues, this has been a saving grace. I can sit in a comfortable reclining electric chair and truly rest.
Just of note; Even my small county library in NV where I lived earlier, had access to the Inter-library Loan system, so it may be worth looking into wherever one lives.

Some of the rx ads discuss problems that would never have come up for public discussion in the past. Personally, I usually research extensively anything
prescribed for me. As far as I am concerned, the ads are superfluous and very
irritating.

During the TV pharm ads I listen to the side effects of these drugs, read in record time, I marvel how the condition the drug’s supposed to treat could be worse than the side effects.

Wow Ronni, I was just thinking the same thing! Big Pharma is really at it! You'd think that psoriasis was a debilitating condition suffered by millions, and that drugs are the answer to everything! So sick of these ads, and I'm sure that doctors are also pushed to sell these drugs! By the time they finish listing what conditions these drugs can create, who would want to take them?!? There really needs to be a system of checks on the drug companies! No wonder we've a drug overdose problem! It's as if they're shouting from the rooftops: "Take this drug and all your problems will be solved!" Disgusting!

Well said. I am a lung cancer survivor, so far, and do not care to be reminded of the the possibility of further treatment in my future. Lung cancer chemo treatments are big on tv and in magazine ads. It is so strange to me that lay people pay so much attention to them that they actually ask their various physicians for the drugs they hear advertised. If you dont have a doctor you trust will treat you with the best drugs available for your unique condition, get a new doctor and leave your care in his hands. Not in tv.....

DTC drug advertising should never have been legalized, for all the reasons mentioned. Its only real purpose is to pressure the public into pressuring their doctors. Its advent marked a precipitous drop in revenue for the medical journal I worked for, as all those ads aimed at the doctors started going instead to the general public. The ads really make me angry when I think of all the false hope and expectations they may raise in uninformed people, and I absolutely explode when at the end of many comes "... and it may even help you lose some weight."

Thanks goodness we don't have TV. Ads are a whole level of aggravation I don't have to contend with! (And there's more time to enjoy peace and quiet, good conversation and a library book.)

The correlation between the money the pharmaceutical companies spend on advertising and the price you pay for your prescriptions is obvious. There is no limit to the amount they can charge and we pay for that in the end.

Will the politicians do anything about it? Ha ha! Not as long as we have money in politics. The money that the politicians get for their own advertising from big pharma is a big part of the cost of drugs, because we all pay for that indirectly.

The high cost of prescription drugs compared to the time that prescriptions were affordable started with Congress who refused to rein in big pharma. Follow the money.

Like Allen, I record programs of interest to me & fast-forward ALL commercials. I am annoyed by all ads & consider watching them a waste of my valuable time. I put my trust in my internist to prescribe my medications; why on earth would I ask for a drug from a TV ad? I research online every prescription, as well as every relevant medical condition that is unique to me. The rest is garbage.
The $$s spent on TV ads could be better spent on reducing the cost of American Drugs for all. It's a pity that some Americans have to choose between food & medication. What a system!

"Ask your doctor about...."

Oh, really?

Manipulate people into being drug shills for gargantuan pharmaceutical companies?

My doc would laugh in my face, like I'd laugh in hers if she walked into my former public high school and subbed for 40 grade nine language arts students, 15 of whom have special needs.

Oh, and while she was taking my former job, I'd take hers..

Who wants to be my first patient?

Hey, where is everyone going?

Oh absolutely, Ronni! So many drugs and the list of possible side effects often sound more dire than the malady the drugs are supposed to treat.

Have you also noticed the huge number of fast-food commercials for burgers and pizza?? Piled high and dripping with sauces and bacon and sausage and goopy cheese.

What's the deal -- eat that garbage -- and then, take the drugs?? Eat garbage, get sick, take the drugs, get sicker, take more drugs...It's kind of a closed loop. Makes one wonder...

Like pigs to slaughter, so are we led...

Meanwhile, I chow down on broccoli and hope for the best...

Recently, I was prescribed Warfarin for a blood clot. The first thing that came to mind was the recollection that I had seen a commercial on TV where the actors were praising another drug that was much better than Warfarin. I even said something to the emergency room doc who did his best not to roll his eyes and then went on to describe other options, all of which presented more problems in my situation than Warfarin. Aargh!

I feel that these ads help make all of us pessimists and/or hypochondriacts. I want to enjoy my evenings not be constantly reminded that I'm mortal and in need of a lot of different drugs. I think all these commercials just encourage people to sit around and talk about all their ailments.
It's hard to avoid all the political trash (and I enjoy, to a certain extent, listening/learning about currant politics) and if you change channel, then it's all about your lung cancer, your achey joints, your heart disease, or whatever.
I just turn off the TV, listen to music, do handwork, read a book!

I refuse to allow "these marketers" to take over my life.

I am appalled at these ads for pharmaceuticals. I am also insulted that they use music from the '70s and '80s to get our attention. The latest is, "Oh oh oh, it's magic!" for ... is it Otezla, or something else that begins with the letter O. I do notice this, and I feel patronized.

The scenarios are always basically the same; an elder couple (heterosexual, of course, and sometimes black, just to mix it up) one of whom is in distress, the other one hovering and concerned. Often grandchildren are involved, in kitschy family settings, usually involving the outdoors.

I don't take any of these medications because I don't have the conditions described - yet. But even when and if I do develop them, none of the ads will resonate with me, as apparently I am not in the demographic they are targeting, except for my age.

I also record programs and fast forward through the ads, but I have noticed the proliferation of drug ads. It would never occur to me to ask my docs for a specific medication. I trust them both to prescribe what they think is best, and those are usually generics.
Down with Big Pharma!

I'm thinking the 39% who said they oppose this change must work either for a pharma company or a TV station. It's another example of how a motivated minority (like the NRA) thru money, lobbying, advertising and media pressure can get special favors at the expense of the majority.

I guess I'm pretty much over TV with ads. I miss a lot of current shows, it's true, but so far I don't think I've missed much in terms of news these days. (whether you like him or not the attention to Trump is at a ridiculous level).
I know this is not an option for many, but moving to Netflix or Hulu or Acorn TV helps a lot. They are not too expensive. The premium cable channels are good too, but not for the wallet.

There is absolutely no moral justification for pushing advanced pharmaceuticals to patients with slick commercial advertising. It's just evil. Another sign of a broken health care system. Others here have summed up the reasons -- I can only agree wholeheartedly.

"Ask your doctor about..." Yeah, right.

Reading all your notes is fascinating. I agree that I record the shows most watched. I do like my evening national news....but not the ads. We are two years away from having to cut cable and other expenses, I can easily get my national news on my computer. They should know that about all of us.

New this summer, I think, is the one for MBC. How nice - a cute new acronym for metastatic breast cancer. I had breast cancer and hope not to have it again. I don't know what the drug is called because I tune out the ad as soon as I hear MBC.

We’ve gone completely to Netflix, Amazon, and PBS online. Have not watched network TV for at least three years. Apparently that makes us young for our age (at least something does). All the commercials, not only the pharm ones, were simply driving us nuts. I do miss Jeopardy, which for the obvious age reasons you mention was fertile ground for the drug ads.

What you say is certainly true. I would like nothing better than for pharma ads to be banned.

I do wonder how doing so would affect the bottom line for broadcasters, then, in turn, their other programming? First they lost tobacco income and then if pharmaceuticals were next to go, I wonder what products would fill that advertising gap to which we’d be subjected?

I have acquired some sort of mechanism in my brain that whenever commercials pop up on TV, my eyes glaze over, and my hearing tunes out. There are so many ads run back-to-back in every break they all fuse together wiping out any impressions from the preceding ad that might have seeped through my filter as to become meaningless.

I don’t blame you for not wanting to hear the word cancer any more. It’s not about avoidance. There are no more depressing words to me than “cancer survivor.” I know the good news is supposed to be the survivor part, but I see it as a way of defining oneself that was invented by big Pharma and Big Medicine. Nobody benefits more from fear of cancer, a fear embodied in those words, than doctors and pharmaceutical companies. Once you have been treated, whether or not you “survived,” you have a right to forget it, not label yourself for all time with the name of your condition.

All television advertisements are assaults, so I avoid commercial TV completely, watching only Turner Classic Movies, PBS, and the premium channels like HBO and Showtime. This makes cable pretty expensive, but to me it has been worth the cost. I have been rethinking this of late, however, now that I have Netflix and Amazon Prime, which with an annual memberhip is practically free given that virtually everything I use in life except food is ordered from Amazon. On those rare occasions when I watch a network channel, I use the delayed option since I never need to see anything so urgently that I can’t wait until it has moved to on-demand.

All television news is anathema to me. My news comes via a daily local newspaper and its on-line clone plus on-line subscriptions to the NY Times and the Washington Post, both of which seem reasonably priced to me. My subscriptions were begun when the media made its plea about the need for support if they were going to be given the job of exposing Donald Trump. I’m not sure how well they have done so far, but these two publications, plus several that are free on-line, have provided plenty of news and I can control when and how I use it.

The snake oil salesmen, minus the carnival show, are alive and well on TV.

Off topic but I just read this blurb from an email I got from USA Today Short List. While I'm sure you will read this yourself, I wanted to send it to you as age bias is in the news.

"You know that we could hire three younger officers for what we pay you?" Keoni May, now 68, said the conversation with his boss's boss still haunts him almost a decade after what he terms his premature retirement – voluntarily on his part, but under duress, he said. Think ageism isn't real? Think again. Ageism is widespread and is termed "an insidious practice which has harmful effects on the health of older adults," by the World Health Organization. Political commentator Bill Maher famously called it the "last acceptable prejudice in America." And he may be right. We talk about #MeToo, and racism in the workplace, but ageism is many workplaces' not-so-secret bias. Here's how companies must shift the conversation about aging workers and retirement.

I am trying to understand why I get so angry and depressed when I see the ads on tv for metastatic breast cancer drugs. I am thinking of chucking my television because I simply cannot bear the anger these ads instill in me. Who are they for? Surely not women who have MBA, since they are (hopefully) under a doctor's care and will follow their doctor's advice. Hopefully they are not for doctors themselves, because I hope doctors get their information elsewhere. All I know is these ads show women who live a lifestyle I could never ever afford. They all seem to have very happy, supportive families. They all seem to have very loving husbands. They all seem to have plenty of energy. The ads just make me feel less than. Less affluent. Less surrounded by support. Less attractive. Less hopeful. Less likely to survive, I guess.

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