Why Do We Put Up With This? (part 2 of 999: Drug Ads)
Let’s start with something we can all agree on, a self-evident truth, a tautology, prima facie, res ipsa loquitur, a priori, and immediately obvious to any casual observer[1]: America is a corporatocracy. Corporations buy the elections, then make the rules.
No better place to start than with the pharmaceutical industry.
The Campaign for Sustainable Rx Pricing
Big Pharma Continues To Pad Their Bottom Line With Direct-to-Consumer (DTC) Advertising, Costing U.S. Taxpayers Billions Of Dollars
Examples of Big Pharma’s money grab:
Big Pharma spent nearly $14 billion on DTC advertising in a single year.
American taxpayers lose more than one billion each year in tax revenue, as pharmaceutical companies write off marketing expenses to further pad their bottom line.
Taxing or prohibiting DTC ads for the ten largest pharmaceutical companies in the U.S. would result in increased federal tax revenue between $1.5 and $1.7 billion per year.
The U.S. is one of only two countries in the world that allow DTC advertising for pharmaceuticals.
DTC advertising can lead to the overutilization of expensive, older meds. A 2023 Forbes column highlights, DTC advertising can contribute to “the (over)use of higher-cost drugs over generics and less expensive alternatives,” which can lead to increased spending on prescription pharmaceuticals.
JAMA Network research paper from January 2023 found that advertising spending on drugs considered having “high therapeutic value” accounts for fewer than one-third of all DTC pharmaceutical advertisements.
An October 2021 study from America’s Health Insurance Plans (AHIP) found that seven of 10 of the largest pharmaceutical companies by revenue spent more on sales and marketing in 2020 than R&D.
A bit dated, but here are the 10 most advertised drugs in 2015 (Pharmacy Times)
Cialis ($248.7 million spent on advertising) ‘Taglines such as “She reminds you every day” and “She’s still the one for you” help Cialis (tadalafil) appeal to both men and women.’
Lyrica ($228.9 million spent on advertising) treatment for pain associated with fibromyalgia and diabetic neuropathy
Eliquis ($219 million spent on advertising) oral anticoagulants
Viagra ($211 million spent on advertising) In one such ad, the woman said, “You know, plenty of guys have this issue.”
Humira ($203.2 million spent on advertising) treatment for psoriasis
Latuda ($179.1 million spent on advertising) to treat bipolar depression
Xeljanz ($160.7 million spent on advertising) rheumatoid arthritis treatment
Celebrex ($118.9 million spent on advertising) arthritis and pain management
Abilify ($107.9 million spent on advertising) schizophrenia and bipolar disorder treatment
Chantix ($103.1 million spent on advertising) smoking cessation
It’s interesting to compare the 2015 heavy hitters with the 2024 list (Fierce Pharma):
Skyrizi Company: AbbVie / What is it? IL-23 immunology drug 2024 spend: $647.1 million
Rinvoq Company: AbbVie / What is it? JAK inhibitor immunology drug 2024 spend: $552.6 million
Dupixent Company: Sanofi and Regeneron What is it? IL-4/IL-13 inhibitor immunology drug 2024 spend: $484.1 million
Wegovy Company: Novo Nordisk What is it? GLP-1 agonist obesity drug 2024 spend: $352.5 million
Rexulti Company: Lundbeck and Otsuka What is it? Atypical antipsychotic 2024 spend: $286.3 million
Tremfya Company: Johnson & Johnson What is it? IL-23 immunology drug 2024 spend: $247.6 million
Jardiance Company: Boehringer Ingelheim and Eli Lilly What is it? Type 2 diabetes and heart failure drug 2024 spend: $216.7 million
Ozempic Company: Novo Nordisk What is it? Injectable GLP-1 Type 2 diabetes drug 2024 spend: $177.6 million
Vraylar Company: AbbVie What is it? Atypical antipsychotic 2024 spend: $172.8 million
Otezla Company: Amgen What is it? PDE4 inhibitor immunology drug 2024 spend: $171.6 million
A Little Background from Elder G
Direct-to-consumer (DTC) prescription drug advertising is the marketing of pharmaceutical products directly to patients via television, print, and digital media. Permitted in only the United States and New Zealand, it remains heavily debated over balancing patient health education against concerns of rising costs, misleading claims, and over-prescribing.
Overview and Rules
Global status: Completely legal only in the U.S. and New Zealand; banned in most other nations.
The U.S. framework: Enabled largely by a 1997 Food and Drug Administration (FDA) policy shift regarding broadcast risk disclosures.
Current oversight: The U.S. Food and Drug Administration (FDA) requires product-claim ads to present a balanced view of a drug’s benefits and major risks.
Arguments For and Against
Potential benefits: Raises public awareness of underdiagnosed conditions, lessens social stigma for sensitive illnesses, and encourages dialogue with healthcare professionals. [1, 2, 3]
Key criticisms: Drives demand for expensive brand-name medications over effective generics, strains the patient-doctor relationship, and can promote self-diagnosis or inappropriate usage.
Focusing on Shareholder Value
Since there’s money to be made, WLBOTT needs to get in on the price gouging.
We’ve already developed our marketing plan.
A Little Perspective from the Austin Lounge Lizards
The Drugs I Need
You've got a headache And I've got some strange disease Don't worry about it This pill will set your mind at ease It's called Progenitorivox It's made by SquabbMerlCo It's a life-enhancing miracle But there are some things you should know
It may cause Agitation Palpitations Excessive salivation Constipation Male lactation Rust-colored urination Hallucinations Bad vibrations Mild electric shock sensations But it's worth it For the drugs I need
My disease may not be fatal But I can ease my fears By taking two twelve dollar pills Each day for fifty years They've spent billions to convince me So now I realize Progenitorivox Beats diet and exercise! I've got insurance At least for now, I do And if I buy generic It would cut my cost in two But I want Progenitorivox! 'Cause I saw it on TV Those families look so functional That paisley pill's for me
But it may cause Depravation Humiliation Debtor's prison and deportation Dark depictions Dire predictions Life as seen in Dickens fiction Empty pocket Court dockets May cause eyes to pop from sockets But it's worth it For the drugs I need But it's worth it… In Canada, they get this for a song! But it's worth it For the drugs I need
The opinions expressed in this song are not necessarily those of SquabbMerlCo or its subsidiaries Progenitorivox is not available, anywhere Offer void in Wisconsin Any resemblance to actual drugs, living or dead, is purely coincidental Any unauthorized use of your judgment in the application of Progenitorivox is strictly prohibited Progenitorivox may not be reproduced without the expressed written consent of Major League Baseball Progenitorivox may cause drowsiness or restlessness in lab animals. Do not resume sexual activity while operating heavy machinery without consulting your physician For erections lasting longer than four hours, insert your own joke here If you experience psychotic episodes, you're crazy. If death occurs, discontinue use of Progenitorivox immediately If symptoms persist, consult your physician /All sales final / Batteries not included
[1] WLBOTT Words of the Day
Self-evident Truth
In epistemology (theory of knowledge), a self-evident proposition is a proposition that is known to be true by understanding its meaning without proof, and/or by ordinary human reason.
Some epistemologists deny that any proposition can be self-evident. For most others, one’s belief that oneself is conscious and possesses free will are offered as examples of self-evidence. However, one’s belief that someone else is conscious or has free will are not epistemically self-evident.
A famous claim of the self-evidence of a moral truth is in the United States Declaration of Independence, which states, “We hold these Truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”; philosophically, these propositions’ self-evidence is debatable.
“Self-evident” means, roughly, a proposition whose truth does not require proof because understanding it is sufficient to recognize it as true. In philosophical language, it is not simply “everybody believes this.” It is closer to: once you grasp what is being asserted, its truth presents itself to reason without needing to be derived from something else.
Tautology
In mathematical logic, a tautology (from Ancient Greek: ταυτολογία) is a formula that is true regardless of the interpretation of its component terms, with only the logical constants having a fixed meaning. It is a logical truth. For example, a formula that states “the ball is green or the ball is not green” is always true, regardless of what a ball is and regardless of its colour.
In literary criticism and rhetoric, a tautology is a statement that repeats an idea using near-synonymous morphemes, words or phrases, effectively “saying the same thing twice”. Tautology and pleonasm are not consistently differentiated in literature.
“There once was a fellow from Perth Who was born on the day of his birth. He got married, they say On his wife’s wedding day, And died when he quitted the earth.”
Image by Elder G
“…und wenn sie nicht gestorben sind, dann leben sie noch heute” (and if they have not died, then they are still alive today), traditional German formula to end a fairy tale (like “they lived happily ever after”).
Image by Elder G
Axiom
Is a number real? For the basic assumptions mathematicians accept without proving them, the closest term is axiom or postulate. An axiom is a proposition accepted as a starting point within a formal system, from which other propositions can be derived.
I find it fascinating that all numbers are accepted by mathematicians, with the exception of the outlier “7”. Quite the renegade!
Res ipsa loquitur
Not sure how this AI image represents the concept, but hey, we paid for it so we might as well use it.
A priori
In epistemology, A priori (‘from the earlier’) and a posteriori (‘from the later’) are the two categories of knowledge, justification, or argument, determining whether or not a proposition is reliant on outside sensory experience; Roughly speaking, a proposition is known or justified a priori if it is known or justified independently of any experience (beyond the experience necessary to understand the proposition).
Fields of knowledge where a priori justification is predominant are, for example, mathematics and formal logic; by contrast, most of the sciences generally involve a posteriori justification.
