Direct-to-consumer pharmaceutical advertising does more harm than good to public health.

America does not have universal healthcare and the people pay more for medicine than other countries. America ranks last overall among wealthy countries in healthcare.

America is all about money. It has the highest national debt of 40 trillion .

SkepticalOne wrote:

Drug companies do not advertise cheap, effective generic medications; they advertise highly expensive, newly patented, brand-name drugs. By artificially inflating consumer demand for these premium products, ads successfully steer patients away from generics that cost a fraction of the price. Furthermore, the billions of dollars spent annually on these flashy ad campaigns are not absorbed by Big Pharma—they are passed directly to the consumer. This inflates insurance premiums, strains public healthcare budgets, and drives out-of-pocket drug costs to astronomical heights. When marketing drives up the price of medicine, low-income patients are forced to ration their doses or skip prescriptions entirely. This is a structural failure of public health caused directly by advertising.\

I'd push back on generics being the answer. Generics are another facet of the same issue. A lot of the production has been outsourced to India, with the idea that they are subject to the same FDA inspections as on-shore manufacturing facilities, but this isn't true because the inspections are never random - producers are given prior warning. India has an absolutely laughable domestic regulatory structure, and due to this policy problems are 'cleaned up' sufficiently before the inspectors ever arrive at the plant. Investigative journalist Katherine Eban wrote a really interesting (and horrifying) book detailing these issues that was a NYT bestseller - Bottle of Lies. These drugs aren't the same quality for less money, even with the crippled regulatory oversight we can exercise we have found things like crushed glass inside the pills, almost none of the active ingredients which are supposed to be there, etc. Indian companies have literally wiretapped investigators from American regulatory agencies to learn which areas of the plant need to be cleaned up before their visit. It's another example of corporations pursuing the bottom line at all costs, putting Americans in danger by skirting domestic regulations and undercutting the competition who are engaging in responsible production and not availing themselves of sweatshop conditions in corrupt, third-world shitholes.

As for the advertisements themselves, I don't think they have much of a consumer impact and I don't think that's the primary reason why pharmaceutical companies air them. In the past, drug manufacturers were often hit very hard by investigations by the media into drug-related scandals. Drug advertising makes up almost a quarter of ad minutes if I recall correctly. This creates an absolutely huge perverse incentive for media organizations themselves to not offend them and to quietly squash negative coverage, as it could put the profitability of their entire business model into question were those ad runs pulled. This dampening effect has left a vacuum that's been filled by a mix of cranks, snakeoil salesmen, and legitimate investigative journalists trying to cover pharmaceutical malfeasance. This makes it easy for the pharmaceutical companies to tar all three with the same brush and discredit any legitimate interrogation of whatever evil shenanigans they've gotten up to. It's had a profound effect on the main consumers of those media products as well - I've never seen the so-called liberals in this country more slavishly devoted to outright defending big pharma than they are today.

When it comes to pushing drugs on people, I think the lobbying/advertising/kickbacks directed at doctors is way more effective and way more egregious, as it severely undermines the respect for medical professionals. Corporate consolidation in the healthcare industry is also a big problem that is seldom addressed - a lot of private practices are being gobbled up, and that's another avenue of influence when you have doctors who are employees of a larger corporation instead of owners of an independent practice. There's one particularly egregious example I can think of during the opioid crisis where Insys was prosecuted under RICO for aggressively promoting an oral fentanyl spray to doctors, who then widely prescribed it, boosting their profits. The case kind of peaked when the company hired a new regional sales director with zero experience in either pharmaceuticals or sales. Nevertheless, this new hire posted incredible sales numbers in her region. This young lady, Sunrise Lee, was a former stripper who was offering doctors with the highest subscription numbers free lap dances and possibly other benefits. The drug was strictly approved by the FDA for terminal cancer patients who had developed a tolerance for other opioids, being a so-called 'drug-of-last-resort'. The stripper saleswomen and an aggressive campaign of paid 'speaking engagements' were meant to pressure the doctors to prescribe it off-label for basic back and neck pain.

The general direction is correct, and those TV drug ads need to be banned, but doctors are not these powerless victims of big pharma you are portraying them as. They are under prescribing pain killers as an overcorrection right now just because they want to cover their asses.

Debby,

 America ranks last overall among wealthy countries in healthcare.

Three things;

1. "Fast food" probably the worst method of food delivery ever developed, not because of the convenience [drive-up], but because of the poor quality
2. "We are what we consume." We put more junk in our bodies than is healthy, and that means more than through the pie hole. It's a fact that
3. American consumerism, while more plentiful than just about anywhere else, is also more damaging by our choice than anywhere else. And that has little to do with the quality of healthcare professionalism and more to do with our personal stupidity re: our personal healthcare. We would utterly wipe out over 80% of our most critical diseases we face [heart disease, cancer, diabetes] just by our personal decision to limit our consumption of junk.

All leads to a more rapid descent into a hypochondriacal society.

They why is DoGe and Trump cut back on healthcare and other critical government programs because junk food was cheap and the American population liked it.

I'd push back on generics being the answer. Generics are another facet of the same issue.

Agreed.

As for the advertisements themselves, I don't think they have much of a consumer impact

Journal of Public Economics estimated that DTCA drove roughly 31% of the total rise in U.S. prescription drug spending since 1997. [Link].

There is an undeniable impact to consumers - increase demand, increased volume, taxpayer funded write-offs, low added clinical value over existing alternatives (not necessarily generics).

and I don't think that's the primary reason why pharmaceutical companies air them.

Perhaps, but this doesn't negate that DTCA is still harmful. Don't get me wrong, I am very sympathetic to the fact that the US Healthcare system is very broken, but that is a much larger can of worms than just DTC advertising.

Dr.Franklin wrote:

The general direction is correct, and those TV drug ads need to be banned,

We are agreed!

but doctors are not these powerless victims of big pharma you are portraying them as. They are under prescribing pain killers as an overcorrection right now just because they want to cover their asses.

Whatever blame doctors bear for our broken healthcare system falls behind hospitals, pharmaceutical companies, insurance companies, and legislators who fail to address the problem.

America needs universal healthcare. Medicine for profit has to end.

Agreed. We spend the most of our peers and get the least.

Then why did you vote for Trump?

You are mistaking me for someone else - Ive never disclosed my vote.

Was it because nothing good came out of it?

Did good come of anyone's vote?

Most vote for a positive outcome.

That's an extremely optimistic outlook on a profession, dare I say human nature in general. I mean sure if we are discussing costs than PBM's and administrative bloat are probably larger factors, Insurance isn't because it is legally mandated by law to spend 85% of its premiums on healthcare, so there is a hard cap to how much it actually contributes. People want to blame insurance because most people or employers pay premiums that gets higher each year but those premiums are higher...because healthcare gets higher, not because Insurance companies are actually making more profit.

That said, doctors are still to blame partially because they hold a cabal of gatekeeping when it comes to resident and med school seats. It is an artificially lower supply that is effectively permanent unless things change, but they won't

Optimistic? I've not said doctors bear no blame for the issues with our healthcare. If you want to quantify doctors as the leading cause, I would vehemently disagree though. I would put Hospitals at the top of that list because they have the power to set prices with very little push back. Pharmaceuticals would be next.

Insurance companies arent as bad as everyone thinks, but they game the system nonetheless. Its true, only 15% goes to their pockets, but if healthcare costs more, their 15% is a larger amount. Don't be fooled. This is a flaw in legislation being exploited while described as a handicap for the poor insurance companies. It is a peverse incentive to allow more and more costs and do very little negotiating.

Healthcare in America isa for profit scheme. America should provide universal healthcare as most of the developed countries do.

I say we are 90% in agreement but health insurers notoriously negotiate...a lot

I'll look into that. Thanks for the discussion.

so you didn’t come prepared?