[henryfjordan]

I would like to see a compromise where new drugs are allowed to be advertised to the public for say 1 year following their release then never again.

People need agency in their own medical choices, and knowing there is a drug for your medical condition is very empowering. Especially as we talk more and more about moving to a single-payer system, it's important to make sure patients have the power to question their doctors and explore their own health instead of essentially being dictated to by the state.

[vertex-four]

I live in a single-payer system in which advertising is banned, and I know every drug that could potentially be taken for my condition and all the upsides and downsides of them, including some side-effects that my doctors refuse to believe are a thing.

There's no way the only possible method of resulting in having informed patients is to put them directly in the middle of a struggle between big companies and doctors. I'd argue that putting doctors in a position of power is terrible (whether single-payer or not), but giving pharma companies' marketing departments the freedom to manipulate people with advertising is also terrible. Two wrongs do not make a right - adversarial systems are poor designs.

[mikeash]

How about we periodically publish a big book that lists all approved drugs, their uses and side effects, and send it to every residence in the country like we (used to?) do with phone books.

[TheOtherHobbes]

In the UK most doctors have a copy of this book on their desks. Drugs and side-effects are also listed on the NHS website. (And on Wikipedia, sometimes.)

Of course the problem is the reliability of the evidence. I recently had to decide whether I wanted to go on a course of some fairly severe drugs with nasty side effects.

The original papers didn't make a lot of sense. The statistical conclusions seemed to be - if not nonsense, then certainly not very consistent.

My doctor said "Well, these are new drugs, so we're still learning about them." I didn't find that reassuring.

The real problem is that big statistical studies don't say much about why side effects happen. There seems to have been far too little research into understanding why/how side effects happen at all, and whether or not it's possible to screen for them.

That would probably require a level of personalised medical screening and dose control that big pharma isn't interested in providing.