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I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker. You can't buy prescription drugs without

• mindcrime 11y ago
  You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. FWIW, I asked my GP about this when I went in for a physical recently. He said he really doesn't get patients coming in asking for specific drugs in response to TV ads, and said he doesn't think it is an issue. Of course that's just one anecdote, but it shows that doctors are hardly in unanimous agreement on this.
  • nedwin 11y ago
    Though the majority of AMA members voted for it.
• MichaelGG 11y ago
  Flip side is that it's vile that we need a "doctor's authorization" to even buy chemicals. While there certainly should be regulation to curb abusive advertising (e.g. fraud), it's sad anyone would find it wrong to ask a doctor for drugs. The way things are set up, that's exactly what many people are forced to do. Also, nitpick, but the news and ads in general are almost certainly far more harmful (for your daughter; perhaps you, too) than hearing about ED meds.
  • Retric 11y ago
    Antibiotics are an obvious counter example to this.
    • MichaelGG 11y ago
      Sure, things that are cause for large scale disease/biohazard might be a good exceptions. The medicines patients seem to be seeking most (psychedelics, relaxants, stimulants, painkillers, erection-assistants) don't seem to fall into this category.
• Aloisius 11y ago
  > The first rule of sales is to pitch the decision maker. You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. The doctor, in turn, may give in to the patient's emotional pleas, since they are, in effect, in a customer service business. This would be an ethical violation. I think most of these ads are targeted to people who are already taking a drug for a condition. They want people to ask their doctor to switch to their drug - something a doctor would have far less ethical issues with. The problem of course is people switch away from a drug that has worked for 40 years to something new because of advertising and their insurance (and in turn, all of us) ends up picking up the cost for something that may have no benefit whatsoever to the patient.
  • FireBeyond 11y ago
    Some of them. Others are so brutally generic that they could apply to almost anyone: "Do you feel tired regularly? Have trouble getting going? Talk to your doctor about xxx". Whilst I realize a lot of this is coded talk for "Do you suffer depression?" for people who might not have realized or be willing to acknowledge it as such, the sheer number of conditions for which "lethargy" is a symptom...
• rtl49 11y ago
  Have you ever sought a particular prescription from a doctor? Many general practitioners in the United States are glorified drug dealers. You will probably get whatever you ask for if you can afford the copay.
  • bunnymancer 11y ago
    Disturbingly easy to get class II drugs without any proof of need.
    • tertius 11y ago
      Most of what a Doctor uses to make a choice on "proof" of need is oral testimony from a patient.
    • rtl49 11y ago
      I have no direct experience seeking a prescription, but I do know a doctor who has repeatedly complained to me about patients coming to him with the expectation of receiving a particular drug. He's considered giving up his DEA license to reduce this problem.
      • FireBeyond 11y ago
        One I see in the field as a paramedic? "Any drug allergies?" "Aspirin, Tylenol, Tramadol, etc" "Oh, so you're allergic to 'all' non-narcotic pain medication? That must be ... inconvenient."
        • MichaelGG 11y ago
          How do you respond to such a thing? If a patient is allergic to aspirin, concerned about liver toxicity from APAP, doesn't want stomach issues from NSAIDs, etc.? Do they just have to suffer or do you "give in" and provide them desired relief?
          • FireBeyond 11y ago
• manachar 11y ago
  In the US, the consumer drives a lot of the healthcare decisions. This has positives, as consumers can be more active participants in their health, but can also lead to people shopping for doctors who will prescribe the drugs that they want based on flimsy research and marketing. Additionally, this is a great backdoor way for consumers to be "educated" about conditions they didn't know they had. Consumers then would go to their doctor to talk about these things. These advertisements are extremely effective at getting patients going to doctors about conditions they hadn't necessarily discussed with the doctor before.
  • toomuchtodo 11y ago
    > This has positives, as consumers can be more active participants in their health, but can also lead to people shopping for doctors who will prescribe the drugs that they want based on flimsy research and marketing. Turns out, people suck at being intelligent healthcare consumers. Its not their fault though. http://www.nytimes.com/2015/11/02/upshot/why-consumers-often-err-in-choosing-health-plans.html http://www.nytimes.com/2015/11/02/upshot/why-consumers-often... http://www.nber.org/papers/w21160 http://www.nber.org/papers/w21160 Disclaimer: I am a strong advocate for single payer.
    • vonmoltke 11y ago
      Demonstrating that consumers have trouble with insurance decisions implies nothing about their ability to make care decisions.
      • toomuchtodo 11y ago
        Most healthcare consumers don't shop around by cost for their healthcare, either because they can't (emergency services) or because its too damn hard (example below). I encourage you to call your three closest hospitals, pick three surgical procedures, and ask them what the cash rate is from their chargemaster. You may get an answer from one hospital, possibly.
        • 11y ago
• Alex3917 11y ago
  > I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker. "Surveys conducted by FDA and private organizations consistently show that DTC advertisements have an impact on whether consumers request and receive a specific brand-name prescription from their physician. [...] In several of these surveys, consumers were asked whether they had seen an advertisement for a prescription drug and whether seeing the advertisement resulted in discussing the medication with their doctor and receiving the prescription. Most consumers (65 to 85 percent) remembered seeing a DTC advertisement. A subset of consumers who saw an advertisement discussed the medication with their doctor. The percentage of patients asking their physicians about a prescription for a specific drug was consistent across studies, about 30 to 35 percent of those who remembered seeing a DTC advertisement. One study estimated that the 32 percent of consumers in a 2001 survey who had discussed a DTC advertisement with their doctor translated into approximately 61.1 million consumers asking about specific medications. In the consumer surveys we examined, the percentage of consumers who, in response to a DTC advertisement, requested and received a prescription from their physician for a drug they were not currently taking was generally about 5 percent (ranging from 2 percent to 10 percent). By our estimate, this means that about 8.5 million consumers received a prescription after viewing a DTC advertisement and asking their physician for the drug in 2000." source: http://www.gao.gov/new.items/d03177.pdf http://www.gao.gov/new.items/d03177.pdf The data doesn't care whether or not you see the logic behind it.
  • wooter 11y ago
    I wonder how much data there is against the First Amendment. I'm not saying the ads aren't a problem, I'm saying censorship isn't the solution.
    • Alex3917 11y ago
      My comment was descriptive, not normative.
      • wooter 11y ago
        Your comment, in context, seemed to imply that customers making bad decisions due to imperfect (mis)information could be corrected by censorship.
• tn13 11y ago
  I do think advertisements make a difference. For example for a given health condition if the advertisement says X is cutting edge, then automatically the patient who receives something else from this doctor would think he is not receiving the best medication possible. This also explains why VISA and MasterCard advertise so much when you as a consumer simply take whatever the bank offers you.
• dboreham 11y ago
  The logic is that they make a vast amount of money.
• Mz 11y ago
  The first rule of sales is to pitch the decision maker. You may need a prescription from a doctor to get a drug, but that doesn't mean you aren't the decision maker. After finally getting a proper diagnosis for my condition, doctors began asking me "What typically works for you?" or "What drug do you like/is your preference?" I had a long history of health problems, thus lots of experience with what worked for me. After they gave me a proper diagnosis (and thus quit acting like dismissive assholes), I could walk into a doctor's office and say "I am having Yadda problem. I want (this list of meds) and am open to suggestions as to what else you think might help me." And get it. Ultimately, I was the decision maker. The doctor's job was, in part, to inform me what my options were. But no one just crammed their medical opinion down my throat, even before I had a proper diagnosis and doctors were routinely being jerks to me and acting like I was some kind of hypochondriac.
• vacri 11y ago
  Not everyone thinks that the health problem they're having is treatable - an ad can let someone know that there is a drug for condition X, prompting a trip to the doctor that would otherwise not happen.
• gist 11y ago
  "I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker." Plenty of logic is there. Part of the purpose is to make the Doctor pay attention to the advertising that they see in a journal. [1] How? Patient goes in and "asks their doctor" about a drug. Then another patient. And another. So now when the doctor sees an ad (or the detail man comes in) the doctor pays more attention and perks up. Similar I guess to the way once you buy a particular car model (or a friend buys one) you start to notice them all over the place. Same reason Pepsi puts ads in football stadiums. Builds general awareness and adds to reinforcement of the product as being "current". HN works in a similar way for YC by the way. Repetition and current relevance very important in advertising. [1] Edit: And of course Physicians also watch TV and read mainstream magazines and an ad is likely to stand out and get noticed just for that. (As a tech person imagine if you saw an ad for some software or SAAS that wasn't mainstream on the nightly news. It would certainly get your attention and stand out (more than if you saw it on Techmeme)).
  • e40 11y ago
    Patient goes in and "asks their doctor" about a drug. I wonder if this really ever happens. I mean, for many of the ads, it's hard to tell even what the drug does, so going to your doctor and asking for that med would amount to a random question.
    • gist 11y ago
      Well let's say you have a discussion with your doctor and they note there is a drug for your gastroparesis. They might mention some names or might not. You aren't ready so you basically don't ask for a script. Later a week a month whatever there is an ad for Reglan on TV and you think "hey that was what the Doctor mentioned". The ad is an ad, well done, so you in theory are now more receptive to taking the med. Especially since your symptoms haven't gotten any better. You are more willing to consider a solution to your problem. So next appointment you ask more questions and walk away with the prescription.
    • kgrin 11y ago
      Most of these are for chronic conditions, where people are seeing their doctor on a fairly regular (once every few months) basis. And yeah, at least some patients absolutely do ask, "hey, I heard about X, is that good for me?" There are of course also the extreme cases of specifically asking for a given prescription, but like the parent mentioned, just having a few patients persistently ask the doc about X is enough of a motivator to get the doctor to pay [marginally] more attention to the doctor-facing literature/ads/sales force.
• jMyles 11y ago
  > As for the free market, we do not have a free market in medicine. It is highly regulated through insurance and government regulation. So, I don't see a problem there. Plenty of us do. The absence of a "free market" in this situation isn't merely a difference of driving economic theory, but of bodily sovereignty.
• copperx 11y ago
  It would be hilarious if commercial platform vendors had ads targeted to software development clients: "Ask your developer about .NET technologies for your next project".
  • SilasX 11y ago
    Twilio has "ask your developer" ads: https://twitter.com/tsunderji/status/579053680919347200 https://twitter.com/tsunderji/status/579053680919347200 Not sure if I'm missing some subtext though...
    • alanh 11y ago
      I don’t think you are! :) I’ve seen these too, and I think they are a little funny, and fairly true. A dev will know Twilio is just how you do phone and SMS, and non-devs generally don’t!
• dctoedt 11y ago
  > The first rule of sales is to pitch the decision maker. Or to pitch the influencers --- for example, grocery stores' putting sugary cereals on lower shelves, where kiddies can see them and ask mom and dad to buy them.
• mizchief2 11y ago
  It worked great for kids cartoons. Talk the kids into bugging their parents to buy the sugary cereal and overpriced plastic toys.
• dheera 11y ago
  The unfortunate truth is that a huge number of doctors are downright incompetent, and the healthcare system only allows you to see a limited selection of doctors. So until the system fixes itself, the onus is still on the patient to try to treat themselves.
  • davak 11y ago
    * Source needed.
• jacquesm 11y ago
  It's the same principle at work when advertisers educate young children about how to nag more effectively. Patients will go to their doctor and ask about a specific medicine and too many doctors will give in to this pressure if they feel that the medicine will not outright harm the patient. Patient happy, doctor can move on to someone who deserves his/her care more.
• a3n 11y ago
  We have these ads for the same reason that bright sugary breakfast cereal is placed on the lower shelves in the grocery store. Children pester their parents for the cereal, and people pester their doctors for Viagra. But the children/people have to know about the product before the pestering can happen.
• smadge 11y ago
  Well, drug companies also market directly to doctors. Only about 12% of pharmaceutical marketing money is "direct to consumer."
• petke 11y ago
  Its the same logic as with toy commercials aimed at children. Children influence their parents by nagging, and patients influence their doctors by nagging. Parents don't want unhappy kids, and doctors don't want unhappy patients.
• stephenhess 11y ago
  One aspect that I haven't seen mentioned here is that these ads are also designed to improve patient adherence. So you have 30 million prescriptions of zoloft prescribed in the US every year (crazy right?) but there's a lot of money left on the table when folks don't refill. The ads are reminders to these people to go get that refill and get back on their meds. For people with asthma, diabetes and hypertension, non-adherence can be really unhealthy and leads to hundreds of billions in unnecessary cost to the healthcare system.
  • peteretep 11y ago
    I think this needs hard evidence to back up - is adherence much worse in the UK where ads like this are banned?
• stephenhess 11y ago
  One aspect that I haven't seen mentioned here is that these ads are also designed to improve patient adherence. So you have 30 million prescriptions of zoloft prescribed in the US every year (crazy right?) but there's a lot of money left on the table when folks don't refill. The ads are reminders to these people to go get that refill and get back on their meds. For people with asthma, diabetes and hypertension, non-adherence can be really unhealthy and leads to hundreds of billions in unnecessary cost to the healthcare system.
• Spooky23 11y ago
  Clearly there are some ethical challenges. My doctors office is littered with Crestor clocks, clipboards, pads, exam table stirrup covers and medical models. You can't say that seeing that logo 500 times a day doesn't influence picking Crestor over, say generic Lipitor.
• unclebucknasty 11y ago
  >I've never understood the logic behind prescription drug ads. Pull marketing.
• chongli 11y ago
  You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. Same logic as for advertisements for children's toys, games and movies.
• rodgerd 11y ago
  > The first rule of sales is to pitch the decision maker. McDonalds advertise at children so they'll harrass their parents into buying crappy food. Drug companies advertise to encourage people to harrass their doctors for prescriptions.
• silentplummet 11y ago
  >watching the news after dinner Found your problem right here. The news no longer serves to inform. It's little more than a conduit for fear, terror, and doubt. Switch off the TV and go read some websites or books to find out what's happening in the world other than the latest development in a terrifying incident in which a handful of people out of nine billion died. Better yet, take your daughter down to city hall or a county government meeting, and get involved with what is actually going to affect you tomorrow.