7 ms·

That the US allows ads for prescription drugs is totally indefensible. When I lived in Japan, it took me a while before I realized that all the drug ads were en

That the US allows ads for prescription drugs is totally indefensible. When I lived in Japan, it took me a while before I realized that all the drug ads were ending with the equivalent of “over the counter” because advertising prescription drugs was illegal. Once I figured it out, it made me wonder why the US would possibly have a different law. It’s crazy!

cortesoft 6y ago
The ‘defense’ is the first amendment. It would violate it if you prevented people from telling other people about their products.
- dawnerd 6y ago
  I've heard another defense that's pretty laughable. Goes something like, the ads tell people about conditions they might have but not realize. I fully think we should be banning prescription drugs. There's precedent already for banning product ads - tobacco ads are no longer allowed for example.
  - bryan0 6y ago
    I think the more charitable interpretation of this defense is: Ads tell people about conditions they might have, but not realize there is an available drug that can treat it. Or at least an encouragement to talk to their doctor about it.
    - throwawayboise 6y ago
      If your condition isn't bothersome enough that you need an ad to prompt you to mention it to your doctor, perhaps it's not really an issue. I think a lot of these ads prod hypochondriacs to rush to their doctor (or perhaps even the ER) to "tell them about their symptoms" which just drives up costs for everyone.
      - renewiltord 6y ago
        > If your condition isn't bothersome enough that you need an ad to prompt you to mention it to your doctor, perhaps it's not really an issue. Au contraire, people will live with all sorts of debilitating conditions, assuming that treatment is exceptionally hard. I lived with an impacted wisdom tooth for a long time, and when it was removed I suddenly realized that it wasn't just a natural way for my body to feel. I also just assumed that I had to poop explosively in the morning just because, and not because I drank the large cup of milk my mother gave me. And that's normal. Loads of people are like this.
        donpott 6y ago
        All the more so in a place without socialized health care.
        renewiltord 6y ago
        Yeah, in my case, I had access to the health care whenever I wanted. I just never thought to.
- ComputerGuru 6y ago
  I’ve heard that argument and but it really doesn’t stand up to scrutiny. You also have a right to run a business and sell things - such as prescription medication - but that hasn’t stopped the government from (too heavily, imho) restricting that.
  - parhamn 6y ago
    The US constitution explicitly grants regulation of commerce to Congress (see the commerce clause). Whereas the constitution explicitly prohibits the abridging of the freedom of speech through law.
    - ComputerGuru 6y ago
      Yes, but let's not pretend there's "absolute" freedom of speech even here in the United States. Cigarette manufacturers no longer have "freedom of speech" to advertise their products with anthropomorphized cartoon characters and relaxing artwork depicting tropical getaways, even though their product is more "freely available" than 5mg of Propranolol, but somehow Tofacitinib¹ ("serious side effects may include infections, cancer, and pulmonary embolism") is spammed on every channel. ¹ I have absolutely nothing against what I'm sure is a very fine drug - it was merely the first result in my search for "most advertised prescription medication" and I'm sure that the side effects are not representative of typical outcome and that someone suffering from serious rheumatoid arthritis is better off taking the drug than not.
      - parhamn 6y ago
        > Yes, but let's not pretend there's "absolute" freedom of speech even here in the United States. This isn't whats happening is it? The exemptions to free speech are well known and taught in entry level civic classes [1]. There are quite a few. Whats happening here is another discussion on the intricacies of free speech (which have hundreds of pages of professional opinion and case law for each exemption) full of nuance. However here, as is the case for most discussion forums, you can only fall into two groups: anarchist or fascist. Heres a more honest view: given free speech laws in the US it's not clear what we should or what is right to do with regards to advertising medicine. We will probably have a populist exemption when it's needed, as we have in the past. [1] https://en.wikipedia.org/wiki/United_States_free_speech_exceptions https://en.wikipedia.org/wiki/United_States_free_speech_exce...
- deleted 6y ago
  [deleted]
- heymijo 6y ago
  When was the last time you saw a cigarette ad on TV? Commercial speech in the United States has limitations. Historically commercial speech was not protected by the 1st amendment. Protections and limitations have largely been established over the past 50 years in Supreme Court rulings [0]. [0] https://mtsu.edu/first-amendment/article/939/corporate-speech https://mtsu.edu/first-amendment/article/939/corporate-speec...
  - tzs 6y ago
    The comparison to cigarettes isn't very convincing. To legally justify a of regulation of commercial speech, the government must show that it is to directly advance a substantial government interest and it is no more extensive than is necessary to serve that interest. Cigarettes physically harm pretty much all of their users, and they are very addicting leading to psychological and financial harm to a large number of users too, and they are available over the counter with no more than an age check to try to keep them out of the hands of non-adults. It's fairly easy to find a substantial government interest in the physical and psychological health of the population, and regulating the spread of something addicting that directly harms that interest directly advances that interest and doesn't seem to be going too far. Prescription drugs cannot even be sold until the government approves them, and even then they can only be sold if prescribed by a doctor. Those measures should already keep them out of the hands of those who would be harmed by them, so it is hard to see what substantial government interest a TV ad ban would directly further that couldn't be better addressed without restricting speech (e.g., limitation on who doctors can prescribe the drug to). I'm not saying that it wouldn't be possible to sufficient justify a TV ad ban on prescription drugs. Just that it is not anywhere near as easy as it is for cigarettes.
    - stjohnswarts 6y ago
      It's incredibly convincing given what happened with opiates and the current hundreds of thousands dead from overdoses over the past 20 years or so.
- nulbyte 6y ago
  The defenses I've seen are less about free speech and more to the tune of "doctors can't possibly know everything, so you should ask them in case they haven't looked into it." Frankly, if you think a TV advert does a better job at informing you about medical research then your doctor, who spent tons to graduate and more still on continuing education to maintain a license, you probably need new doctor.
- anonymfus 6y ago
  A person exercises their freedom of speech when they say whatever they want. The advertisement is when somebody is paid to say something with implication that they don't want to say that, as otherwise they would not be paid. So advertisement is an opposite of the freedom of speech. P. S.: I am watching the video and Tom Scott gives a very similar definition of advertisement at 3:44, and basically the whole video is about how that logic is applied in British and American laws. P. P. S.: I am now at the last section "The Land Of The Free" (24:47) where Tom Scott talks specifically about freedom of speech in US, and basically everything in this thread is brought up by him.
m463 6y ago
It's interesting to go elsewhere in the world and see advertisements for say hard alcohol.
- Animats 6y ago
  The US has ads for hard alcohol. They were never illegal, but it took until 1996 until the booze industry decided that they weren't going to trigger a return to Prohibition by advertising on TV.
  - m463 6y ago
    I haven't seen any, where would you look?
    - tekromancr 6y ago
      I see ads like that all the time. Never see anyone drinking the product, just sophisticated looking adults mingling intercut with shots of liquors being poured into glasses. And then a voice at the end saying "please drink responsibily"
      - deleted 6y ago
        [deleted]
Animats 6y ago
Prescription ads to consumers were legalized in the US in 1985. "Deregulation", it was called. Only the US and New Zealand allow this.
- rhino369 6y ago
  It didn't really take off in the USA until the FDA loosed side-effect notification rules in 1997. Literally overnight a huge number of TV commercials started playing.
  - deelowe 6y ago
    Yep, I remember when this happened. Viagra seemed to be the main driver "little blue pill."
    - pessimizer 6y ago
      Don't forget Prozac.
  - Dylan16807 6y ago
    > the FDA loosed side-effect notification rules in 1997 It's not the side effects that mattered. It's that before the rule change they weren't allowed to talk about what the drug did at all.
an_opabinia 6y ago
I don't know. Ads for monoclonal antibody therapies against COVID would probably save lives - by convincing doctors to use them. Smoking cessation products (they are prescribable for insurance reimbursement purposes) definitely save lives. Lots of smokers in Japan. What about PReP? It's prescription only. Lofexidine? It's not so black and white. If your conclusion is, make stuff over the counter, I feel like you're missing the point. Of course promoting drugs that work are a great outcome. Like what are we even talking about?
- gjulianm 6y ago
  > by convincing doctors to use them. I don't think it's patients the ones that need to convince the doctors of what to use. If anything, patients demanding solutions without any knowledge of whether they're useful or not would make treatment much more difficult. > Smoking cessation products A lot of smoking cessation products are over the counter. Here in Spain I see ads about them, and we have the same prohibition of adverts of prescription meds. > What about PReP? It's prescription only Sexual education covers this, no need to monetize ads. Not to mention that the return on investment on an anti-HIV medication is probably not ideal > Lofexidine Again, I doubt the market for opioid withdrawal meds is high enough. > Of course promoting drugs that work are a great outcome. Like what are we even talking about? Doctors are the one that prescribe drugs, not patients. Why would you need to market a prescription drug that one takes only after a doctor visit to patients? They are not the ones making the decision on the drug. They do not have the information required to evaluate whether the drug is appropriate or not. At best, ads for prescription drugs will be useless because it's the doctor that makes the decision. At worst it encourages self-medication and forces doctors to make non-optimal choices due to patient pressure. The only ones that stand to benefit from prescription drugs ads are pharmaceutical companies and ad agencies.
- tsimionescu 6y ago
  > Of course promoting drugs that work are a great outcome. Like what are we even talking about? If it works, there's no need to promote it, your doctor will know about it from better sources than TV ads. The purpose of TV ads for prescription medicine is to induce nagging behavior - trying to convince patients to nag their doctors and so increase the sales of these things. Like all advertising, it is a practice meant to distort our behavior in a way that makes us better consumers.
wendyshu 6y ago
What's wrong with ads for drugs?
- p1necone 6y ago
  Because prescription drugs are supposed to be prescribed by a doctor with actual medical knowledge. Average joes watching ads shouldn't be deciding what prescription drugs their doctor gives them.
  - deleted 6y ago
    [deleted]
  - greeneggs 6y ago
    I think that they positively spread awareness of both problems and solutions. If a patient doesn't know about a drug, then they might not bring the problem up with their doctor. Viagra might be a good example. Many, or even most, men wouldn't be comfortable bringing up ED with their doctors were they not aware of a possible solution. Perhaps the Internet does a better job at surfacing this information than was the case before, but I am not sure. Personally, I have benefitted from learning, via ads, about a cure that I never would have known existed otherwise, for a problem that I had assumed I would just have to live with.
    - scotty79 6y ago
      Same could be achieved by sponsoring social ads about specific illness without mentioning perscription drug. Yet drug corporations don't do that in countries where ads for perscription drugs are banned. I guess that does not bring the same value to them as pushing drug explicitly.
    - pjc50 6y ago
      I'm convinced that this is the worst possible example given that Viagra marketing produced an absolute tidal wave of spam in the early 2000s. It was advertising at its worst, and least ethical.
    - 6y ago

cortesoft 6y ago

The ‘defense’ is the first amendment. It would violate it if you prevented people from telling other people about their products.

dawnerd 6y ago
I've heard another defense that's pretty laughable. Goes something like, the ads tell people about conditions they might have but not realize. I fully think we should be banning prescription drugs. There's precedent already for banning product ads - tobacco ads are no longer allowed for example.
- bryan0 6y ago
  I think the more charitable interpretation of this defense is: Ads tell people about conditions they might have, but not realize there is an available drug that can treat it. Or at least an encouragement to talk to their doctor about it.
  - throwawayboise 6y ago
    If your condition isn't bothersome enough that you need an ad to prompt you to mention it to your doctor, perhaps it's not really an issue. I think a lot of these ads prod hypochondriacs to rush to their doctor (or perhaps even the ER) to "tell them about their symptoms" which just drives up costs for everyone.
    - renewiltord 6y ago
      > If your condition isn't bothersome enough that you need an ad to prompt you to mention it to your doctor, perhaps it's not really an issue. Au contraire, people will live with all sorts of debilitating conditions, assuming that treatment is exceptionally hard. I lived with an impacted wisdom tooth for a long time, and when it was removed I suddenly realized that it wasn't just a natural way for my body to feel. I also just assumed that I had to poop explosively in the morning just because, and not because I drank the large cup of milk my mother gave me. And that's normal. Loads of people are like this.
      - donpott 6y ago
        All the more so in a place without socialized health care.
        renewiltord 6y ago
        Yeah, in my case, I had access to the health care whenever I wanted. I just never thought to.
ComputerGuru 6y ago
I’ve heard that argument and but it really doesn’t stand up to scrutiny. You also have a right to run a business and sell things - such as prescription medication - but that hasn’t stopped the government from (too heavily, imho) restricting that.
- parhamn 6y ago
  The US constitution explicitly grants regulation of commerce to Congress (see the commerce clause). Whereas the constitution explicitly prohibits the abridging of the freedom of speech through law.
  - ComputerGuru 6y ago
    Yes, but let's not pretend there's "absolute" freedom of speech even here in the United States. Cigarette manufacturers no longer have "freedom of speech" to advertise their products with anthropomorphized cartoon characters and relaxing artwork depicting tropical getaways, even though their product is more "freely available" than 5mg of Propranolol, but somehow Tofacitinib¹ ("serious side effects may include infections, cancer, and pulmonary embolism") is spammed on every channel. ¹ I have absolutely nothing against what I'm sure is a very fine drug - it was merely the first result in my search for "most advertised prescription medication" and I'm sure that the side effects are not representative of typical outcome and that someone suffering from serious rheumatoid arthritis is better off taking the drug than not.
    - parhamn 6y ago
      > Yes, but let's not pretend there's "absolute" freedom of speech even here in the United States. This isn't whats happening is it? The exemptions to free speech are well known and taught in entry level civic classes [1]. There are quite a few. Whats happening here is another discussion on the intricacies of free speech (which have hundreds of pages of professional opinion and case law for each exemption) full of nuance. However here, as is the case for most discussion forums, you can only fall into two groups: anarchist or fascist. Heres a more honest view: given free speech laws in the US it's not clear what we should or what is right to do with regards to advertising medicine. We will probably have a populist exemption when it's needed, as we have in the past. [1] https://en.wikipedia.org/wiki/United_States_free_speech_exceptions https://en.wikipedia.org/wiki/United_States_free_speech_exce...
deleted 6y ago
[deleted]
heymijo 6y ago
When was the last time you saw a cigarette ad on TV? Commercial speech in the United States has limitations. Historically commercial speech was not protected by the 1st amendment. Protections and limitations have largely been established over the past 50 years in Supreme Court rulings [0]. [0] https://mtsu.edu/first-amendment/article/939/corporate-speech https://mtsu.edu/first-amendment/article/939/corporate-speec...
- tzs 6y ago
  The comparison to cigarettes isn't very convincing. To legally justify a of regulation of commercial speech, the government must show that it is to directly advance a substantial government interest and it is no more extensive than is necessary to serve that interest. Cigarettes physically harm pretty much all of their users, and they are very addicting leading to psychological and financial harm to a large number of users too, and they are available over the counter with no more than an age check to try to keep them out of the hands of non-adults. It's fairly easy to find a substantial government interest in the physical and psychological health of the population, and regulating the spread of something addicting that directly harms that interest directly advances that interest and doesn't seem to be going too far. Prescription drugs cannot even be sold until the government approves them, and even then they can only be sold if prescribed by a doctor. Those measures should already keep them out of the hands of those who would be harmed by them, so it is hard to see what substantial government interest a TV ad ban would directly further that couldn't be better addressed without restricting speech (e.g., limitation on who doctors can prescribe the drug to). I'm not saying that it wouldn't be possible to sufficient justify a TV ad ban on prescription drugs. Just that it is not anywhere near as easy as it is for cigarettes.
  - stjohnswarts 6y ago
    It's incredibly convincing given what happened with opiates and the current hundreds of thousands dead from overdoses over the past 20 years or so.
nulbyte 6y ago
The defenses I've seen are less about free speech and more to the tune of "doctors can't possibly know everything, so you should ask them in case they haven't looked into it." Frankly, if you think a TV advert does a better job at informing you about medical research then your doctor, who spent tons to graduate and more still on continuing education to maintain a license, you probably need new doctor.
anonymfus 6y ago
A person exercises their freedom of speech when they say whatever they want. The advertisement is when somebody is paid to say something with implication that they don't want to say that, as otherwise they would not be paid. So advertisement is an opposite of the freedom of speech. P. S.: I am watching the video and Tom Scott gives a very similar definition of advertisement at 3:44, and basically the whole video is about how that logic is applied in British and American laws. P. P. S.: I am now at the last section "The Land Of The Free" (24:47) where Tom Scott talks specifically about freedom of speech in US, and basically everything in this thread is brought up by him.

m463 6y ago

It's interesting to go elsewhere in the world and see advertisements for say hard alcohol.

Animats 6y ago
The US has ads for hard alcohol. They were never illegal, but it took until 1996 until the booze industry decided that they weren't going to trigger a return to Prohibition by advertising on TV.
- m463 6y ago
  I haven't seen any, where would you look?
  - tekromancr 6y ago
    I see ads like that all the time. Never see anyone drinking the product, just sophisticated looking adults mingling intercut with shots of liquors being poured into glasses. And then a voice at the end saying "please drink responsibily"
    - deleted 6y ago
      [deleted]

Animats 6y ago

Prescription ads to consumers were legalized in the US in 1985. "Deregulation", it was called. Only the US and New Zealand allow this.

rhino369 6y ago
It didn't really take off in the USA until the FDA loosed side-effect notification rules in 1997. Literally overnight a huge number of TV commercials started playing.
- deelowe 6y ago
  Yep, I remember when this happened. Viagra seemed to be the main driver "little blue pill."
  - pessimizer 6y ago
    Don't forget Prozac.
- Dylan16807 6y ago
  > the FDA loosed side-effect notification rules in 1997 It's not the side effects that mattered. It's that before the rule change they weren't allowed to talk about what the drug did at all.

an_opabinia 6y ago

I don't know. Ads for monoclonal antibody therapies against COVID would probably save lives - by convincing doctors to use them. Smoking cessation products (they are prescribable for insurance reimbursement purposes) definitely save lives. Lots of smokers in Japan. What about PReP? It's prescription only. Lofexidine? It's not so black and white. If your conclusion is, make stuff over the counter, I feel like you're missing the point. Of course promoting drugs that work are a great outcome. Like what are we even talking about?

gjulianm 6y ago
> by convincing doctors to use them. I don't think it's patients the ones that need to convince the doctors of what to use. If anything, patients demanding solutions without any knowledge of whether they're useful or not would make treatment much more difficult. > Smoking cessation products A lot of smoking cessation products are over the counter. Here in Spain I see ads about them, and we have the same prohibition of adverts of prescription meds. > What about PReP? It's prescription only Sexual education covers this, no need to monetize ads. Not to mention that the return on investment on an anti-HIV medication is probably not ideal > Lofexidine Again, I doubt the market for opioid withdrawal meds is high enough. > Of course promoting drugs that work are a great outcome. Like what are we even talking about? Doctors are the one that prescribe drugs, not patients. Why would you need to market a prescription drug that one takes only after a doctor visit to patients? They are not the ones making the decision on the drug. They do not have the information required to evaluate whether the drug is appropriate or not. At best, ads for prescription drugs will be useless because it's the doctor that makes the decision. At worst it encourages self-medication and forces doctors to make non-optimal choices due to patient pressure. The only ones that stand to benefit from prescription drugs ads are pharmaceutical companies and ad agencies.
tsimionescu 6y ago
> Of course promoting drugs that work are a great outcome. Like what are we even talking about? If it works, there's no need to promote it, your doctor will know about it from better sources than TV ads. The purpose of TV ads for prescription medicine is to induce nagging behavior - trying to convince patients to nag their doctors and so increase the sales of these things. Like all advertising, it is a practice meant to distort our behavior in a way that makes us better consumers.

wendyshu 6y ago

What's wrong with ads for drugs?

p1necone 6y ago
Because prescription drugs are supposed to be prescribed by a doctor with actual medical knowledge. Average joes watching ads shouldn't be deciding what prescription drugs their doctor gives them.
- deleted 6y ago
  [deleted]
- greeneggs 6y ago
  I think that they positively spread awareness of both problems and solutions. If a patient doesn't know about a drug, then they might not bring the problem up with their doctor. Viagra might be a good example. Many, or even most, men wouldn't be comfortable bringing up ED with their doctors were they not aware of a possible solution. Perhaps the Internet does a better job at surfacing this information than was the case before, but I am not sure. Personally, I have benefitted from learning, via ads, about a cure that I never would have known existed otherwise, for a problem that I had assumed I would just have to live with.
  - scotty79 6y ago
    Same could be achieved by sponsoring social ads about specific illness without mentioning perscription drug. Yet drug corporations don't do that in countries where ads for perscription drugs are banned. I guess that does not bring the same value to them as pushing drug explicitly.
  - pjc50 6y ago
    I'm convinced that this is the worst possible example given that Viagra marketing produced an absolute tidal wave of spam in the early 2000s. It was advertising at its worst, and least ethical.
  - 6y ago