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Medical Marketing in the United States, 1997-2016 (jamanetwork.com)
43 points by el_duderino 4 days ago | hide | past | web | favorite | 18 comments





I would love to see pharmacy advertising banned from television and streaming services during certain times of the day. I would also love to see the same advertising banned on billboards. If [1]this is true, we are exposed, on average, to 5000 advertisements a day.

Pharma advertising culture has lead us (in America) to become a culture of self-diagnosers and a culture where we don’t want to be exposed to any emotion or pain. This is not to say that drugs are bad, because they have amazing uses in the world. I know many people that benefit from antidepressants, antipsychotics, and so-called illegal substances to be functioning members of society, but along with that, I know plenty of people who have been taught by the big shiny box that they don’t need to feel the pain of a loved ones death, or a bad breakup.

I find this woman’s account of going through a hysterectomy in Germany to be enlightening when compared to our own culture.

https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-ge...

[1] https://stopad.io/blog/ads-seen-daily


There’s interesting information to be gleaned based on what’s being advertised. The biggest revelation to me was the prevalence of long term opioid usage.

I noticed that nearly every day I would see commercials to treat “opioid induced constipation” and thought to myself, “How many people are on long term opioids that it’s financially worthwhile to be marketing an auxiliary drug to deal with side effects?!


Pharmacy and health care advertising should be banned, period.

> I know plenty of people who have been taught by the big shiny box that they don’t need to feel the pain of a loved ones death, or a bad breakup.

I was with you up until there. If only antidepressants were effective for those situations. They're not. But I suspect we'd both agree that TV ads for chemotherapies are over some kind of line.


This. Before we disappear down the HN antidepressant conspiracy rabbit hole, ever actually seen a commercial with either of those themes? You haven't - FDA would shut 'em down in a heartbeat because that's not in the label.

> I would love to see pharmacy advertising banned from television and streaming services

In every country in the world it is, except two. The US, and New Zealand, where it is being phased out, and was only allowed in the first place because the US demanded it as part of a trade agreement.


Is this a joke?

> Finding: From 1997 through 2016, medical marketing expanded substantially, and spending increased from $17.7 to $29.9 billion

Adjusted for inflation, that might even constitute a decrease in spending: 2.5% annual marketing spend increase vs, I'm guessing, 3% inflation '97-2016?

> Meaning: There has been marked growth in expenditures on and extent of medical marketing in the United States from 1997 through 2016.

Not that we shouldn't have a good talk about medical marketing, but this isn't the basis for it.


"Spending is reported in 2016 dollars"

“The most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9%) of total spending in 1997 to $9.6 billion (32.0%) of total spending in 2016.“

In terms of inflation, you can actually check. What cost $17.7 in 1997 would cost $27.07 in 2016. So, no it’s an increase.

https://westegg.com/inflation/infl.cgi


Spending is already adjusted to 2016 dollars.


"Schmooze docs"? It hasn't been like that in decades.

Most pharma reps I know do the following: 1) arrive at doctor's office, 2) wait anywhere from 10 min to 3 hours for the doctor to speak to them, 3) spend 5-10 min dropping off new materials and answering any questions [often focused on insurance], and 4) head to the next office.

I wouldn't call that "schmoozing".


It's right there in the linked JAMA article:

> Marketing to health care professionals by pharmaceutical companies accounted for most promotional spending and increased from $15.6 billion to $20.3 billion, including $5.6 billion for prescriber detailing, $13.5 billion for free samples, $979 million for direct physician payments (eg, speaking fees, meals) related to specific drugs, and $59 million for disease education.

Speaker fees are a particularly insidious approach: https://www.npr.org/sections/health-shots/2013/06/25/1952325...

> At least 17 of the top 20 Bystolic prescribers in Medicare's prescription drug program in 2010 have been paid by Forest to deliver promotional talks. In 2012, they together received $284,700 for speeches and more than $20,000 in meals.


Are they prescribing a lot because they are paid speakers kr are they paid speakers because they prescribe a lot and believe in the product?

The industry presumably isn't spending a billion dollars a year on speaker fees and meals out of a charitable desire to improve doctors' personal lives.

Regardless of proof that these particular doctors are being influenced by the money, the offer of the money creates a perverse incentive. If a doctor likes a particular drug they can proselytize it on their own time and dime.

I was in a cancer treatment waiting room just the other day. A pharma rep came in with lunch and a bunch of other freebies for the office staff. He didn't sit around waiting.

Depends on the office!

Just because they brought lunch doesn’t mean they listened to them. Many reps have told me “they told me where to put the lunch then told me to leave”.

Don’t think the docs don’t know how to get the perks without giving anything in return.




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