8 ms·
> research funding is dwarfed by marketing for example i really believe pharma advertising should be banned
by ptah 7y ago
> research funding is dwarfed by marketing for example
i really believe pharma advertising should be banned
- ollie87 7y agoIt is where I live, so weird visiting the US and seeing "ask your doctor for" adverts. If I asked my GP for a specific medication they'd look at me like an alien.
- mattrp 7y agoThey do that pretty much no matter what planet you live on :)
- Murrawhip 7y agoNope, it's only legal in US and New Zealand.
- chimeracoder 7y agoConsumer advertising for pharmaceuticals is legal only in the US and New Zealand. Direct-to-doctor marketing is legal almost everywhere else, and it's by far what pharmaceutical companies spend more money on.
- mattrp 7y agoSorry that’s not what I meant... it was a joke of course but I was saying if you suggest any course of treatment to a doctor you’re going to get a hairy eyeball in response. I wasn’t saying anything at all about the places where ads are allowed.
- m_ke 7y agoYeah it's really weird walking around NYC and seeing most of ads be from hospitals, colleges, pharma and lawyers.
- throwlaplace 7y agodon't forget ED drugs! america: take all the dick pills you want through a shady phone app (sponsored by VCs) but don't expect to have have your life threatening illnesses treated affordably! edit: i'm getting downvoted. in case you weren't aware the subways in NY are plastered with HIMS and Roman health ads. https://www.vice.com/en_us/article/ne5ndb/erectile-dysfunction-hims-roman-thinx-subway-ads https://www.vice.com/en_us/article/ne5ndb/erectile-dysfuncti...
- jotm 7y ago> If I asked my GP for a specific medication they'd look at me like an alien. He shouldn't. They're not all knowing super genius specialists who keep up with all the drugs and research.
- ivolimmen 7y agoThat's why we (the Dutch) have pharmacies that take the prescription of the doctor and then determine, based on your current medicine and medical history, alter your new prescription to fit your need (and he will confer with the GP if needed)
- throwaway_tech 7y agoIn the US, we have something similar (but evil) that people don't know or refuse to acknowledge. A Doctor writes a script, and then a pharmacist (not on their own, but at the direction of an insurance company) suggests a change typically to benefit the insurer (for example changing a name brand to a generic or changing 30 days to 90 days so the patient doesn't get seen by the doctor again for 90 days for additional testing/monitoring). In the US the pharmacy/pharmacist can not change the script so they send the recommendation to the doctor for approval (and get paid a bonus from the insurer for sending the request), if the doctor approves the pharmacy gets a 2nd bonus, if the doctor does not make the change, there is a very good chance the insurer will drop the doctor from their network for not doing what the insurer asks to lower their costs through the pharmacy proxy.
- chimeracoder 7y ago> for example changing a name brand to a generic In most states, the law explicitly requires the pharmacist to fill a prescription with a generic (if available) unless the doctor specifically writes "dispense as written". Not allows - requires. The purpose of these laws is to protect patients - in the overwhelming majority of cases, the generic and brand name drugs are equivalent for patients, so patients save money by purchasing the generic medication even if the physician prescribed the drug using its more well-known name (the brand name).
- vonmoltke 7y ago> It is where I live, so weird visiting the US and seeing "ask your doctor for" adverts. Those ads are a small portion of pharma marketing budgets for prescription products. The vast majority goes to direct-to-doctor marketing.
- redisman 7y agoThat's 10 times more unnerving though. Especially given the very recent opioid prescription crisis.
- vonmoltke 7y agoAbsolutely. I feel it is important to point out, though, given the number of people here who think these budgets are driven by American DTC ads.
- programmertote 7y agoYou can read my other comment [https://news.ycombinator.com/item?id=22127805 https://news.ycombinator.com/item?id=22127805] about my experience at a pharma-hosted dinner for my wife's former internship mentor (a doctor). Given that experience, I'd not be surprised if pharma spend a ton of money on direct-to-doctor marketing.
- mc32 7y agoI know a couple of doctors overseas and while there isn’t direct to consumer advertising for Rx drugs, the doctors get invited by the pharmas to conferences in the Greek islands or the Adriatic, sometimes they are invited to “talk”. They can bring their spouses too... in addition I think they get kickbacks for Rxs -but I’m not sure. Not sure which one is better or worse.
- umvi 7y agoOn the other hand, I hate the general attitude of "don't question your doctor or do your own medical research; the doctor knows what's best" Doctors are mortals too and can only have so much time to draw on info they crammed X years ago. Patients can quickly become more expert than GPs with regards to their own diseases, especially if they have months to research it. Anecdotal example - my sister had a wierd skin condition in high school. My mom researched skin images and symptoms for hours and hours and concluded it was shingles. My Mom then brought her in and discussed her findings with the GP who scoffed and said she was far too young for it to be shingles. He then admonished my mom for doing her own research. Long story short and one embarrassed GP later, it was shingles.
- intopieces 7y ago> Patients can quickly become more expert than GPs with regards to their own diseases, especially if they have months to research it. Waking into a 15 minute appointment with months worth of research seems like a bad way to approach collaboration with healthcare professionals. Or do people still have personal relationships with doctors outside the appointment window? It seems like GPs have become dispensers of medicine rather than care.
- carbocation 7y agoIt isn't always possible to answer every question in 15 minutes, but I think it's helpful when people have questions to come prepared with those questions. It's literally our job to provide health advice; the "realities" of dealing with high volume can't/shouldn't change that.
- umvi 7y agoThe only people that do months of research are those with a chronic disease (diabetes, cancer, Lyme, etc.) However, many people will at least do several hours of research before going into the doctor
- amyjess 7y agoRegarding chronic disease... So I have a friend with Hashimoto's. Before finally being diagnosed, she had a long history of being misdiagnosed, blown off, and having her symptoms dismissed as nothing. After being diagnosed, she connected with a number of other Hashimoto's patients and sufferers of chronic illness in general and found out that pretty much everyone she's talked to has the same stories. Constant invalidation, ignoring of symptoms, doctors just plain not listening, until they finally find someone who actually knows their stuff.
- pkaye 7y agoI have a lot of serious long term health issues and quickly found out you have to be the champion for your own health and research everything. But that doesn't mean just asking for the latest drug in the market. Its about asking the right questions. Unless you have a common well understood health issues, you will quickly reach a roadblock.
- GordonS 7y agoI agree that it's important to be informed, especially if you have a health problem that is remotely non-obvious. Pharma TV and billboard ads are the last place I'd seek such information though.
- Baeocystin 7y agoIs it really such an odd question? Putting advertising outside, it seems to me that it would be a common occurrence that someone dealing with problem X has probably spoken to other people with the same issue, and what the group knows works well would be spread around. In my case, I'm asthmatic, and I know very well what works best for me, simply because I've had decades of experience figuring it out. When I've gone to see a new doctor, I've been specific in my medicine requests, and it has been received well enough.
- JTbane 7y agoThis. Not only is it an unnecessary cost, but likely leads to overmedication and misuse
- fortran77 7y agoWhen television cigarette advertising was banned (in the US) profits and stock prices went up! [1] Since all the cigarette companies were in an even playing field, they saved a lot of money by not having to advertise. I think it may be a win-win if the U.S. prohibited television medical advertising. [1] https://economicdynamics.org/meetpapers/2011/paper_868.pdf https://economicdynamics.org/meetpapers/2011/paper_868.pdf
- vonmoltke 7y agoThe vast majority of tobacco marketing was to the consumer. That isn't the case for prescription drugs, so the two situations are not comparable.
- UnFleshedOne 7y agoLet us not stop at medical advertising...
- joyeuse6701 7y agoAnother aspect of the story is the support by tobacco companies for this because it removed the obligation to air anti-tobacco messaging by law[1]. [1]https://truthinitiative.org/research-resources/tobacco-industry-marketing/what-do-tobacco-advertising-restrictions-look-today https://truthinitiative.org/research-resources/tobacco-indus...
- rayiner 7y agoNote that the biggest portion of what’s counted as “pharmaceutical advertising” is actually free samples: https://www.insurancejournal.com/news/national/2019/01/11/514594.htm https://www.insurancejournal.com/news/national/2019/01/11/51... The TV ads you see for drugs add up to $6 billion, which is a small fraction compared to industry R&D.
- thinkcontext 7y agoI don't disagree but by far the largest amount of marketing is spent targeting doctors not patients. Every few years they get caught sending them on junkets, paying them kickbacks disguised as fake speaking gigs, hiring cheerleaders or strippers as "sales associates", etc
- badrequest 7y agoWe should make doctor kickbacks from pharmaceuticals illegal too.
- beamatronic 7y agoIt seems like there is a perception by these companies that there is a discoverability problem. If they are truly making a useful and safe drug, there should be a market for it. Instead of marketing, shouldn’t there be a way to make all products and services more discoverable? By doctors in this case and generically in the larger sense. Incidentally, I have had two occasions where I wanted to search for a product by its physical dimensions. One was for furniture and one was for a refrigerator. I haven’t seen a search engine that lets me start by searching by physical dimensions: length, width, height. On these occasions, I had a specific physical space that I needed to put something into.
- vkou 7y ago> It seems like there is a perception by these companies that there is a discoverability problem. The rest of the world manages to 'discover' that these drugs exist on the market just fine, yet pharma advertising is banned in most of it.
- malandrew 7y agoFWIW, a medicine I have been taking since 2003 is still not available in all other countries except the US and Canada (and it's only recently become available in Canada). It's still the only effective treatment for my condition.
- EForEndeavour 7y agoI'm genuinely curious: what is your condition, if you don't mind disclosing it?
- vkou 7y agoThere's typically a couple of reasons for that, and awareness is not really one of them. Just like the FDA reviews drugs for safety and efficacy, and just like your insurer reviews drugs for price, national health boards review drugs for safety, efficacy, and price. Sometimes, the boards want to wait and see if the drug is actually effective in clinical use. Sometimes the boards want to wait and see if the drug is actually safe in clinical use. Sometimes, that equation does not swing in the drug's favour. If a drug is $10,000/year, compared to a $500/year, but provides someone taking it for 10 years, on average, with a month's extra life, it would be foolish to spend $100,000 on the better drug - if for that money, you can buy more than a month of life for other people, with another drug, or with surgeries, or better screenings, etc, etc. Likewise, if a drug improves quality of life for someone, how do weigh that against saving someone's life? There's a limited medical budget, and there's some ethical calculus that you plug the numbers in, and determine which of those options is a better use of scarce resources. But in order to do that, you actually need to get the numbers. Clinical trials, in themselves, don't give all of those answers. The FDA differs from the FAA, in that the world does not consider it the sole gatekeeper of medical efficacy, safety, and cost. What will not solve this problem, is the drug manufacturer spending half a billion dollars on taking doctors, medical directors, and politicians on all-expense paid junkets to the Carribean. You're not going to get better awareness from this, you're going to get more corruption, and more expensive drugs. (The $500/year alternative can't compete with the $100,000/year alternative in this sense - as the manufacturer of the latter can trivially out-bribe the former.)
- lostlogin 7y agoIt is nearly everywhere, with New Zealand and the US allowing direct to consumer advertising. https://en.m.wikipedia.org/wiki/Pharmaceutical_marketing https://en.m.wikipedia.org/wiki/Pharmaceutical_marketing
- stevehawk 7y agoIt's banned in all countries except 2 I believe
- davidsawyer 7y agoI agree. The US and New Zealand are the only countries in the world that allow full-on pharma ads. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278148/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278148/
- nokcha 7y agoOf potential relevance: The U.S. Supreme Court ruled on the constitutionality of a statute restricting the advertising of the prices of prescription drugs in Virginia State Pharmacy Board v. Virginia Citizens Consumer Council, 425 U.S. 748 (1976). (https://www.law.cornell.edu/supremecourt/text/425/748 https://www.law.cornell.edu/supremecourt/text/425/748). The Court ruled that statute at issue was unconstitutional under the First Amendment.
- ryanmercer 7y agoBut I like cartoons telling me about amazing drugs I desperately need in my life while someone soothingly mentions oily rectal leakage [1], compulsive gambling [2], and suicide [3] as potential side effects! [1] https://www.drugs.com/sfx/orlistat-side-effects.html https://www.drugs.com/sfx/orlistat-side-effects.html [2] https://time.com/4317182/abilify-aristada-aripiprazole-sex-gambling/ https://time.com/4317182/abilify-aristada-aripiprazole-sex-g... [3] https://www.health.com/condition/depression/medications-depression https://www.health.com/condition/depression/medications-depr...