Another Example of Americans Paying Corporations to Join Their Sales Force
Nicholas Johnson
The Gazette, June 8, 2021, p. 6A
“Ask your doctor if your purchase of this over-priced, patent-protected, copy of a generic drug, with its possible hazardous side effects might be right for our shareholders.”
In 2001 global pharmaceutical sales were $390 billion. In 2020 they were $1.27 trillion.
In 2018 the pharma industry spent $6.46 billion on direct-to-consumer (DTC) “ask your doctor” TV commercials – enlisting you and me to help boost their sales. (It also spent nearly $30 billion wooing doctors with speaking fees, travel, meals, free samples and “education.”)
When I was young, companies paid people to walk around downtown Iowa City wearing small advertising billboards. Today people pay companies to display company names and logos on their hats, shirts, pants and shoes.
Persuading doctors to write prescriptions for drugs we don’t need, may cause harm, or with no more significant benefits than generics, may be another example of our paying corporations to join their sales force.
But it’s much more serious. The West Health Policy Center reports “If current drug pricing trends continue [some patients’ inability to pay those prices] will result in the premature deaths of 112,000 beneficiaries a year, making it a leading cause of death in the U.S., ahead of diabetes, influenza, pneumonia, and kidney disease.”
Once again, “We’re Number One!” We’re number one in defense spending, and percentage of persons in prisons – and now “ask your doctor” commercials.
But this time we’re not just number one, we are almost the only one. Only two countries permit advertising drugs directly to consumers. (New Zealand permits it, but robust opposition continues.)
How can this be? Every year between 1999 and 2018 the pharmaceutical industry spent an average of $1.5 billion on political contributions and lobbying.
Isn’t it kind of weird to advertise a product to those legally forbidden to buy it? We can’t go into a drug store and buy this stuff. We must nag our doctor for the permission slip called a “prescription.”
Want an analogy? Think about TV ads for toys on children’s programs. Aside from a handful of young, energetic entrepreneurs – and kids with advanced degrees in parental manipulation – children cannot buy what the capitalists are advertising.
That’s like big pharma’s “ask your doctor” TV spots – except we’re now the children and the doctors are our parents.
Listening to the FDA-required itemization of side effects makes you question whether it is “right for you” – or anyone else. But you don’t listen, because the commercial keeps telling you, “Oh, look at the squirrel.” See the happy grandparents with their happy grandchildren; the couple fishing or swimming in the lake or lovingly watching the sunset from the deck of their $400,000 summer cabin.
There are things capitalism can do better than public programs. Providing the pharmaceutical portion of our nation’s healthcare is not one of them.
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Nicholas Johnson, former co-director, Institute for Health, Behavior and Environmental Policy, is the author of What Do You Mean and How Do You Know? mailbox@nicholasjohnson.org
“Ask your doctor if your purchase of this over-priced, patent-protected, copy of a generic drug, with its possible hazardous side effects might be right for our shareholders.”
In 2001 global pharmaceutical sales were $390 billion. In 2020 they were $1.27 trillion.
“Revenue of the worldwide pharmaceutical market from 2001 to 2020,” Statista, May 4, 2021, https://www.statista.com/statistics/263102/pharmaceutical-market-worldwide-revenue-since-2001/In 2018 the pharma industry spent $6.46 billion on direct-to-consumer (DTC) “ask your doctor” TV commercials – enlisting you and me to help boost their sales. (It also spent nearly $30 billion wooing doctors with speaking fees, travel, meals, free samples and “education.”)
“Direct-to-consumer spending of the pharmaceutical industry in the United States from 2012 to September 2019,” Statista, Sept. 24, 2020, https://www.statista.com/statistics/686906/pharma-ad-spend-usa/When I was young, companies paid people to walk around downtown Iowa City wearing small advertising billboards. Today people pay companies to display company names and logos on their hats, shirts, pants and shoes.
Roopal Luhana, “Pharmaceutical Companies Paid Billions to Doctors in 2018: Influencing Prescriptions?” New York Injury Law News, Legal Examiner, Aug. 2, 2019, https://newyork.legalexaminer.com/health/pharmaceutical-companies-paid-billions-to-doctors-in-2018-influencing-prescriptions/
Persuading doctors to write prescriptions for drugs we don’t need, may cause harm, or with no more significant benefits than generics may be another example of our paying corporations to join their sales force.
But it’s much more serious. The West Health Policy Center reports “If current drug pricing trends continue [some patients’ inability to pay those prices] will result in the premature deaths of 112,000 beneficiaries a year, making it a leading cause of death in the U.S., ahead of diabetes, influenza, pneumonia, and kidney disease.”
“More than 1.1 million deaths among Medicare recipients due to high cost of drugs,” West Health Institute, American Association for the Advancement of Science (AAAS), EurekAlert!, Nov. 19, 2020, https://www.eurekalert.org/pub_releases/2020-11/whi-mt1111820.phpOnce again, “We’re Number One!” We’re number one in defense spending, and percentage of persons in prisons – and now “ask your doctor” commercials.
Aran Ali, “Mapped: The World’s Top Countries for Military Spending,” Visual Capitalist, May 15, 2021, https://www.visualcapitalist.com/worlds-top-countries-for-military-spending/But this time we’re not just number one, we are almost the only one. Only two countries permit advertising drugs directly to consumers. (New Zealand permits it, but robust opposition continues.)
“Countries with the largest number of prisoners per 100,000 of the national population, as of May 2021,” Statista, June 2, 2021, https://www.statista.com/statistics/262962/countries-with-the-most-prisoners-per-100-000-inhabitants/
Susan Kelly, “U.S. doctor group calls for ban on drug advertising to consumers,” Reuters, Nov. 17, 2015, https://www.reuters.com/article/us-pharmaceuticals-advertising/u-s-doctor-group-calls-for-ban-on-drug-advertising-to-consumers-idUSKCN0T62WT20151117 (“The United States and New Zealand are the only two countries that allow direct-to-consumer advertising of prescription drugs.”)We go to doctors because few patients are equipped to self-diagnose or choose remedies. The American Medical Association made a strong case for banning the ads. It was unsuccessful.
Beth Snyder Bulik, “Doctors in New Zealand—the only non-U.S. country that allows DTC advertising—call for bans,” Fierce Pharma, March 20, 2017, https://www.fiercepharma.com/marketing/doctors-new-zealand-only-other-country-allows-dtc-advertising-hate-it-too
“Statement from New Zealand Public Health Experts on Direct-to-Consumer Advertising of Prescription Drugs (relating to Consumer NZ Poll),” Media Release from University of Otago, New Zealand Doctor, August 7, 2019, https://www.nzdoctor.co.nz/article/undoctored/statement-new-zealand-public-health-experts-direct-consumer-advertising
Joel Lexchin, David B. Menkes, “Can Direct-to-Consumer Advertising of Prescription Drugs be Effectively Regulated?” New Zealand Medical Journal, no date, dates on footnoted material go to 2019, https://www.nzma.org.nz/journal-articles/can-direct-to-consumer-advertising-of-prescription-drugs-be-effectively-regulated (Conclusion: “Taken together with international evidence that regulation has consistently failed to prevent the inappropriate promotion of prescription drugs, these findings suggest that DTCA is more likely to cause harm than benefit and should be banned.”)
Raktim Kumar Ghosh, Samhati Mondai Ghosh, “Drug advertisements: what a physician should know,” The New Zealand Medical Journal, vol. 123, no. 1314, May 14 2010, https://assets-global.website-files.com/5e332a62c703f653182faf47/5e332a62c703f6f72e2fd7ea_kumar.pdf
Dan Mangan, “Americans Oppose Fast Approvals, Want Drug Ads Off TV: Survey,” NBC News, May 11, 2016, https://www.nbcnews.com/health/health-care/americans-oppose-fast-approvals-want-drug-ads-tv-survey-n572301 (“the American Medical Association, the nation's largest physicians' group, called for a ban on direct-to-consumer advertising of prescription drugs and medical devices.”)How can this be? Every year between 1999 and 2018 the pharmaceutical industry spent an average of $1.5 billion on political contributions and lobbying.
Olivier J. Wouters, “Lobbying Expenditures and Campaign Contributions by the Pharmaceutical and Health Product Industry in the United States, 1999-2018,” JAMA Internal Medicine, March 3, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054854/Isn’t it kind of weird to advertise a product to those legally forbidden to buy it? We can’t go into a drug store and buy this stuff. We must nag our doctor for the permission slip called a “prescription.”
Want an analogy? Think about TV ads for toys on children’s programs. Aside from a handful of young, energetic entrepreneurs – and kids with advanced degrees in parental manipulation – children cannot buy what the capitalists are advertising.
That’s like big pharma’s “ask your doctor” TV spots – except we’re now the children and the doctors are our parents.
Listening to the FDA-required itemization of side effects makes you question whether it is “right for you” – or anyone else. But you don’t listen, because the commercial keeps telling you, “Oh, look at the squirrel.” See the happy grandparents with their happy grandchildren; the couple fishing or swimming in the lake or lovingly watching the sunset from the deck of their $400,000 summer cabin.
There are things capitalism can do better than public programs. Providing the pharmaceutical portion of our nation’s healthcare is not one of them.
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