Selling Drugs to the Masses

Watching CBS in the morning, you might feel a bit overwhelmed by disease. Every commercial break is chock full of ads targeted to patients for chronic diseases.

According to the CDC, chronic diseases are responsible for 7 of 10 deaths each year, and treating people with chronic diseases accounts for 86% of our nation’s health care costs. It’s definitely not something to be ignored, but I’m not sure that advertising dollars are the way to bring attention to it.

Selling Drugs and a Lifestyle between the News

In the span of 15 minutes, I saw ads from Xarelto, Harvoni and Symbiocort. I barely understood any of the benefits they were touting and the situations seemed considerably unrealistic. With a bit of research, I learned that the United States and New Zealand are the only countries in the world that allow direct-to-consumer advertising of pharmaceuticals. And let me say, it’s an interesting media category.

Consider Xarelto. I can’t imagine a group of men out golfing are going to order giant salads for lunch. And I also don’t expect that they will be discussing how great a prescription is. There’s a lot of complex information that the actors have to communicate about complications with other conditions — and that doesn’t include the typical disclaimers by a narrator at the end of the commercial.

Harvoni focuses on patients who’ve recently been diagnosed with Hepatitis C who haven’t taken other medications. I would imagine that this target user group would be dealing with a lot and be looking for a quick answer (but even WebMD says the medicine is “quite expensive”). I didn’t even know what Hepatitis C was until I searched it on Google and I still don’t know what Interferon and Ribavirin are.

Symbicort almost looks like it’s appealing to children, with the majority of the commercial comprised of a wolf cartoon character who is spending time with his wolf family. I’ve heard of COPD before, but again, this is an example of targeting very specific user groups.

The Beginning of Advertising Pharmaceuticals

According to Keith Veronese’s article in io9, we can blame Joe Davis, a regular salesman who sold packaged goods.

Davis went to his friend William Castagnoli, an executive at the medical advertising company Medicus in the mid-1980s. Castagnoli was of a like mind, and the two devised a way to “pull the drug through the system” through direct-to-consumer marketing. The problem was that the FDA required any drug ad to include a full list of possible side-effects, which often took several pages of tiny print. Hard to do that in a TV spot.
So the two devised a way to recommend drugs in ads that did not mention the name of the medication, but only the positive effects of a hypothetical drug with the exact attributes of a specific pharmaceutical. Commercials ended with instructions for the consumer to see their doctor for more information. By omitting the name of the drug, the two were able to slide their ads through a loophole in FDA regulations.
The unnamed drug they marketed was Seldane, which they tagged as an “antihistamine that did not cause drowsiness.” When patients asked doctors for this exact type of drug, they got Seldane. Over the next few years, Seldane went from sales of $34 million a year in 1985, to $800 million per year. (Seldane, interestingly, was removed from the U.S. market in 1997 after it was found that the drug could cause heart arrhythmias.)

Woah! Sales increased 23 times over!

This reminds me of the home commercials that claimed to be better than the “leading brand” like this Mr. Clean commercial. Though now, brands don’t hesitate to cut down other brands, creating intense marketing rivalries. Coca-Cola and Pepsi have one of the more famous rivalries.

In the face of all this

Could there be an end?

There’s signs on the horizon that marketers will need to watch what they say (and promise) to consumers.

The American Medical Association (AMA) called for an end to direct-to-consumer advertising of prescription drugs in November 2015.

“Today’s vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices,” said AMA Board Chair-elect Patrice A. Harris, M.D., M.A. “Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”

It’s especially interesting that the AMA focuses on the financial implications in setting pricing of drugs and costs to insurers. This starts to address how consumer behavior has a great impact on the broader healthcare system. While the AMA could have called out more ways that the system is impacted, it’s just reality that money talks. Especially when you talk about people charging too much or taking money hostage.

I was pleasantly surprised to see that Consumer Reports tackled this issue by breaking down the realities behind the claims made in specific commercials; they called out when a cheaper option was available or that other (non-medicine) methods could achieve similar or better results. They recognized that medicine is not a silver-bullet and presented options that relied on better habits or managing related conditions. Along with tearing apart particular medications, the publication clearly sided with the AMA in suggesting that drug ads should be banned.

Just a couple days ago, Lumosity, the “brain training” program was fined by the FTC for advertising that use of the product would “reduce or delay cognitive impairment associated with age and other serious health conditions.”

I applaud this action because it recognizes that consumers have fears and that companies shouldn’t prey on those fears. We’d all like to think that we will stay healthy forever; but, when that belief is challenged by statistics or watching medical conditions impact our friends’ or families’ lives, we’re going to look for any way to avoid that. It’s simply not fair for a company to take advantage of that fear without creating a real value for people.

It may still be a while until my morning news doesn’t leave me nervous or confused about a multitude of maladies that I didn’t even know existed. But, consumers need to speak up with their wallets and their voices to take charge; and not get bowled over by drug company behemoths.