How Americans got stuck with endless drug ads


In most of the world, this is a strange sight. It’s a TV commercial for a prescription drug. These ads are illegal in most countries. but in the US, they’re everywhere. On average, 80 of them air every hour on American television. “Ask your doctor.” “…my doctor told me…” “Ask your doctor.” The American Medical Association, a major group of doctors, has called for a ban on these direct-to-consumer ads. But there’s a case to be made for them too. So today we’ll take a look at both sides. First, a little background. Before the 1980s, prescription drug commercials were unheard of in the US. Drug companies focused their marketing solely on doctors, and they didn’t want to hurt those relationships. When asked by Congress in 1984, if direct-to-consumer advertising should be allowed, one pharmaceutical executive said: And an executive at Schering-Plough, which is now part of Merck, said: Needless to say, they changed their minds. At the time there was a larger cultural shift
in health care toward empowering patients to make decisions rather than just listening
to their doctors. And advertisements fit with that trend. Drug Ads started appearing in print publications, but there was still another thing keeping them off TV, and that was FDA’s regulations at the
time. They were interpreted as requiring ads to
include all of the information about the drug’s risks and side effects, which simply wasn’t feasible to do in a tv or radio commercial the way it was in
a magazine. There was a bizarre loophole though: The ads didn’t have to mention the drug’s risks, if they also didn’t mention the disease
or condition that the drug was supposed to treat. Here’s what that looked like — in an ad
for Claritin back before it was available over the counter: “It’s time.” “It’s time!” “Don’t wait another minute with Claritin.” “Claritin.” “I’ll ask my doctor!” “It’s time to see your doctor.” “Mr. Wilkin, the doctor will see you now.” “At last, a clear day is here.” Confused? Yeah, everyone was. So in 1997, the FDA clarified that the industry could run the full drug ads and wouldn’t have to give ALL the risk information from
the label, as long as they included the major side effects and referred viewers to another source for the rest. That’s why the commercials direct us to
phone numbers or print ads. Come for the pharmaceutical fine print — stay for “the secret to crisp contact in soggy conditions” That new FDA guidance removed the main barrier keeping drugs off of television. and you can guess what happened next… spending on ads quadrupled by 2004. And now, we know the names of prescription drugs like we know the names of cars and clothing brands. “Lunesta, Xanax, Celebrex, Flomax, and HGH.” “And as of Thursday, Lipitor.” “Oh and if you have trouble sleeping, Marla has Ambien. I prefer Lunesta.” “Lipitor, Baby Aspirin… Flomax.” “Flomax?” “…and some Cialis! I’m just assuming.” So that’s how we got here. Drug ads are now the most frequent form of health communication that most Americans see. So what does that mean for public health? Are those prescriptions going to the right
people? Or are they going to people who probably won’t benefit from the drug — people for whom the potential risks outweigh the potential benefits? Well, the answer seems to be: both. A clever experiment in 2005 tested this by
sending actors to real primary care doctors. Dr. Richard Kravitz: We helped them make appointments. In half of the visits, the actors reported
symptoms of depression. In the other half of the visits, the actors
said they were feeling down after becoming unemployed. The study authors called this an “adjustment disorder.” In some visits, the actors mentioned seeing
an advertisement for Paxil on TV, that’s an antidepressant. In others, they didn’t bring up medication
at all. And the doctors seemed to take patients more seriously if they mentioned seeing the Paxil commercial. They were more likely to refer patients to
a mental health consultation, And much more likely to prescribe an antidepressant. That may be a good thing for those with major depression, who might benefit from an medication. But it’s more questionable for those with
a more temporary condition. This study, and others, have shown that doctors can be persuaded to broaden the scope of who gets treated with drugs. And advertisements often seem designed to encourage that. Take Androgel — it was approved to treat men with hypogonadism: that’s extremely low testosterone levels due to injury or disease. But here’s how it was promoted by Abbott:
“Millions of men 45 and older just don’t feel like they used to. Are you one of them? Remember when you had more energy for 18 holes with your buddies? More passion for the one you love.” Some middle aged men don’t feel like they
used to? You don’t say. A study looking back at 10 years of testosterone prescriptions found that only half had been diagnosed with hypogonadism in the previous year. Drug ads give the industry an incentive to
make healthy people feel unhealthy. “Latisse is the only FDA approved prescription treatment for inadequate, or not enough lashes.” And they contribute to unrealistic expectations about what pharmaceuticals can do. So what’s wrong with that? Well, every single drug comes with risks. Big ad campaigns are usually for newer drugs, for which not all the risks may be known yet. In the case of the painkiller Vioxx, a massive ad campaign led millions of people with arthritis to switch to Vioxx instead of sticking with
older drugs like Ibuprofen. “It’s a beautiful morning…ask your doctor
today about Vioxx, and find out what Vioxx can do for you.” Vioxx was more expensive and not actually more effective, and… “The manufacturer of Vioxx have just recently pulled this popular arthritis drug from the market over health concerns.” Merck withdrew the drug after it became clear that it increased the risk of heart attacks
and stroke. A Kaiser Permanente study later confirmed
that ad exposure was linked to inappropriate prescribing of Vioxx and a similar drug called Celebrex. So that’s a worst case scenario. But there is also an argument that these ads can be good for public health. Sidney Taurel: “There are many diseases for which people don’t seek treatment. So if you can educate through direct-to-consumer
about the fact that this can be treated, you will get a better outcome for everyone.” In their view, more communication with your doctor is always a good thing. And it’s up to the doctor to make the right
prescribing decisions. Surveys of the public have confirmed that
drug ads prompt people to visit their doctor, in some cases for diabetes, hypertension, depression — these are conditions that are thought to be under treated. In the case of the HPV vaccine, that’s now recommended for all pre-teens to prevent cervical and other cancers, Merck’s ad blitz for Gardasil
probably reached more people than a government communications effort could. And whatever you think of erectile dysfunction drugs, they got men to see their doctors and undergo the required heart screening, potentially catching problems not yet treated. But the strongest argument in favor of drug
ads may be the legal one. The Supreme Court ruled in favor of prescription drug advertising back in the 1970s, when the state of Virginia tried to prohibit pharmacists from advertising their prices. Harry Blackmun: “We further hold that so called commercial speech is not wholly outside the protection of the 1st and 14th amendments. The individual consumer and society in general may have strong interests in the free flow of commercial information.” It was the first time that the Court said
advertisements were entitled to free speech protections. There was only one dissenting Justice at the time: William Rehnquist — who Ronald Reagan would later appoint Chief Justice —
In his dissent, Rehnquist wrote a kind of uncanny prediction of the type of commercials that would come decades later: “Don’t spend another sleepless night. Ask your doctor to prescribe Seconal without delay.” Rehnquist worried that ads would “generate patient pressure on physicians to prescribe” drugs; and that they’d end up being “advertised on television.” And as we know now, for better or for worse, that’s exactly what happened.

100 thoughts on “How Americans got stuck with endless drug ads

  1. You forgot to mention that the drugs don’t magically “go” to anyone who sees the commercial regardless of their medical condition. They must be prescribed by a licensed practitioner. Come on.

  2. In Spain we have them but they don’t have to say: “This can cause (insert side effects)”
    You just ask your doctor/pharmacist, which is public and free

  3. Same on Croatian TV. 90% of comercials are about drugs. We started thinkig that we are the unhealthiest country in the world

  4. In Italy and Albania, we have ads for Ibuprofen, Aspirin, Cough Syrup, Stomach Acidity Regulators and other almost harmless stuff. No prescription medication though…

  5. I'm in Australia. Even on mental health forums you are not allowed to discuss drugs. This is because they want to leave it all to the professionals. Also we use generic drugs so same active ingredients but not from the big brands. I'd rather leave it to the doctors. Otherwise I could be on the wrong medication.

  6. Both sides.
    Yes, let uneducated people be swooned by companies giving it their all to sell as much as possible.
    SOME of them might be correct.

    Really, Vox? Really?!

  7. Makes ya think people started thinking for them selfs no we got Anti Vaccines people
    Another thing the American healthcare system is really bad and yet they charge outrageous prices for something that doesn’t work

  8. Gardasil is actually a very bad example of the benefits of consumer exposion to ads since it is banned in many countries and is scientifically known to cause more harm, illnes and several types of cancer than VPH

  9. Did anyone else notice that this video doesn't link to a page on the vox website on the topic? Do a google search for " 'How Americans got stuck with endless drug ads' site:vox.com " and the only place this video appears on the site is as a recommended video… I'm writing a paper for school and was hoping I could cite some of the sources used in the video, but they don't have a reference list anywhere? Why would you cite such formal sources in the video and not present them to the viewer? Is there something I'm missing?

  10. Speaking of this: Are you a man who feels 'inadequite'? Millions of American men suffer from Perceived Penile Inadequacy (PPI). If you are one of them, you should insist to your doctor that prickstata is right for you. Side effects are generally severe and include arrhythmias, stroke, diverticulitis, and increased chance of infections, particularly STIs. Do not take prickstata if you are pregnant or nursing (kinda obvious since it is for men). Do not take prickstata if you are taking an MAOI or thioretizine.

  11. lol the drug dealers want to give you options for you to choose your drug of choice but what about Weed! 😂

  12. Only in America could you justify this unethical medical practice by citing the failures of your education system.

  13. Biggest thing unsaid here is the overall increase to drug costs when advertising is allowed. Suddenly every company must spend on advertising to stay competitive – sometimes up to 1/4 of their budget.

  14. "a shift towards empowering patients" is a pretty slick way of saying "deregulating and privatizing everything under the guise of 'choice'". also, there are ways to encourage patients to seek medical treatment without allowing brands to market directly to them and doctors.

  15. Some of the foods that we eat contained some bad chemicals that can cause mutations that are conflicting with our good cells, therefore, killing our good cells by these mutations, like allergies, arthritis, and cancers and all kinds of maladies and the pharmas knew this and that's how they designed their medicines.

  16. I was visiting The United States and it was soooo weird. It was like every ad, back at home I would enjoy watching ads. The ads were like buy this great drug, and then they say every side effect.

  17. I am Huge NFL fan
    I no longer watch it live because of so many drug advertisements
    I just watch the highlights on YouTube
    It makes mad

  18. Most of these drugs mentioned in the video I've never heard of because here in Australia we don't have ads like these.

  19. I'm a physician and drug ads are making me sick, so does insurance system and the whole pharmaceutical lobby industry. No I'm not getting paid by any of these f..ers and I don't believe to have any kind of financial relationship with any of these people is ethical either. I don't care about this study, the only good way to practice medicine is the trust between doctor and patient. Also, wise-content doctors who did not enter the practice for money (which is rare in the US)

  20. Because I see so many drug ads sometimes I get very pissed off becasue THEY BASICALLY ONLY POTRAY ECZEMA SUFFERERS AS ONLY OLD PEOPLE.

  21. Oh oh America what have you become that you need to keep 30% of the population sick, AT the same time with out this 30% of sick people US economy could collapse so so sad, what we need is a preventive health system rather them a corrective one

  22. Did we ever invent an ad blocker for cable? Like a box that detects a set of commercials that could be kept current on some server?

  23. The ultimate goal of drug companies by playing drug commercials incessantly over and over again while you watch tv is to program your mind to accept chronic and terminal illness as a normal human condition. Years ago the only commercials were for constipation, heartburn, arthritis, and erectile dysfunction…well now it’s heart disease, cancer, bipolar and manic depression, diabetes and breathing issues…their ultimate goal is to get you to a doctor by instilling the fear that you have or will soon get an illness so they can put you on a drug, make money from tests and get you to take vaccines. This onslaught of drug commercials is an assault on human consciousness..changing humanity’s perception of what is normal human health by creating an expectation of disease especially heart and cancer and creating the belief that taking drugs to treat heart disease and cancer is normal because we are all doomed to get these diseases. And what you think and believe to be true always becomes your reality… yes drug companies know this. The irony is that prescription drugs kill more people than car crashes and are the 3rd leading cause of death after heart disease and cancer due to medical mistakes.

  24. $money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$money$

  25. These type of drugs is the type of drugs that says cures the condition but makes it worse and have bad side effects and allergic reactions.

  26. I wish drug companies would go and see the harm their ads are causing. I truly believe that with the rise of drug commercials goes hand in hand with the rise of addiction in Americans. We tell children to not do drugs and then they go home and see drug commercial after drug commercial on tv, on their social media sites and so on. It needs to stop, I feel that this sort of advertising is causing more harm than good.

  27. Americans live on average 10 years less than central Europeans. Any more proof about who has the superior healthcare?

  28. OMG…we are oversaturated with these medical commercials even on Hulu or youtube, they are so annoying. I skip them every chance I get, nothing positive about them. It's so ridiculous!

  29. At first I thought this was now this, but once I started to hear their defense of drug advertisement, I knew it was Vox.

  30. Ah, that's why my friends who studied in USA have much more knowledge in drugs than my other friends who studied in Europe.

  31. is everyone going ignore the fact that we have been graced with the presence of this mesmerizing beauty.. honestly i skipped parts of the video which did not have her ❤️

  32. What if you went to go see your Dr. during one of those studies…the whole time he'd be thinking "is THIS the actor?"

  33. my favorite thing about these commercials is when they show the sick/depressed person being all happy around their family/friends while someone lists all 10000 side effects of the drug that include suicidal thoughts or death

  34. Advertising Drugs, Alcohol and Tobacco is illegal in Australia. Most drugs are subsidized here and cost about $6.00. GP's and Hospitals are free !!! The self-diagnosis by citizens of the USA sees the opioid crisis, among hundreds of other dire problems.

  35. The United States of Freedom and Liberty. Where everything, even public healthcare is about making money.
    God forbid the evil govt having any powers over pharma companies. They have to make profits for god's sake!

  36. Not trying to give any condescending lessons or something, not saying it's all wonderful elsewhere either, but that's what happens when you let big corporations run your country…

  37. in my country there are only Casino ads… The government actually tried to restrict them but thanks to the EU they couldn’t do anything and Gambling addiction is thriving!

  38. I went to the USA for work, for 4 days only, and oh boy, there were only drug ads "ask your doctor…." I was fed up immediately

  39. I am unable to imagine ads for prescription drugs here in Germany. Haha! Only allowed in USA and New Zealand.
    It sounds so hilarious.
    And dangerous too.

  40. I hate watching them but it gives you power to know about these drugs. Otherwise the doctor could much more easily prescribe you meds by which ones give him the biggest kickbacks instead of if you really need it.

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