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How pharmaceutical companies find sick users on Facebook

191 points by atg_abhishek 5y ago

deleted 5y ago
[deleted]
dools 5y ago
The article seems to suggest this is a bad thing, but my first reaction is "fantastic". Pharmaceutical companies create life saving medicines and then use advanced social media targeting to locate the people that need them. The only bad thing about it is if those people targeted can't afford the medication, which is why healthcare needs to be a universal right. People love to bitch about Big Pharma but I have a magical little blue tool that completely relieves my asthma, and I can buy them with absolutely no trouble at the pharmacy for about $6. My brother got diagnosed with MS recently. My aunt got diagnosed with MS 40 years ago. Thanks to the research that happened in the last 40 years, my brother's experience with MS is worlds apart (mostly because we live in Australia and he has free access to tens of thousands of dollars of treatment). Pharmaceutical companies are responsible for developing vaccines for a global pandemic at light speed. They're great! Let's celebrate Big Pharma! But let's also make sure that the gains from these amazing advances in technology are shared equitably. And maybe, just maybe, if the medical companies find they need to use Facebook to shift their product, we should be looking at a more formal and closely regulated method of distribution that isn't so commercially driven. I mean, the private sector is great at commercialisation, but is it really the be all and end all when it comes to such a crucial social function as healthcare?
- refurb 5y ago
  Let's go ahead and see what the FDA found out about direct to consumer (DTC) advertising of drugs as they've conducted numerous surveys[1]. Not all bad it seems! - Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit. - Many physicians thought that DTC ads made their patients more involved in their health care. - Physicians thought the ads did not convey information about risks and benefits equally well. - Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked. - The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated. - Doctors believe that patients understand that they need to consult a health care professional about appropriate treatment. [1]https://www.fda.gov/drugs/information-consumers-and-patients-drugs/impact-direct-consumer-advertising https://www.fda.gov/drugs/information-consumers-and-patients...
- thomasedwards 5y ago
  Or, I go to a doctor, who is a medically trained professional, and they prescribe a medicine to me based on their experience and training, without any incentive for financial reward?
  - jaspax 5y ago
    Do you think that doctors don't have financial incentives to treat patients?
    - throwaway3699 5y ago
      Not where I live. This is a uniquely US problem among first-world countries.
      - refurb 5y ago
        A financial incentive to treat? No, that's pretty common across healthcare systems. It's being worked on as system move away from fee-for-service, but generally, the more a physician does, the more they make.
      - mrweasel 5y ago
        Technically I don't think it's unique to the US. In Denmark doctors get a fee per consultation. It's pay with tax money, but still the doctor is financially motivated to see patients. It might only apply to general practitioner though, I think hospital doctors are on a fixed salary. One issue, that could excuse medical companies going directly to the patients would be a lack of knowledge among doctors. Doctors contently write prescriptions for medication that's no longer available and is often not as updated as a pharmacy on new medication. This means that at least some doctors aren't suggesting the best treatment, simply because they aren't aware of it.
        varispeed 5y ago
        The doctor can also put a generic name of the drug on the prescription and patient can tell the pharmacy to sell them a particular brand instead of a generic. So there is space where such direct advertising could work.
- lozenge 5y ago
  You appear to be assuming the advertisement medically benefits a patient. I don't believe there's any evidence for this and ads for prescription drugs are banned almost globally for good reason. "Ask your doctor about" may bias the doctor away from a different drug that is more appropriate but has a lower profit margin, for example.
  - toast0 5y ago
    There's some benefit to the patient if the drug is effective treatment for a condition they knew they had but didn't know there was treatment for. Or if it's a new thing that treats something where the old treatment didn't work well or had bothersome side effects for the patient. Major new drugs may get news coverage or may be brought up if a doctor sees something on your chart at a checkup, but ads may (or may not) reach more people.
- fabcomm 5y ago
  The vaccine has me thinking of these things, and my reaction was closer to yours. I don’t think ads here are fantastic. What I think is fantastic is companies wanting to remove the “dis” from “disease”. But we must not rely on pharmaceuticals. They are just a few tools in the tool belt of healing.
- ceilingcorner 5y ago
  Have you heard the expression, "A solution in search of a problem"? Because that what this is. Multinational billion-dollar corporations using their marketing dollars to convince people that their pill is the solution to all of your problems. This should be illegal.
  - sizzle 5y ago
    It either is or it isn’t, at the end of the day a Doctor was taught what to prescribe at med school and you can’t demand they prescribe you anything unless you are a drug seeker and will be blacklisted quickly if it’s controlled substances. Go look at peer reviewed studies and clinical trials data to make an informed decision on medical treatment options.
- rozab 5y ago
  Why on earth should the patient choose whichever drug put money into advertising, rather than the one their doctor deems the most suitable? How could that possibly be beneficial? edit: reading further down the article, there is an advert for an antipsychotic medication which offers a $15 discount on your copay. This particular medication has serious discontinuation effects, it's not something you can just stop taking and it's not something that is prescribed lightly in the first place. Offering a discount for the first few doses is plainly exploitative.
  - perl4ever 5y ago
    There are some aspects to the supply and demand of drugs, particularly psych drugs, that I'm not sure are described in econ 101 or popularly known. Let's say the most common, first prescribed drug for your condition is available in a generic, for $0.30/month. That's not entirely hypothetical, that really happens. A naive person would say "ok, if the generic is so cheap, then the brand name can't be much more, can it?" - free market competition, the FDA ensures they're all equivalent, blah blah blah. However, I noticed that in recent years, the alternatives to the dirt cheap first-line option are way more expensive and going up. So I thought about why. It occurred to me, that a simplistic view of competition ignores the fact that the different options are not exactly in competition at all. Because everyone tries the cheap one first, and then if they have problems or it's ineffective, they try another. This means that fundamentally the drugs which are supposed to be in competition are not in competition practically speaking. If you have a drug that is not the first option, then you might as well charge $1000/month because everyone who is a possible customer already by definition has given up on the cheap one. And even worse, in order to justify (for example) $1000/month, you don't have to have something better, just different enough to give people a little hope. They proliferate, but it's not progress.
- s5300 5y ago
  If the blue tool you're talking about is an inhaler, I'm happy for yours being $6, as was mine I believe, but some still aren't so fortunate. They still go for $300-$500 for some people, in the U.S. https://www.health.harvard.edu/blog/millions-skip-medications-due-to-their-high-cost-201501307673 https://www.health.harvard.edu/blog/millions-skip-medication... "Died because couldn't afford inhaler" will bring up some fairly good hits. Things have been fairly good, and are always mostly getting better - but damned if we couldn't be so, so much better than we are given the other things our country fronts billions upon billions of dollars for is the idea always lingering in my and others minds.
- helloworld11 5y ago
  I don't know why you were downvoted into the grey zone. I don't entirely agree with your points about Big Pharma finding needy patients instead of doctors prescribing based on professional experience (though there's still plenty of room for bias there too) but overall, fully agreed, the pharmaceutical industry is a wonderful thing on the whole, and while it gets a lot of knee-jerk hatred from too many people, i'd love to see somebody suggest something practically better (as opposed to ideally better based on their limitless dreams of a perfect world).
  - Ensorceled 5y ago
    Maybe the bribery to get your Doctor to recommend a different drug than is probably best for you or your pocket book? Maybe the campaigns pushing opioids on doctors and patients to the point of crisis? Insulin is at least twice the price (depending on type might be 3 or 4 times) in the $US as anywhere else in the world. There's that famous case where a Turing Pharma skyrocketed price of Daraprim that only they were manufacturing because, well, they could get away with it.
    - fighterpilot 5y ago
      "Insulin is at least twice the price" That is the government's fault. What's the reason you can't import extremely cheap insulin from overseas? The government has endowed a local monopoly.
      - Ensorceled 5y ago
        I don't think you can entirely blame unethical, predatory behaviour on the government that enables it.
        fighterpilot 5y ago
        It's not a government that enables it, it's a government that enforces it through laws that guarantee and endow a local monopoly. Whenever you have an endowed monopoly without substitutes, you have extremely high prices. It's econ 101 and will happen 100% of the time (that's why I call it enforcement instead of enablement). If the government just got out of the way, the price of insulin would plummet.
- pjc50 5y ago
  Has everyone forgotten the OxyContin scandal? Or are we just all grateful that Big Pharma has saved us from the pandemic that we're going to overlook the past specific, illegal, actions of pharmaceutical marketing? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ > When Purdue Pharma introduced OxyContin in 1996, it was aggressively marketed and highly promoted. Sales grew from $48 million in 1996 to almost $1.1 billion in 2000.1 The high availability of OxyContin correlated with increased abuse, diversion, and addiction, and by 2004 OxyContin had become a leading drug of abuse in the United States.
  - sizzle 5y ago
    So one company running wild without government intervention selling a controlled highly addictive narcotic negates all medical discoveries by big pharma since the dawn of time including the record breaking speed of making a COVID vaccine? Yeah okay…
- StreamBright 5y ago
  Yeah so I guess the users have nothing to say in this. If I walk in to store they supposed to know what I want and a clerk puts the items into my basket and kicks me towards the checkout. Are you serious?
- LorenPechtel 5y ago
  In almost all these cases the doctor should know what the patient needs, pushing patients to ask their doctors about certain medicines. The one case I think drug ads are legitimate is when it's a dramatic improvement in treatment for a live-with-it type condition. The prime example would be Viagra--before Viagra there were not any good options, a patient very well might not mention it to their doctor so the doctor wouldn't know to suggest it. Thus "talk to your doctor about new options for erectile dysfunction" ads should have been acceptable to run for a while. I'm not sure what the medical situation was when the overactive bladder ads were coming out, that one might also be acceptable. I can't think of anything else right now.
moksly 5y ago
“If you’re a drug manufacturer looking for patients”. Maybe I’m just too Scandinavian to understand, but wouldn’t it be the other way around? Now I also wonder if I should see a doctor. I’ve been getting a lot of “is your will in order” commercials from law firms on Facebook recently. I sure hope big tech advertising doesn’t know something I don’t.
- smcl 5y ago
  Did you fill your date of birth on any age-protected content (websites for distilleries or breweries, for example) as 1st January 1940 or something? They could just mistakenly believe you're 81 based on that :)
  - designium 5y ago
    But it could be similar to the case where Target was able to targets ads to women who did not even know they were pregnant. In this case, the above commenter could be doing things signaling that he may need a will soon due to diseases or life situation that he is not aware of. Or he/she has looked into content similar to those people in need. ¯\_(ツ)_/¯
    - kalleboo 5y ago
      > But it could be similar to the case where Target was able to targets ads to women who did not even know they were pregnant In this case, she knew she was pregnant. Her family didn't.
    - mbg721 5y ago
      For every "Big Tech figured out my diagnosis before I did" there are a thousand instances of "You just bought a fridge--I bet you love buying fridges, here, let me show you some".
      - Retric 5y ago
        People do take products back they don’t like. So statistically it’s not as unlikely as you might think.
GuB-42 5y ago
Is there some proof that big pharma really targets sick people? The article mentions targeting for things like "cancer awareness" as a proxy for cancer patients. But why target patients? Patients usually don't decide on the drugs they take, doctors do, they should be the target, not patients. So maybe we can take things at face value, big pharma is not targeting cancer patients, instead they are targeting those who are the most likely to have an interest in cancer besides patients: health professionals. Note: I don't live in the US, and generally, only doctors get ads about prescription drugs, I heard the situation is different in the US for some reason.
- varispeed 5y ago
  The patient can say to the doctor "I feel that X drug may be better for me than Y". Sure, ultimately it's the doctor decision, but if patient puts enough pressure and the doctor thinks that there is no material difference between X and Y except e.g. price, they may side with the patient for the sake of their peace of mind. You know the placebo factor etc.
  - vanc_cefepime 5y ago
    This is true, but not as frequent in my rural town in my experience. Most have terrible insurance plans or no insurance at all and I have to use whatever is cheapest on Walmart/Publix/Winn-Dixie standard formulary. Other towns or specialists may have different experiences. Source: me, small town MD.
- Closi 5y ago
  Is there a practical difference between intentionally targeting cancer patients and intentionally targeting proxy signals for cancer patients? This is the whole part of internet marketing targeting right? You don't know for certain if someone is a cancer patient without their medical records, so you record a load of signals and infer that someone is likely to require cancer medication in the absence of absolute information.
- dave84 5y ago
  When I visited the US a few years ago it seems like every TV ad break there was a "Feeling X, ask your doctor about Y". Where X was some generic condition like bloating or feeling old, and X was a brand name prescription drug.
Wolfenstein98k 5y ago
"How Big Auto finds users with car troubles on Facebook" "How Big Lighting finds users with blown bulbs on Facebook" "How Big Chocolate finds users with cravings on Facebook"
- Uberphallus 5y ago
  You beat me to it. Digital marketing 101.
- cornel_io 5y ago
  How anyone finds users that will buy their products on Facebook: serve ads, report revenue, and let FB figure out how the fuck to optimize it without you doing a goddamn thing. Frankly that's all that digital marketing should be (a button PMs press, not a division at every company), I'd rather one or two highly regulated and excruciatingly scrutinized companies manage all the details than millions of small shitty ones that nobody pays attention to. I fully agree with everyone including Kara Swisher that FB is not as regulated as it should be, but that model does seem ideal to me if we can figure out the regulation.
  - Ensorceled 5y ago
    Regulation is pretty simple, ban collecting information on users behaviour for advertising. If advertising is forced back into being based on the content you are currently viewing or the site you are currently on or the key words you typed into the search bar ... this levels the playing field for all advertisers and ends the adtech arms race.
    - sizzle 5y ago
      And location data tracking
  - paulcole 5y ago
    > that's all that digital marketing should be (a button PMs press, not a division at every company Who writes/designs the ads that are served? Who decides how much revenue is spent? Who interprets the reported revenue? Who decides whether the ads are working? Who sets the strategy for the next round of ads?
durnygbur 5y ago
> How Big Pharma Finds Sick Users on Facebook Living in a country where advertisements of pharmaceuticals are allowed, it's unbearable. Basically Facebook in real life - in TV, on billboards, in newspappers, YouTube ads, omnipresent leaflets. All flavours of dietary suplements, Rutin and Ibuprofen products, cures for fungal and intimate infections, wonder cures for liver and joints, "digestion catalysers". They're throwing the most awkward and malignant stuff at everyone. Pharma industry is malicious scum and has to be kept on short tight leash.
- mns 5y ago
  I had to come back to my home country for a few weeks now, having been away for one year and a half, and it's absolutely insane how every ad on tv and radio is for drugs. They even target children for car sickness. Instead of educating people to avoid these things, everything is: smoke and bad breath, get breathazol, drink too much or eat only unhealthy stuff: forteliver plus. There was a movement to ban all pharma advertising, but the lobbying was just too strong and the project did not move forward.
  - durnygbur 5y ago
    Ah yes, the radio ads - forgot to mention these.
    - geoduck14 5y ago
      So vintage!
- logicchains 5y ago
  >Pharma industry is malicious scum and has to be kept on short tight leash. That sounds a bit anti-vax.
  - boomboomsubban 5y ago
    The industry has repeatedly put profits ahead of people's well-being, Oxycotin being the easiest example. Their actions should be met with severe skepticism.
viviansolide 5y ago
I didn't know The Markup. The articles and the methodologies used are very clever.
unyttigfjelltol 5y ago
Facebook is disclosing to third parties that its users have an "interest" in a medical condition although FB purports not to disclose users' medical conditions. Per @refurb in the comments, when people have an "interest" in a medical condition, they almost always actually suffer from that condition. It's almost like the algorithms are in charge over there, unsupervised.
- yarcob 5y ago
  I don't think it's an algorithm, I think it's a bunch of executives who think they are really smart because they found a loophole in the law.
okareaman 5y ago
I like targeted ads. I just wish they were better. For example I am open about being in recovery for alcoholism on FB but they still show me ads for hard liquor.
- jmfldn 5y ago
  I guess a simpler fix here would be to explicitly opt out of certain classes of ads eg gambling / alcohol. It feels like we should have rights not to see ads for damaging products.
- andrepd 5y ago
  I'm afraid you might not be seeing beyond the first-order effects: "ads are annoying, relevant ads are less annoying, therefore I like surveillance!" Consider all the implications that ubiquitous surveillance by unaccountable private entities carries. Plus, the fact that you can advertise extremely harmful drugs such as alcohol (or gambling) at all, not to mention do so precisely to those you figure are more susceptible to this manipulation is pretty disgusting in itself.
  - TchoBeer 5y ago
    >Consider all the implications that ubiquitous surveillance by unaccountable private entities carries I've legitimately never seen an implication other than "I'm uncomfortable with it" that isn't illegal. >Plus, the fact that you can advertise extremely harmful drugs such as alcohol (or gambling) at all Yeah, advertising those things at all should be illegal.
    - andrepd 5y ago
      Many such examples: https://theintercept.com/2016/04/28/new-study-shows-mass-surveillance-breeds-meekness-fear-and-self-censorship/ https://theintercept.com/2016/04/28/new-study-shows-mass-sur... http://www.gnu.org/philosophy/surveillance-vs-democracy.html http://www.gnu.org/philosophy/surveillance-vs-democracy.html
  - okareaman 5y ago
benreesman 5y ago
Anyone who wants to can scroll through my comment history and see that on average I’m the ex-FB guy defending FB. And usually the claim or accusation is debatable, if not dubious. But as someone who’s got a lot of sweat equity in seeing FB ads pay for all that long-haul fiber that HN smart asses take for granted, FB is on legitimately thin ice here. It’s possible for someone with a blog to learn things about a cookie that shouldn’t be shared. What FB can know and what FB should know, and what FB will admit to knowing are potentially all different things. FB should learn to forget medical data, sexual data, political data, etc. etc. The short term erection some lit major at an agency gets from seeing some intrusive targeting option is not worth the trust that FB has somehow managed to maintain with most real users. And if you’ve got a new take on why FB sucks and turned down an offer, feel free to take it there. The world has more than enough “I’m angry at leetcode” deep threads.
cebert 5y ago
I can relate to this from my personal experience of having a sick family member. Five years ago, my father-in-law was diagnosed with Multiple Myeloma, a rare blood cancer. I was close to him and joined several support and information pages on Facebook. Since doing that, I see ads on Facebook and elsewhere targeted to me as if I too had cancer. Now my father in law has passed, yet I still see ads that remind me of the horrible disease he battled.
- dhimes 5y ago
  Can you not turn off certain ad types in facebook?
- jack_pp 5y ago
  Have you tried telling Facebook to not show you these ads through the 3 dot menu in the top right? I don't go on Facebook much anymore, just curious
  - joncrane 5y ago
    Ironically, you are helping Facebook when you do this. Their algorithms get tuned by users saying they don't want certain ads. This is why I stopped doing this on Instagram.
    - fighterpilot 5y ago
      > Their algorithms get tuned by users saying they don't want certain ads. Do they increase or decrease the targeting of ads towards the types of people who say that they don't want to see these ads?
      - fujidust 5y ago
        I did this for ALL ads on FB over many months and am now relatively as free. It helps that I only visit FB from a browser that’s isolated from other web browsing.
    - pc86 5y ago
Giorgi 5y ago
what seems to be a problem here? is not this the whole idea of the relevant ads?
Fuzzeh 5y ago
You only have to look at the ads Signal ran to expose this, to see the sort of information facebook will give advertisers.
bhalina 5y ago
Ughhhhhh
bhalina 5y ago
Ughhhhh
LorenPechtel 5y ago
My wife used to be an example of targeting going really wrong on YouTube. She used to only watch stuff in Mandarin (her mother tongue)--their targeting had absolutely nothing to go on and thus was nuts. I would say the majority of the ads she got were pharma ads, but for a whole slew of things. Everything I noticed was niche stuff, I would presume groups narrow enough that they did some ads aimed on age alone.

191 points by atg_abhishek 5y ago

deleted 5y ago

[deleted]

The article seems to suggest this is a bad thing, but my first reaction is "fantastic". Pharmaceutical companies create life saving medicines and then use advanced social media targeting to locate the people that need them. The only bad thing about it is if those people targeted can't afford the medication, which is why healthcare needs to be a universal right. People love to bitch about Big Pharma but I have a magical little blue tool that completely relieves my asthma, and I can buy them with absolutely no trouble at the pharmacy for about $6. My brother got diagnosed with MS recently. My aunt got diagnosed with MS 40 years ago. Thanks to the research that happened in the last 40 years, my brother's experience with MS is worlds apart (mostly because we live in Australia and he has free access to tens of thousands of dollars of treatment). Pharmaceutical companies are responsible for developing vaccines for a global pandemic at light speed. They're great! Let's celebrate Big Pharma! But let's also make sure that the gains from these amazing advances in technology are shared equitably. And maybe, just maybe, if the medical companies find they need to use Facebook to shift their product, we should be looking at a more formal and closely regulated method of distribution that isn't so commercially driven. I mean, the private sector is great at commercialisation, but is it really the be all and end all when it comes to such a crucial social function as healthcare?

refurb 5y ago
Let's go ahead and see what the FDA found out about direct to consumer (DTC) advertising of drugs as they've conducted numerous surveys[1]. Not all bad it seems! - Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit. - Many physicians thought that DTC ads made their patients more involved in their health care. - Physicians thought the ads did not convey information about risks and benefits equally well. - Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked. - The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated. - Doctors believe that patients understand that they need to consult a health care professional about appropriate treatment. [1]https://www.fda.gov/drugs/information-consumers-and-patients-drugs/impact-direct-consumer-advertising https://www.fda.gov/drugs/information-consumers-and-patients...
thomasedwards 5y ago
Or, I go to a doctor, who is a medically trained professional, and they prescribe a medicine to me based on their experience and training, without any incentive for financial reward?
- jaspax 5y ago
  Do you think that doctors don't have financial incentives to treat patients?
  - throwaway3699 5y ago
    Not where I live. This is a uniquely US problem among first-world countries.
    - refurb 5y ago
      A financial incentive to treat? No, that's pretty common across healthcare systems. It's being worked on as system move away from fee-for-service, but generally, the more a physician does, the more they make.
    - mrweasel 5y ago
      Technically I don't think it's unique to the US. In Denmark doctors get a fee per consultation. It's pay with tax money, but still the doctor is financially motivated to see patients. It might only apply to general practitioner though, I think hospital doctors are on a fixed salary. One issue, that could excuse medical companies going directly to the patients would be a lack of knowledge among doctors. Doctors contently write prescriptions for medication that's no longer available and is often not as updated as a pharmacy on new medication. This means that at least some doctors aren't suggesting the best treatment, simply because they aren't aware of it.
      - varispeed 5y ago
        The doctor can also put a generic name of the drug on the prescription and patient can tell the pharmacy to sell them a particular brand instead of a generic. So there is space where such direct advertising could work.
lozenge 5y ago
You appear to be assuming the advertisement medically benefits a patient. I don't believe there's any evidence for this and ads for prescription drugs are banned almost globally for good reason. "Ask your doctor about" may bias the doctor away from a different drug that is more appropriate but has a lower profit margin, for example.
- toast0 5y ago
  There's some benefit to the patient if the drug is effective treatment for a condition they knew they had but didn't know there was treatment for. Or if it's a new thing that treats something where the old treatment didn't work well or had bothersome side effects for the patient. Major new drugs may get news coverage or may be brought up if a doctor sees something on your chart at a checkup, but ads may (or may not) reach more people.
fabcomm 5y ago
The vaccine has me thinking of these things, and my reaction was closer to yours. I don’t think ads here are fantastic. What I think is fantastic is companies wanting to remove the “dis” from “disease”. But we must not rely on pharmaceuticals. They are just a few tools in the tool belt of healing.
ceilingcorner 5y ago
Have you heard the expression, "A solution in search of a problem"? Because that what this is. Multinational billion-dollar corporations using their marketing dollars to convince people that their pill is the solution to all of your problems. This should be illegal.
- sizzle 5y ago
  It either is or it isn’t, at the end of the day a Doctor was taught what to prescribe at med school and you can’t demand they prescribe you anything unless you are a drug seeker and will be blacklisted quickly if it’s controlled substances. Go look at peer reviewed studies and clinical trials data to make an informed decision on medical treatment options.
rozab 5y ago
Why on earth should the patient choose whichever drug put money into advertising, rather than the one their doctor deems the most suitable? How could that possibly be beneficial? edit: reading further down the article, there is an advert for an antipsychotic medication which offers a $15 discount on your copay. This particular medication has serious discontinuation effects, it's not something you can just stop taking and it's not something that is prescribed lightly in the first place. Offering a discount for the first few doses is plainly exploitative.
- perl4ever 5y ago
  There are some aspects to the supply and demand of drugs, particularly psych drugs, that I'm not sure are described in econ 101 or popularly known. Let's say the most common, first prescribed drug for your condition is available in a generic, for $0.30/month. That's not entirely hypothetical, that really happens. A naive person would say "ok, if the generic is so cheap, then the brand name can't be much more, can it?" - free market competition, the FDA ensures they're all equivalent, blah blah blah. However, I noticed that in recent years, the alternatives to the dirt cheap first-line option are way more expensive and going up. So I thought about why. It occurred to me, that a simplistic view of competition ignores the fact that the different options are not exactly in competition at all. Because everyone tries the cheap one first, and then if they have problems or it's ineffective, they try another. This means that fundamentally the drugs which are supposed to be in competition are not in competition practically speaking. If you have a drug that is not the first option, then you might as well charge $1000/month because everyone who is a possible customer already by definition has given up on the cheap one. And even worse, in order to justify (for example) $1000/month, you don't have to have something better, just different enough to give people a little hope. They proliferate, but it's not progress.
s5300 5y ago
If the blue tool you're talking about is an inhaler, I'm happy for yours being $6, as was mine I believe, but some still aren't so fortunate. They still go for $300-$500 for some people, in the U.S. https://www.health.harvard.edu/blog/millions-skip-medications-due-to-their-high-cost-201501307673 https://www.health.harvard.edu/blog/millions-skip-medication... "Died because couldn't afford inhaler" will bring up some fairly good hits. Things have been fairly good, and are always mostly getting better - but damned if we couldn't be so, so much better than we are given the other things our country fronts billions upon billions of dollars for is the idea always lingering in my and others minds.
helloworld11 5y ago
I don't know why you were downvoted into the grey zone. I don't entirely agree with your points about Big Pharma finding needy patients instead of doctors prescribing based on professional experience (though there's still plenty of room for bias there too) but overall, fully agreed, the pharmaceutical industry is a wonderful thing on the whole, and while it gets a lot of knee-jerk hatred from too many people, i'd love to see somebody suggest something practically better (as opposed to ideally better based on their limitless dreams of a perfect world).
- Ensorceled 5y ago
  Maybe the bribery to get your Doctor to recommend a different drug than is probably best for you or your pocket book? Maybe the campaigns pushing opioids on doctors and patients to the point of crisis? Insulin is at least twice the price (depending on type might be 3 or 4 times) in the $US as anywhere else in the world. There's that famous case where a Turing Pharma skyrocketed price of Daraprim that only they were manufacturing because, well, they could get away with it.
  - fighterpilot 5y ago
    "Insulin is at least twice the price" That is the government's fault. What's the reason you can't import extremely cheap insulin from overseas? The government has endowed a local monopoly.
    - Ensorceled 5y ago
      I don't think you can entirely blame unethical, predatory behaviour on the government that enables it.
      - fighterpilot 5y ago
        It's not a government that enables it, it's a government that enforces it through laws that guarantee and endow a local monopoly. Whenever you have an endowed monopoly without substitutes, you have extremely high prices. It's econ 101 and will happen 100% of the time (that's why I call it enforcement instead of enablement). If the government just got out of the way, the price of insulin would plummet.
pjc50 5y ago
Has everyone forgotten the OxyContin scandal? Or are we just all grateful that Big Pharma has saved us from the pandemic that we're going to overlook the past specific, illegal, actions of pharmaceutical marketing? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ > When Purdue Pharma introduced OxyContin in 1996, it was aggressively marketed and highly promoted. Sales grew from $48 million in 1996 to almost $1.1 billion in 2000.1 The high availability of OxyContin correlated with increased abuse, diversion, and addiction, and by 2004 OxyContin had become a leading drug of abuse in the United States.
- sizzle 5y ago
  So one company running wild without government intervention selling a controlled highly addictive narcotic negates all medical discoveries by big pharma since the dawn of time including the record breaking speed of making a COVID vaccine? Yeah okay…
StreamBright 5y ago
Yeah so I guess the users have nothing to say in this. If I walk in to store they supposed to know what I want and a clerk puts the items into my basket and kicks me towards the checkout. Are you serious?
LorenPechtel 5y ago
In almost all these cases the doctor should know what the patient needs, pushing patients to ask their doctors about certain medicines. The one case I think drug ads are legitimate is when it's a dramatic improvement in treatment for a live-with-it type condition. The prime example would be Viagra--before Viagra there were not any good options, a patient very well might not mention it to their doctor so the doctor wouldn't know to suggest it. Thus "talk to your doctor about new options for erectile dysfunction" ads should have been acceptable to run for a while. I'm not sure what the medical situation was when the overactive bladder ads were coming out, that one might also be acceptable. I can't think of anything else right now.

moksly 5y ago

“If you’re a drug manufacturer looking for patients”. Maybe I’m just too Scandinavian to understand, but wouldn’t it be the other way around? Now I also wonder if I should see a doctor. I’ve been getting a lot of “is your will in order” commercials from law firms on Facebook recently. I sure hope big tech advertising doesn’t know something I don’t.

smcl 5y ago
Did you fill your date of birth on any age-protected content (websites for distilleries or breweries, for example) as 1st January 1940 or something? They could just mistakenly believe you're 81 based on that :)
- designium 5y ago
  But it could be similar to the case where Target was able to targets ads to women who did not even know they were pregnant. In this case, the above commenter could be doing things signaling that he may need a will soon due to diseases or life situation that he is not aware of. Or he/she has looked into content similar to those people in need. ¯\_(ツ)_/¯
  - kalleboo 5y ago
    > But it could be similar to the case where Target was able to targets ads to women who did not even know they were pregnant In this case, she knew she was pregnant. Her family didn't.
  - mbg721 5y ago
    For every "Big Tech figured out my diagnosis before I did" there are a thousand instances of "You just bought a fridge--I bet you love buying fridges, here, let me show you some".
    - Retric 5y ago
      People do take products back they don’t like. So statistically it’s not as unlikely as you might think.

GuB-42 5y ago

Is there some proof that big pharma really targets sick people? The article mentions targeting for things like "cancer awareness" as a proxy for cancer patients. But why target patients? Patients usually don't decide on the drugs they take, doctors do, they should be the target, not patients. So maybe we can take things at face value, big pharma is not targeting cancer patients, instead they are targeting those who are the most likely to have an interest in cancer besides patients: health professionals. Note: I don't live in the US, and generally, only doctors get ads about prescription drugs, I heard the situation is different in the US for some reason.

varispeed 5y ago
The patient can say to the doctor "I feel that X drug may be better for me than Y". Sure, ultimately it's the doctor decision, but if patient puts enough pressure and the doctor thinks that there is no material difference between X and Y except e.g. price, they may side with the patient for the sake of their peace of mind. You know the placebo factor etc.
- vanc_cefepime 5y ago
  This is true, but not as frequent in my rural town in my experience. Most have terrible insurance plans or no insurance at all and I have to use whatever is cheapest on Walmart/Publix/Winn-Dixie standard formulary. Other towns or specialists may have different experiences. Source: me, small town MD.
Closi 5y ago
Is there a practical difference between intentionally targeting cancer patients and intentionally targeting proxy signals for cancer patients? This is the whole part of internet marketing targeting right? You don't know for certain if someone is a cancer patient without their medical records, so you record a load of signals and infer that someone is likely to require cancer medication in the absence of absolute information.
dave84 5y ago
When I visited the US a few years ago it seems like every TV ad break there was a "Feeling X, ask your doctor about Y". Where X was some generic condition like bloating or feeling old, and X was a brand name prescription drug.

Wolfenstein98k 5y ago

"How Big Auto finds users with car troubles on Facebook" "How Big Lighting finds users with blown bulbs on Facebook" "How Big Chocolate finds users with cravings on Facebook"

Uberphallus 5y ago
You beat me to it. Digital marketing 101.
cornel_io 5y ago
How anyone finds users that will buy their products on Facebook: serve ads, report revenue, and let FB figure out how the fuck to optimize it without you doing a goddamn thing. Frankly that's all that digital marketing should be (a button PMs press, not a division at every company), I'd rather one or two highly regulated and excruciatingly scrutinized companies manage all the details than millions of small shitty ones that nobody pays attention to. I fully agree with everyone including Kara Swisher that FB is not as regulated as it should be, but that model does seem ideal to me if we can figure out the regulation.
- Ensorceled 5y ago
  Regulation is pretty simple, ban collecting information on users behaviour for advertising. If advertising is forced back into being based on the content you are currently viewing or the site you are currently on or the key words you typed into the search bar ... this levels the playing field for all advertisers and ends the adtech arms race.
  - sizzle 5y ago
    And location data tracking
- paulcole 5y ago
  > that's all that digital marketing should be (a button PMs press, not a division at every company Who writes/designs the ads that are served? Who decides how much revenue is spent? Who interprets the reported revenue? Who decides whether the ads are working? Who sets the strategy for the next round of ads?

durnygbur 5y ago

> How Big Pharma Finds Sick Users on Facebook Living in a country where advertisements of pharmaceuticals are allowed, it's unbearable. Basically Facebook in real life - in TV, on billboards, in newspappers, YouTube ads, omnipresent leaflets. All flavours of dietary suplements, Rutin and Ibuprofen products, cures for fungal and intimate infections, wonder cures for liver and joints, "digestion catalysers". They're throwing the most awkward and malignant stuff at everyone. Pharma industry is malicious scum and has to be kept on short tight leash.

mns 5y ago
I had to come back to my home country for a few weeks now, having been away for one year and a half, and it's absolutely insane how every ad on tv and radio is for drugs. They even target children for car sickness. Instead of educating people to avoid these things, everything is: smoke and bad breath, get breathazol, drink too much or eat only unhealthy stuff: forteliver plus. There was a movement to ban all pharma advertising, but the lobbying was just too strong and the project did not move forward.
- durnygbur 5y ago
  Ah yes, the radio ads - forgot to mention these.
  - geoduck14 5y ago
    So vintage!
logicchains 5y ago
>Pharma industry is malicious scum and has to be kept on short tight leash. That sounds a bit anti-vax.
- boomboomsubban 5y ago
  The industry has repeatedly put profits ahead of people's well-being, Oxycotin being the easiest example. Their actions should be met with severe skepticism.

viviansolide 5y ago

I didn't know The Markup. The articles and the methodologies used are very clever.

unyttigfjelltol 5y ago

Facebook is disclosing to third parties that its users have an "interest" in a medical condition although FB purports not to disclose users' medical conditions. Per @refurb in the comments, when people have an "interest" in a medical condition, they almost always actually suffer from that condition. It's almost like the algorithms are in charge over there, unsupervised.

yarcob 5y ago
I don't think it's an algorithm, I think it's a bunch of executives who think they are really smart because they found a loophole in the law.

okareaman 5y ago

I like targeted ads. I just wish they were better. For example I am open about being in recovery for alcoholism on FB but they still show me ads for hard liquor.

jmfldn 5y ago
I guess a simpler fix here would be to explicitly opt out of certain classes of ads eg gambling / alcohol. It feels like we should have rights not to see ads for damaging products.
andrepd 5y ago
I'm afraid you might not be seeing beyond the first-order effects: "ads are annoying, relevant ads are less annoying, therefore I like surveillance!" Consider all the implications that ubiquitous surveillance by unaccountable private entities carries. Plus, the fact that you can advertise extremely harmful drugs such as alcohol (or gambling) at all, not to mention do so precisely to those you figure are more susceptible to this manipulation is pretty disgusting in itself.
- TchoBeer 5y ago
  >Consider all the implications that ubiquitous surveillance by unaccountable private entities carries I've legitimately never seen an implication other than "I'm uncomfortable with it" that isn't illegal. >Plus, the fact that you can advertise extremely harmful drugs such as alcohol (or gambling) at all Yeah, advertising those things at all should be illegal.
  - andrepd 5y ago
    Many such examples: https://theintercept.com/2016/04/28/new-study-shows-mass-surveillance-breeds-meekness-fear-and-self-censorship/ https://theintercept.com/2016/04/28/new-study-shows-mass-sur... http://www.gnu.org/philosophy/surveillance-vs-democracy.html http://www.gnu.org/philosophy/surveillance-vs-democracy.html
- okareaman 5y ago

benreesman 5y ago

Anyone who wants to can scroll through my comment history and see that on average I’m the ex-FB guy defending FB. And usually the claim or accusation is debatable, if not dubious. But as someone who’s got a lot of sweat equity in seeing FB ads pay for all that long-haul fiber that HN smart asses take for granted, FB is on legitimately thin ice here. It’s possible for someone with a blog to learn things about a cookie that shouldn’t be shared. What FB can know and what FB should know, and what FB will admit to knowing are potentially all different things. FB should learn to forget medical data, sexual data, political data, etc. etc. The short term erection some lit major at an agency gets from seeing some intrusive targeting option is not worth the trust that FB has somehow managed to maintain with most real users. And if you’ve got a new take on why FB sucks and turned down an offer, feel free to take it there. The world has more than enough “I’m angry at leetcode” deep threads.

cebert 5y ago

I can relate to this from my personal experience of having a sick family member. Five years ago, my father-in-law was diagnosed with Multiple Myeloma, a rare blood cancer. I was close to him and joined several support and information pages on Facebook. Since doing that, I see ads on Facebook and elsewhere targeted to me as if I too had cancer. Now my father in law has passed, yet I still see ads that remind me of the horrible disease he battled.

dhimes 5y ago
Can you not turn off certain ad types in facebook?
jack_pp 5y ago
Have you tried telling Facebook to not show you these ads through the 3 dot menu in the top right? I don't go on Facebook much anymore, just curious
- joncrane 5y ago
  Ironically, you are helping Facebook when you do this. Their algorithms get tuned by users saying they don't want certain ads. This is why I stopped doing this on Instagram.
  - fighterpilot 5y ago
    > Their algorithms get tuned by users saying they don't want certain ads. Do they increase or decrease the targeting of ads towards the types of people who say that they don't want to see these ads?
    - fujidust 5y ago
      I did this for ALL ads on FB over many months and am now relatively as free. It helps that I only visit FB from a browser that’s isolated from other web browsing.
  - pc86 5y ago

Giorgi 5y ago

what seems to be a problem here? is not this the whole idea of the relevant ads?

Fuzzeh 5y ago

You only have to look at the ads Signal ran to expose this, to see the sort of information facebook will give advertisers.

bhalina 5y ago

Ughhhhhh

bhalina 5y ago

Ughhhhh

LorenPechtel 5y ago

My wife used to be an example of targeting going really wrong on YouTube. She used to only watch stuff in Mandarin (her mother tongue)--their targeting had absolutely nothing to go on and thus was nuts. I would say the majority of the ads she got were pharma ads, but for a whole slew of things. Everything I noticed was niche stuff, I would presume groups narrow enough that they did some ads aimed on age alone.