
Doctors want ban on prescription drug, device advertisements - pavornyoh
http://arstechnica.com/science/2015/11/doctors-want-ban-on-prescription-drug-device-advertisements/
======
nsxwolf
These ads are one of the main reasons I became a cord cutter. I'm very happy
they have not yet followed me onto any of the streaming services I use.

They are the creepiest thing ever on television. The actors sit around dinner
tables with family members speaking unnatural, FDA manipulated dialog ("Oh,
I'm doing great, I've been taking Pradaxa for my afib, not caused by a heart
valve problem!") Then you get the unending list of side effects read aloud
("death" almost always one) while the actors smile and stare off into space.

Occasionally, one of these ads will come in a 2 minute and 30 second variety
that fills the entire commercial break.

A regulation I'd like to see is that all the side effects must be acted out in
the commercial as they are read. Show the peacefully sleeping woman suddenly
awakened, choking on her swelling tongue. Or a man running around with an
actual 4+ hour erection.

~~~
hammock
The irony of wanting to ban Rx drug ads because they are creepy, is that it
was regulations that made them creepy to begin with. (You seem aware of this
already)

There is an argument to be made for consumer advertising for a drug like
Viagra. Without awareness that an effective treatment exists, patients with ED
or another embarrassing condition are not likely to bring it up with their
doctor on their own, thus resulting in unnecessary suffering.

Another argument is that for various reasons some patients are unlikely to
seek a second opinion, even when one is warranted. Consumer advertising is a
way to present alternative treatment options to a patient whose doctor will
not.

~~~
Turbo_hedgehog
What if you allow basically the same ad but disallow mention of any brand
names - only the generic name or condition to be treated?

~~~
johncolanduoni
Then we have a tragedy of the commons, where Pfizer and Lilly (the makers of
Viagra and Cialis respectively) will wait for the other to create generic ED
ads that they will both benefit from.

~~~
alanh
Or they would, you know, work together for exactly this reason, like how dairy
farmers supported Got Milk? together

~~~
johncolanduoni
"Got Milk?" was originally commissioned by the California Milk Processor
Board, which is administered by the California Department of Food and
Agriculture (i.e. the government) [1]. Also note that milk lacks much in the
way of strong brand identity or distinguishing features, unlike Viagra and
Cialis which are very different medications.

[1]:
[https://en.wikipedia.org/wiki/Got_Milk%3F](https://en.wikipedia.org/wiki/Got_Milk%3F)

------
joshuaheard
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 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. This rule
would remove the ethical temptation of doctors

Further, it will be nice not to hear about an erection lasting over 4 hours,
and not being too old for sex, in front of my 11 year old daughter while
watching the news after dinner.

From a policy perspective, since the patients are not usually paying for the
meds (you and I do), it makes sense to keep demand and prices low, as the
doctors assert.

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.

~~~
gist
"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
_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.

~~~
Cass
Oh hell yes. The main one peaople ask me about right now is Marcumar/Warfarin,
a drug many patients with atrial fibrillation have to take for the entire rest
of their life, despite the fact that it has awful side effects and requires
them to go to their doctor every two to four week to have a blood test done.
Many patients are quite excited to hear that there's now new alternative drugs
(NOAKs) that let you skip the biweekly blood draw. I get asked about Pradaxa,
Eliquis and Xarelto so often, my standard Marcumar pitch now includes a whole
paragraph about how those alternatives are just as bad. This is getting harder
to sell as new studies are coming in and my arguments against the new drugs
are steadily being reduced to "They're a lot more expensive." Patients really
do NOT want to hear about how they have to get stuck with needles every two
weeks so their doctor can save a few Euro a month in the prescription budget.

The whole NOAK advertising scheme seems like a huge win for the pharma
companies to me. (Possibly also for the patients. Not so much for the
affordability of our medical system.)

~~~
davak
As an ICU physician, I hate the NOAKs. The data may say that they bleed less.
However, when they do bleed, I've got nothing that really reverses the
bleeding.

Of course, novel reversal agents are coming and each one will likely only
reverse one drug... and each one will cost an arm and a leg.

I understand why patients do it. I just don't like bleeding that I often can't
directly control.

~~~
oaktowner
I will never stop being impressed at the breadth and depth of the HN audience.
Thanks, you two, for your comments.

------
phren0logy
I'm a doctor, and I think this is a good idea.

The information provided to both doctors and patients by drug companies is
marketing material. The best source of information is peer-reviewed
publications, and even those are subject to some bias. Still, that's the best
source we have, and should be the primary way all of us get health care
information. If you, as a patient, do not understand what the reasearch
articles are about, bring them with you to your appointment.

In my clinic, I do not accept visits or items from drug reps (including glossy
marketing materials, pens, etc); the only thing they can leave me is a copy of
a peer-reviewed article.

~~~
a3n
That's a great approach.

However ... when I was unemployed, I was very happy that my doctor had free
samples from her rep of $DRUG_THAT_KEEPS_ME_ALIVE. Our pediatrician also had
free samples for some of the things our kid needed.

~~~
creshal
> However ... when I was unemployed, I was very happy that my doctor had free
> samples from her rep of $DRUG_THAT_KEEPS_ME_ALIVE. Our pediatrician also had
> free samples for some of the things our kid needed.

Just remember, public health care is _communist!_ Better dead than red.

~~~
a3n
I wonder how long it's going to take to get our heads out of our asses, calm
the fuck down, and really exploit civilization's gifts to take care of
ourselves and our brothers.

------
hackbinary
I live in the UK, and I love that there are no Rx TV commercials here. Then
again, I live in Scotland, and I get my prescriptions for free. The NHS is an
incredible service, and it surprises me that most Americans don't want
publicly funded healthcare. Even those darn Canadian guys north of your
boarder have a good public healthcare system.

BTW, the UK economy spends almost half in, relative terms, at 9.6% of the UK
GDP vs the Americans spend of 17.9% of GDP, on healthcare. In real terms (2012
dollars), the UK spends $3480 per person vs the US spending $8362 per person.
And we have a health care system free at the point of delivery.

~~~
duderific
We're 'MURICANS! We don't need no stinking gubmint telling us what doctor we
can see! Now let me get down to Walmart on my Medicare provided scooter
because I'm too obese to walk...
[https://www.medicare.gov/Pubs/pdf/11046.pdf](https://www.medicare.gov/Pubs/pdf/11046.pdf)

~~~
hackbinary
Just so we're absolutely clear, I can choose my own doctors. GP's,
specialists, dentists, and even a Homeopath!; if I don't like 'em, I can find
another, and all on the NHS. I think, in fact, I have more choice than
Americans--don't you have to go to whomever your HMO tells you to use? Also,
your Canadian neighbours to the north get to choose their doctors.

~~~
JoeAltmaier
Most medical plans create doctor pools and aggressively recruit doctors for
those pools. I've never found a doctor that didn't accept my insurance.

~~~
hackbinary
I am saying three things:

1.) There is a very common assumptions in the USA that because a State funds
healthcare, the individual is not allowed choice of doctor, which is incorrect
in every public healthcare system I have used.

2.) That public or state run health care system is not substandard or less
efficient to the American private system, but actually generally better for
just about everyone.

3.) That if every American paid a flat 18% tax for healthcare (instead of any
healthcare insurance premiums, whether paid directly by you, or by your
employer), then the American government nationalised all American healthcare,
every American should then receive at least a $4000 tax rebate. Then again
your government could use that money fund better schools and universities.

[EDIT] And by-the-way, the UK Government still spends less than the American
Government on every citizen, on healthcare. The American government spends
$4437 per every single American citizen every year on healthcare. By contrast,
the UK spends $2919 per person, every year. You tell me which tax payer is
getting better value for money.

[http://www.theguardian.com/news/datablog/2012/jun/30/healthc...](http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-
spending-world-country)

~~~
JoeAltmaier
I'm suspicious of govt-run healthcare. Look at Canada - their system is in
collapse.

~~~
hackbinary
Is it? BTW, provision of healthcare in Canada is a provincial matter, so there
are 13 separate healthcare systems in Canada. Which one is in collapse? Or are
all the provinces facing severe budgetary constraints imposed by the previous
Conservative, let's not tax the rich, government.

There are some very powerful, vested interests, namely the insurance and drug
companies, that do not want public healthcare.

I am completely suspicious of private, for profit healthcare.

Are you seriously telling me that private healthcare is better? (Okay, private
healthcare is better for the maybe the top 1% who can pay for their healthcare
out of pocket, but if that is not you, the public system is better.) If I
change employer, and therefore insurance policy and/or provider, I will never
have to think about previous conditions that may not be covered with my new
employer, for instance.

------
davak
See how much money your physician takes from drug companies.

[https://www.cms.gov/openpayments/](https://www.cms.gov/openpayments/)

As a physician I can tell you that this type of public reporting has radically
decreased the amount of stuff that doctors take from drug companies.

Removing advertising from the TV will do the same. It is much easier for a
physician to give a patient the most correct medication without these biases.
Remember that in the US, we spend about 2-3X as much as anybody else for less
length and quality of life.

[http://qz.com/553181/americans-spend-nearly-three-times-
as-m...](http://qz.com/553181/americans-spend-nearly-three-times-as-much-on-
healthcare-as-other-wealthy-countries-and-die-earlier/)

~~~
maerF0x0
I would argue the opposite. By creating a separate class of individual that
receives information about medicines we obfuscate what the options are. Under
the current model a doctor could say "You should take <x>" and I would have
little to no exposure to alternatives" .

IMO the real issue is that advertising (not just pharmaceutical) is not very
informative anymore, we need a return to fact based ads. No more "sexy" women
draped over whatever, no more saccharine smily women glowing after their
husband took <y> ... Ads today are propaganda.

~~~
Florin_Andrei
> _information about medicines_

TV ads are not "information about medicines", that's just ridiculous. They are
mind-games the advertisers play with potential customers in hope of squeezing
more cash out of them.

You want true information? Read peer-review studies.

> _Under the current model a doctor could say "You should take <x>" and I
> would have little to no exposure to alternatives_

Right, 'cause doctors are evil like that. I just saw an ad revealing what
doctors don't want me to know, I am totally going to believe it!

~~~
crusso
You could say similar things about political ads. They're mind-games. Do we
want to get rid of them too?

~~~
TeMPOraL
ABSOLUTELY YES.

That we, as a society, allow people deceive us and to lie in our faces, and
not only that - we've turned it into an respected occupation - still boggles
my mind.

~~~
netheril96
In order to ban lies, you need to entrust power in someone else to discern the
lies from truth. But that someone else lies too.

It is simply intractable. Like the halting problem.

~~~
crusso
Exactly. That's why we opt for free speech. We allow people to lie and attempt
to deceive and spin because we know that it's better for citizens to be
accustomed to the marketing and somewhat robust against it than to trust some
other higher power that can betray the unprotected and unaware masses.

~~~
TeMPOraL
I don't buy it. I think "we" didn't allow a thing, it's just that lying makes
money, money gives power, and power can be used to keep your lying legal (and
money can be used to make it be perceived as socially acceptable occupation).

~~~
crusso
And how do you get around the problem of who watches the watchers?

[edit add: Because I actually don't disagree with anything you said, but the
solution you propose never seems to work]

------
c3534l
I guess I'll be the one to go against the grain here. I've seen a lot of
doctors over the years, primarily for mental illness, but my experience has
served me well generalizing to normal, physical health. The model of a doctor
as a paternal guardian who knows better than you so you should just do as he
says is a very bad model. They're as flawed human beings as anyone else and
the only person qualified to fight for your best interests is you. Doctors get
complacent, lazy and fail to keep up with the latest information unless you
press them to do so. You HAVE to stay informed and aware to get the best
treatment. Ads can serve an important function of informing patients of new
treatment options and if doctors could truely be entrusted with your health
without question then there wouldn't be a need to regulate these ads at all
since doctors would only be perscribing the best treatments anyway. Medicine
works best when it's a two-way, active dialog. In my personal experience
anyway.

~~~
arawde
As someone who also has mental health issues, I want to say I agree. However,
I don't think ads are the optimal way for a populace to stay educated.
Personally, every medication I've been prescribed has been followed by my own
research as to how the medication is designed to work.

I will agree though that the relationship between me and my doctor should be a
two-way one. I am completely open with my doctor and make it known what i
expect out of them, and they are the same with me.

~~~
c3534l
It's not the best solution, but I don't think banning them will do any good.
I'm more rebutting the attitude in this thread that medical information is
only for your doctor and not you. I don't think you'll get better health
outcomes by focusing all of your medical advertising budget on influencing
doctors behind the backs of patients. And advertising does serve a legitimate
purpose; I knew a woman with restless leg syndrome who had suffered from it
for all her life, but a treatment wasn't developed until something like 5 or
10 years ago. She'd have never asked her doctor about it had she not seen the
advertising since she had gone without medication for 50 or 60 years at that
point.

~~~
chillwaves
We should just ban profit seeking in health care. It removes the incentive to
cheat.

------
Dwolb
This is an issue for both doctors and pharmaceutical companies. Doctors hate
it because patients may want a drug that's not optimal for them (but I saw if
on TV) and it's bad for pharmaceuticals because they've had to become
marketing machines, investing massive amounts of money into advertising and
sales apps.

The biggest issue with an outright ban is consumer education. Someone,
something, or some organization needs to be responsible for properly
communicating and educating consumers on a drug, its benefits, and its
negatives. It needs to be educational, supplemental, and neutral.

Stuff like this does exist for cancer drugs but should spread to other drug
areas as well.

~~~
sanderjd
> Someone, something, or some organization needs to be responsible for
> properly communicating and educating consumers on a drug

Why shouldn't this just be their doctor?

~~~
jonlucc
The best reason, in my opinion, is that there are new drugs all the time. The
FDA approves on the order of 20 or so drugs per year (that's new drugs, not
including new generic versions of old drugs). So physicians have to learn 2
new drugs per month in enough depth to consider how it should change their
current prescribing habits.

~~~
aquadrop
And now, when advertising is allowed, doctors don't have to learn those new
drugs?

~~~
brandonmenc
When there's a brand new drug for your semi-rare condition, your family doctor
might not yet know such a drug even exists were it not for you seeing the ad
and asking about it.

~~~
ejstronge
Family doctors are not likely to be treating a semi-rare condition.

To put it in programming terms, a front-end web developer would seek advice
from a networking expert if her or his application was experiencing a lot of
networking difficulties.

------
teddyh
Even though many commenters here write about how creepy these ads are, I don’t
think many people realize how _weird_ this looks to the rest of the world. The
US and New Zealand are the _only two western nations_ which even allow them to
exist.

As I am not residing in the US myself, the only experience I have of this
phenomenon is in parody form: Progenitorivox!

[https://www.youtube.com/watch?v=mYodDH4qZQo](https://www.youtube.com/watch?v=mYodDH4qZQo)

(I may or may not have written this comment with the exclusive purpose of
linking that video.)

~~~
gjm11
See also: Paracetamoxyfrusebendroneomycin,
[https://www.youtube.com/watch?v=qWfwNdmK2lA](https://www.youtube.com/watch?v=qWfwNdmK2lA).
(Warning: contains some rude words.)

------
paxtonab
One of the arguments I've commonly heard against a ban like this is that
pharmaceutical companies need to market their products because of the cost
developing new drugs. However, this has turned into a strategy of expanding
the medical uses of already approved drugs and then marketing the "new uses".

Tylenol is the perfect example of this. Everyone "knows" that it reduces the
risk of heart attacks, because of the marketing campaigns. But what most
people don't know is how little of an impact Tylenol actually makes.

~~~
nickff
> _" Tylenol is the perfect example of this. Everyone "knows" that it reduces
> the risk of heart attacks, because of the marketing campaigns. But what most
> people don't know is how little of an impact Tylenol actually makes."_

Do you mean Aspirin?[1]

[1] [http://www.scq.ubc.ca/should-i-take-tylenol-advil-or-
aspirin...](http://www.scq.ubc.ca/should-i-take-tylenol-advil-or-aspirin/)

~~~
johnward
lol

------
pyrocat
Good the fuck luck. Pharmaceuticals are one of the biggest lobbying groups in
DC. Advertising firms would be heavily against this as well.

I'm all for this, but it's never going to happen without severe public outcry,
and even then...

------
chrisprobert
Key question for digital health / biotech startups is whether direct to
consumer (D2C) advertising for testing services (e.g. genetic carrier
screening; cancer risk screening) would be included.

------
aquadrop
Great news, so pharma companies could focus more on drugs itself and less on
marketing. It's huge money waste with mysterious intention - if your drug is
the best, doctors should use it anyway, and if it's bad but you can increase
its usage with huge marketing campaign, then mankind just gets screwed for own
money.

~~~
TeMPOraL
> _if your drug is the best, doctors should use it anyway, and if it 's bad
> but you can increase its usage with huge marketing campaign, then mankind
> just gets screwed for own money._

That's 100% true for everything - just replace "drug" with "product". As soon
as an advertisement is leaving the point of informing about product's
existence and features, it's starting to trick people into chosing a
suboptimal option.

~~~
agarden
If people acted like homo economicus, that would be true. But people are so
irrational, that sometimes they need to be convinced to do the right thing for
the wrong reason, no?

In other words, a given advertisement might be tricking people into choosing
the optimal option.

~~~
TeMPOraL
> _In other words, a given advertisement might be tricking people into
> choosing the optimal option._

It could be so, in principle, but do you trust people who profit off not
having your best interest in mind to do that?

------
cperciva
While I agree with the idea here, it's important to not take it too far. In
Canada "advertising to patients" is interpreted to mean almost any
communications at all -- including putting up websites with purely
informational content. As a patient who sometimes needs information _about
drugs I 'm already taking_, this is not helpful. (Fortunately many such
websites allow a "why yes, _of course_ I'm a doctor" checkbox to get access to
more medical information. But not all.)

I think disallowing "push" advertising while still allowing companies to make
information available to patients who deliberately seek it out would be a good
compromise.

------
Aloisius
I'm surprised the AMA, insurance companies or the US government haven't built
a simple website that compares the drugs used to treat various conditions to
combat the problem of people switching drugs because they are new or are
heavily advertised.

While a layman can't be expected to fully understand the
benefits/drawbacks/interactions of a drug in detail, it seems like it should
be possible to have an easy to understand grid of positives, negatives, retail
price, etc. that would make comparing say, the brand new bipolar drug to old
generic lithium.

------
brightball
There's a part of me that wants to agree completely...and there is another
part that has concerns about the messenger.

The end result of that would be that the gatekeeper to knowing about these
drugs or devices are the doctor's themselves meaning those companies just have
to work harder to advertise to the doctors to recommend their drug/device.

From Last Week Tonight w/ John Oliver:
[https://www.youtube.com/watch?v=YQZ2UeOTO3I](https://www.youtube.com/watch?v=YQZ2UeOTO3I)

------
dannysatan
Why not remove a ban on buying whatever you want WITHOUT prescription.

------
DigitalSea
When I was in the US for most of last year for business this is the one thing
that really perplexed me. In Australia the only advertisements we have are for
Nurofen and popular paracetamol product Panadol. In the US, things are ramped
up quite substantially, ads for blood pressure medication and erectile
dysfunction.

I just stopped turning on the TV in the end. These ads seemingly dominate
television over there and some of the side effects for those drugs sound
horrible, death is mentioned a lot.

------
danans
One of my parents is a doctor, and I grew up getting a amazing front-row
baseball seats courtesy of pharmaceutical sales representatives. Not to
mention dinners out at nice restaurants when I tagged along to medical
conferences.

I thought that practice was forbidden, but perhaps not:
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811591/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811591/)

------
donatj
I'm a grumbly old man despite my age, and am rarely in favour of new laws.
That said, I find outlawing prescription drug ads entirely reasonable.

------
evanpw
Relevant slatestarcodex: [http://slatestarcodex.com/2015/04/30/prescriptions-
paradoxes...](http://slatestarcodex.com/2015/04/30/prescriptions-paradoxes-
and-perversities/)

TL/DR: Doctors like to prescribe new flashy drugs, and patient vs. doctor's
ratings of various drugs are negatively correlated.

------
slr555
Doctors are very good at keeping tabs on earnings of others but have no limits
on the estimates of their own value. We in turned are conditioned to respect
doctors as the vessels which carry the whole of healthcare. Nothing could be
further from the truth. Talk to a very large percentage of doctors outside the
office and you find that money is there bottom line. They're all for tort
reform so you can't recover a large settlement when they are negligent. They
grouse endlessly about how much they have to pay for malpractice insurance. I
recently saw a doctor get into a private chauffeured limousine with a vanity
plate outside a major NY hospital. I don't know too many pharma execs that
live that high on the hog. Did I mention the chauffeur was armed. I guess you
can make people angry when you flaunt wealth like that. My own doctor lamented
not making as much money as "those wallstreet guys" just before he forgot I
was in the hospital for a week. Oops.

~~~
anonymous30
Absolutely. US doctors have the highest income in the world. Even our
supposedly underpaid GPs have higher salaries than specialists in almost every
other country. And the public accepts it, even defends it! Yet our health
outcomes aren't any better.

~~~
marcoperaza
Health outcomes are determined by more factors than the quality of medical
care. Obesity (and it's bed fellow diabetes), sedentary lifestyles, drinking &
drugs, etc. Given current medical knowledge and technology, no medical system
can undo the harm caused by those cultural factors. Doctors' advice is just
that, advice that you are free to ignore.

Even more specific metrics can be misleading. E.g. we know that cancer
patients are more likely to be cured in the US than in Europe, but there's
enough confounding factors to muddle any conclusions. It could be that earlier
detection in the US leads to treatment for a cancer that would have gone into
remission on its own and never been detected by doctors in another country. Or
it could be that US cancer care is superior.

------
ChuckMcM
I would support such a ban. But mostly so that watching the nightly news
without being able to skip commercials would be more palatable.

~~~
thieving_magpie
Get ready for more Draft Kings one day fantasy duel promo code:
GambleYourFamilysMoneyAway.

~~~
ChuckMcM
There is that. It is interesting to see how television in particular seems to
have lost a lot of advertising diversity, excluding advertising for other
shows on the same network, these days just drugs, cars, lawyers, and pay-to-
play games, with the occasional movie trailer for good measure. Bad news for
television networks.

~~~
thieving_magpie
Yeah - to the point that I can't stand it. I can't even watch football
anymore. I generally end up muting the commercials and forgetting to check
back when they're over.

~~~
johnward
Monday night football is like USAA and IBM Watson commercials over and over.
With erectile disfunction thrown in.

------
kozukumi
I am from the UK. When I first went to the US in the 90s I was _shocked_ to
see adverts on TV for prescription meds. Sure I was used to an ad for some
"premium" paracetamol in the UK but drugs to treat depression? nerve pain?
Etc.

When I released it was the norm I wasn't surprised the US never established an
NHS style system. Way too much money to be lost.

------
pjc50
As part of the UK's single-payer system, it is illegal to advertise
prescription medicines to the public. Seems to work.

~~~
refurb
You mean DTC advertising?

There are still sales reps in the UK, no?

~~~
pjc50
Yes, although actual prescribing is supposed to be limited by the government
agency NICE.

(see also [https://www.gov.uk/guidance/advertise-your-
medicines](https://www.gov.uk/guidance/advertise-your-medicines) )

------
brandonmenc
Are family doctors able or willing to keep up on the flood of new medicines
available, each of which may only apply to a handful of their patients?

Aren't drug ads, in a way, a good method for matching medicines to the people
who need them? As far as I know, your family physician isn't going to call you
when a new drug comes out that better treats your semi-rare, non-fatal
condition - and patients aren't going to read medical journals to discover new
drugs to ask their doctor about.

~~~
ejstronge
I replied to this comment elsewhere:

Family doctors are not likely to be treating a semi-rare condition.

To put it in programming terms, a front-end web developer would seek advice
from a networking expert if her or his application was experiencing a lot of
networking difficulties.

Further, even if your family physician is monitoring the progress of your
disease, you'll likely also be seeing a specialist who will also be monitoring
the progress of your disease.

~~~
brandonmenc
> Family doctors are not likely to be treating a semi-rare condition.

Really?

I have family members with rare conditions - for example diverticul(it/os)is,
which affects 0.74% of the population - and they don't see specialists. The
family physician monitors it. And this is with a "Cadillac" insurance plan.

I don't think every rare condition automatically gets you in with a
specialist.

~~~
ejstronge
It likely sounds like a rare condition for you and your family members but
that particular example happens to be something regularly discussed in first
year medical school courses. See [1] for a discussion of how common this is.

Also consider that a family practitioner might easily have 2,000 patients.
Thus, she or he will likely have direct experience with diverticulitis.

Further (and this is more inside baseball), your family members would need to
be admitted to a hospital if their disease worsens to the point that a
standard course of antibiotics won't help.

There might be better examples of 'rare' conditions than this, but the point
stands - for any condition where extensive domain knowledge is required,
you'll have a specialist involved.

Incidentally, diverticulitis is a very American disorder, likely attributable
to our eating habits. You and all other readers should be sure to include
fiber in your diet.

[1]
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/)

~~~
brandonmenc
> Incidentally, diverticulitis is a very American disorder, likely
> attributable to our eating habits. You and all other readers should be sure
> to include fiber in your diet.

The family member in question has eaten a near total vegetarian diet for most
of their life, so fiber intake is not the problem in this case.

------
pinaceae
only the US and NZ allow direct-to-consumer advertising of prescription drugs.

let that sink in a bit.

from germany to japan to ghana to timor leste - everyone else has disagreed on
this approach.

~~~
aianus
Argumentum ad populum is a logical fallacy.

Only Uruguay has legal marijuana, doesn't make illegal marijuana a fantastic
public policy.

~~~
pinaceae
everyone agrees jumping from the roof of a 6 story building will hurt - but
please go ahead, try your debate theory against it.

------
lando2319
There is one I see advertised regularly, one of the side effects is "suicidal
thoughts, or actions", can you believe that, OR ACTIONS. It's one thing when a
pill causes my body to fail and I die, it's quite another to have a pill put
me in a state of mind where I kill myself.

Also I have seen recently the words, "these are not all the side effects, see
our website for a complete list".

It's unbelievable what it has come to.

~~~
netheril96
> It's unbelievable what it has come to.

I don't understand your sentiment. Do you think that the drugs you take before
do not have this many side effects, including suicidal thoughts or actions? Or
do you find it unbelievable these side effects are now required to be spelt
out in front of you?

------
Shivetya
I would not mind keeping them provided that they were required to mention the
generic if it exist by name in regular sized print and voice.

Most of the drugs I see are ED/PE related and yes you can get prescriptions.

Still in the end, if we are going to allow untested by the FDA and others
supplements to be advertised then why would we block drugs which have passed
rigid testing from being advertised. Sorry, that would make zero sense.

------
6502nerdface
Such a ban would probably be damaging to many publicly traded companies (not
just in health care, but also media and related) that are large components of
the Health Care index funds and even broader market index funds sitting in
Americans' retirement accounts... which might make this difficult to
accomplish politically. (Aside from constitutionality issues, etc.)

~~~
Florin_Andrei
Ah, yes, the "it will hurt the free markets" red herring.

~~~
6502nerdface
How is it a red herring with respect to political feasibility? (Which you'll
note is my point; I'm not arguing anything here about the merit of the idea
itself on this basis, except insofar as one counts feasibility as in-scope for
merit.)

------
akg_67
I wonder if HN community reaction would have been different if the headline
was "Doctors want ban on access to information to general public on
prescription drug and device."

This community sees the word "advertisement" and flips out. I guess health
insurance and medical special interest groups did their homework on how to
phrase the argument in their favor.

------
sehugg
I'd like to know more about the strategy for disrupting that $4.5 billion
gravy train. The pharma industry and consolidated media is going to fight
tooth and nail, and our current surgeon general seems too close to the
industry to act as the heavy in calling for more regulation, as did his
predecessors with tobacco.

------
SilasX
This is a great idea, so long as you also ban doctors who fail to keep up with
advancements in medicine.

------
guelo
Glad to see AMA expand their lobbying efforts beyond protecting incompetent
doctors from lawsuits.

------
solipsism
I'm trying to understand, but I'm pretty confused. There must be something I'm
missing, because it seems that this is an obvious move to the majority of the
world, as well as the majority of Hacker News. Could you all help me out? What
am I missing?

First, implicit in most of the comments here is the idea that whether you
_need_ or _don 't need_ a drug is a simple, black-and-white thing. The idea
seems to be: if you truly had a need for a drug you'd be going to the doctor
for it already, and if you were going to the doctor for it already you'd get
the medication. It seems to me there's a lot more nuance. There are many, many
classes of drugs that solve problems that aren't obviously "go to the doctor!"
kinds of problems. I take a prescription medicine sometimes when I do public
speaking. It never occurred to me to talk to a doctor about that problem,
because it just seemed like a "problem" some people have and others don't. I
happened to find out that this situation is easily treatable online, but I
easily could have found out by watching a commercial. And this medicine makes
my life significantly better, so that commercial would have been of enormous
benefit to me, the consumer.

Secondly, it seems obvious that commercials which increase demand would
inflate price. For the class of drugs like above -- drugs that make people's
lives better but aren't saving lives or addressing significant medical
problems -- why should that not be the case? I pay zero dollars for this drug
because I have good benefits. Why should that be? I make plenty of money, and
I can survive just fine without this drug. Why should I pay zero dollars for
it? Why shouldn't the free market be in play in that situation? If we pretend
my insurance didn't pay for this drug, I would be happy to pay a bunch of
money for it -- or choose not to pay a bunch of money for it because it's too
expensive. It's exactly the same decision I make about food at the store, or a
new TV.

I understand that there are many prescription drugs that aren't "casual" in
this way. I think it's good for society to do everything it can to grant to
citizens a certain level of health, and therefore I'm all for restrictions on
how these kinds of drugs are priced. And therefore it makes sense to have
restrictions about how these kinds of drugs are advertised. But Viagra? Why
shouldn't Viagra be subject to the free market? I'm an ultra-progressive
(though rational) liberal here, so I don't really understand what I'm missing.
Clue me in!

------
docb
The doctor has to write a prescription for the drug based on his knowledge and
experience the tv add therefore is superfluous and solicitous and Unnessary
the add is an attempt push the new expensive drug on the patient and their
doctor

------
ArkyBeagle
1) Please, please, please... 2) There goes TV.

"May Cause Death." That's some good advertisin' right there.

Of course, it's interleaved with the ads from law firms trolling for the
victims of the stuff advertised from five years ago...

------
privacy101
Color me surprised and happy... I hope this become a reality.

------
Cub3
They're banned in Australia, I've never actually seen one before just heard
about them from American comedians. I find the practice very strange

------
ddingus
Yes, please do. Completely agreed.

I find these ADS very highly disturbing, and I'm old enough to remember times
before these ADS too.

------
thadd
I agree the ads suck.

Banning things rarely makes things better.

------
masterleep
What rubbish! Let speech be free, and let people make up their own minds about
things.

~~~
paviva
I'm a doctor, and very into free speech, but the problem here is that in
healthcare, patients' choices are paid with other people money.

~~~
jtuente
As a healthy, single, white male who hasn't had a threatening reason to visit
a doctor, This. I probably wouldn't have health insurance right now if it
weren't for the Affordable Care Act (even though my employer pays most of it).
Sure that could bite me in the ass if something were to happen to me, but I'm
comfortable with that risk and have family to help me out. There's no good
reason for me to "outsource" my healthcare options.

~~~
Archio
> Sure that could bite me in the ass if something were to happen to me, but
> I'm comfortable with that risk

Has it ever occurred to you don't have much control over that risk, and that
you are a human being that like every other can become sick for no reason at
all?

> and have family to help me out

Has it ever occurred to you that many people in the United States do not have
family to help them out?

~~~
johnward
That's ok because the emergency room has to treat you if you don't have
insurance but don't mention single payer or those same people will flip out.
Even though those costs are being passed on to the insured int he current
setup.

~~~
orangecat
Uncompensated care in the US for 2013 was $85 billion
([http://kff.org/uninsured/report/uncompensated-care-for-
the-u...](http://kff.org/uninsured/report/uncompensated-care-for-the-
uninsured-in-2013-a-detailed-examination/)). Which may seem like a lot, but
it's a drop in the bucket compared to the total health care spending of $3.8
trillion ([http://www.forbes.com/sites/danmunro/2014/02/02/annual-u-
s-h...](http://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare-
spending-hits-3-8-trillion/)). The alleged problem of people deliberately not
buying health insurance and then freeloading when they get sent to the
emergency room just isn't a significant factor. But the ACA cleverly uses that
as a pretense to force young and healthy people to pay far more than the fair
market value for insurance policies, as a way to disguise subsidies to others.

------
oneJob
"Patients want ban on doctors taking money from prescription drug companies"

------
ck2
How about banning reps from visiting doctors and pushing their products?

------
aggieben
Medical advertisements aren't the problem. The problem is that consumers
aren't spending their own money and don't know how much things cost because
medical providers can't/won't tell them.

Let's fix _that_ problem.

------
sosuke
Yay! I was thinking they should be unable to use actors and only be able to
use people with the conditions they treat.

------
tosseraccount
Can't a free market sort out the problems with drug use?

~~~
ksherlock
As it is, there are too many distortions. You don't pay for your drugs, your
insurance company does. You don't even pay for your insurance, your employer
does. So once a year, maybe, you grumble that your insurance premiums (the
part you pay, at least) are going up, then the next day ask your doctor about
Scrotium.

~~~
wooter
Also, tying health insurance to employment is a direct result of the Feds wage
and price controls of the past. Business couldn't compete in cash, so they
went for the next biggest benefit.

------
eevilspock
Over and over people on HN come to the defense of advertising. Doctors tend to
be Republican and free-market adherents. So why would they be against drug
advertising?

 _" It is difficult to get a man to understand something, when his salary
depends upon his not understanding it!"_ _\- Upton Sinclair_

~~~
vonmoltke
> Doctors tend to be Republican and free-market adherents.

Where did you get this idea from?

~~~
TeMPOraL
Not to mention this idea:

> _Over and over people on HN come to the defense of advertising._

~~~
eevilspock
> _Doctors tend to be Republican and free-market adherents._

This was based on an outdated[1][2] understanding and personal experience (my
father is a physician and nearly every physician I knew supported Reagan). I
retract.

> _Over and over people on HN come to the defense of advertising._

I know this because in my comments here I frequently criticize the role of
advertising on the internet and society in general. The downvotes are many.
Not everyone defends ads, but many do, and my comment is directed at them.

Here's one thread[3]. I can't spend more time on this, so if you guys still
don't believe me, you win (for the moment). I'd rather you were right anyway.
-

[1] "In the mid-90s, 72% physicians' campaign donations went to Republicans."
[https://www.advisory.com/daily-briefing/2015/04/30/how-
docto...](https://www.advisory.com/daily-briefing/2015/04/30/how-doctors-
political-affiliations-have-changed)

[2] "The percentage of contributions that doctors have given to Republicans
has mostly declined since 1996. It dipped below 50 percent in 2008 before
rebounding in 2010." "The study attributed the partisan shift to an increase
in female physicians and the shrinking number of doctors running their own
solo and small practices." [http://www.nytimes.com/2014/06/03/upshot/doctors-
arent-stron...](http://www.nytimes.com/2014/06/03/upshot/doctors-arent-
strongly-republican-anymore.html)

[3]
[https://news.ycombinator.com/item?id=10398290](https://news.ycombinator.com/item?id=10398290)

~~~
TeMPOraL
> _my father is a physician and nearly every physician I knew supported
> Reagan_

Reminds me of a pretty interesting post by Yvain[0]. The relevant quote:

"There are certain theories of dark matter where it barely interacts with the
regular world at all, such that we could have a dark matter planet exactly co-
incident with Earth and never know. Maybe dark matter people are walking all
around us and through us, maybe my house is in the Times Square of a great
dark matter city, maybe a few meters away from me a dark matter blogger is
writing on his dark matter computer about how weird it would be if there was a
light matter person he couldn’t see right next to him.

This is sort of how I feel about conservatives.

(...)

What I mean is – well, take creationists. According to Gallup polls, about 46%
of Americans are creationists. Not just in the sense of believing God helped
guide evolution. I mean they think evolution is a vile atheist lie and God
created humans exactly as they exist right now. That’s half the country.

And I don’t have a single one of those people in my social circle. (...)

I live in a Republican congressional district in a state with a Republican
governor. The conservatives are definitely out there. They drive on the same
roads as I do, live in the same neighborhoods. But they might as well be made
of dark matter. I never meet them."

\--

> _Here 's one thread. I can't spend more time on this, so if you guys still
> don't believe me, you win (for the moment). I'd rather you were right
> anyway._

Hah. An advertising-bashing thread I missed :<. I post a lot of negative
comments about advertising too, and the reactions are... mixed. I have an
impression that HN is a bit split on the issue, some believing that it's
absolutely necessary and others (like me) who would say "good riddance" if all
ad-supported web sites disappeared right now. But I don't feel like there's a
HN consensus around ads.

[0] - [http://slatestarcodex.com/2014/09/30/i-can-tolerate-
anything...](http://slatestarcodex.com/2014/09/30/i-can-tolerate-anything-
except-the-outgroup/)

~~~
eevilspock
Likewise no one I spend time with are creationists, but the Internet acts as
an inter-dimensional gateway, connecting me with creationists with whom I
schooled as a child, and the die-hard you-get-what-you-deserve libertarians
here.

I'm writing a treatise on advertising and the internet, or at least I'm
trying. I might hit you up for feedback. It may be a while.

~~~
TeMPOraL
Please do, I'll be happy to give you feedback. I'm also gathering my beliefs
on this topic myself.

I find myself repeating so often, and being asked the same questions so often,
that I decided to write down and maintain a description of my current beliefs
on most frequent topics - to serve both as a FAQ for someone asking and as a
collection of points and citations to quote.

I'm in the process of writing stuff down, but I still haven't figured out what
would be the best way to publicize it. I'd like something that would show the
current state of article, but would also allow to easily view the changes over
time (as my beliefs get updated based on evidence). Sort of like more
streamlined Wiki, or Wiki meets Github meets Etherpad or sth.

