[snarf21]

There can be no "honest" advertising of drugs. We need to start banning ads for drugs completely. It probably wouldn't hurt to do the same for alcohol, etc. It's not like people still won't drink or asking for drug X but it stops the patients from demanding it. We've already made some strides by banning the pharma reps from sending super models to doctor's office to flirt and convince them to push drug X but we need to push further.

Instead we should be spending more money at the FDA level. The surgeon general should have the resources that say that condition X, the approved drugs are A, B, C, D and E. You can also do in a phased fashion. You always prescribe A. Only if that fails do you prescribe B, etc. There are lots of treatment plans like this already (usually driven by insurance costs) but these could be built by leading physicians in each specialty. There are providers that have the knowledge of what works and doesn't but we do an awful job of capturing it. Most doctors just know what they learned in school 30 years ago or what they can google. We need better codification of successful treatment options for each condition X.

[Cub3]

Am confused by this whole thing, As someone who grew up in Australia I've never seen drug advertising, the closest would be supplements / vitamins that you can buy over the counter

Is the idea that a user sees a drug advertised then goes to their doctor to ask for that specific one? Wouldn't the doctor give you a yay or nay for needing it then perscribing it?

Do doctors in the US let the patient decide whether they should be perscribed the drug despite not agreeing with it?

[maxlybbert]

I know several people who have been diagnosed with, say, fibromyalgia, Crohn’s disease, PCOS, or some other chronic problem and would be happy to know about new, potentially more effective medication. In theory, they’re the primary audience for these commercials.

Additionally, some commercials are targeted at people who have undiagnosed problems, who may not even realize that what they have is unusual. Those commercials start with a list of symptoms, a recommendation to talk with a doctor, and a note that if you do have a particular condition a new drug could potentially help.

And, of course, there are ads for things that people can readily self-diagnose, like erectile dysfunction.

In practice, the ads leave a lot to be desired. Probably the worst marketing campaign I remember was Nexium, which ran ads for several years encouraging people to talk with their doctors about “the purple pill,” without ever mentioning what it could treat. The tag line — “little, purple, different” — didn’t help.

[JohnTHaller]

The other issue is that sometimes the new, more-expensive, under-patent medications are less effective than something that already exists. But they don't say that in the ad. Or to doctors when they're wining and dining them.

[ceejayoz]

> Probably the worst marketing campaign I remember was Nexium, which ran ads for several years encouraging people to talk with their doctors about “the purple pill,” without ever mentioning what it could treat. The tag line — “little, purple, different” — didn’t help.

IIRC, this trick lets them avoid the big list of disclaimers and side-effects, as they're not making any medical claims in the ad. Nasty, IMO.

[maxlybbert]

It took a while for me to remember, but let me correct something: Nuprim’s tagline was “little, yellow, different” ( https://youtu.be/kPYACe8I-T8 ). Nexium was just the purple pill with mysterious ads.

[petronio]

Doctors in the US generally won't prescribe medications they deem unnecessary, but there's a few issue that reduce the effectiveness of that. Two big ones are:

1. If an individual sees drug advertisements with particular symptoms they might think that they have them, which would make their concerns sound more probable to doctors when they complain about it.

2. In the US medical malpractice suits are a big issue, so that fear often causes things that might be considered on the edges of unnecessary in most countries to be converted to "maybe, I don't want to get sued if something does happen". This is magnified by point 1.

Take more people thinking they are sick, multiplied by multiple conditions, multiplied by doctors effectively excessively afraid of false negatives in diagnosing, and you have one big public health concern and some big marketing bonuses.

[rapind]

"Doctors in the US generally won't prescribe medications they deem unnecessary"

I'm not sure about this statement. Pharma is literally paying doctors to push their drugs. Obvious conflict of interest no?

E.g. https://www.abcactionnews.com/news/full-circle/pharmaceutica...

[alistairSH]

The sibling comments cover advertising to the general public, which is allowed in the US. And yes, many of us in the US find it just as strange as those of you in other places.

There is another problem, and I don't know how it is resolved elsewhere. Pharma companies have paid sales rep that travel to medical offices, and push their product directly to doctors. This is ostensibly in the name of educating the MDs, but they hand out free samples. The hope is to convince the MDs that this drug is better than its predecessor.

[ceejayoz]

Free samples is just the start. Big prescribers get cushy dinners, "educational" retreats at resorts, "speaking fees", and the like.

[AlexTWithBeard]

I'm in the US, I see drug commercials all the time, but I don't understand how they work.

Am I just supposed to go to my GP and ask for a drug I saw on TV? Are there really that many drugs so that any decent GP doesn't know most of them?

[Angostura]

I think that's exactly how its meant to work. I'm sitting at home, and I have a bad stomach, an advert comes on the TV: "Do you have a bad stomach? Ask your GP about engorgolate today!". So I do. 2% of GPs then end up prescribing it

[Cub3]

Ah that makes sense, thanks for writing this out

[maxerickson]

With liability for deviating from the plans?

Having experienced a vaguely diagnosed condition that the doctor treated with intuition, I hope you don't get put in charge.