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Comment by hannob | Hacker News Reader

Consumer marketing for drugs is forbidden in many parts of the world, the US is more an outlier. However this still leaves marketing to doctors, which is a problem. There are some initiatives that reject that (e.g. there's a german group called Mezis).

It also completely makes sense. The decision for or against a drug should be guided by scientific evidence. So the only form of "marketing" that should be allowed are high quality scientific studies. And they shouldn't be delivered to the doctors or patients via marketing brochures, but via scientific articles and recommendations from independent organizations reviewing scientific articles.

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> Consumer marketing for drugs is forbidden in many parts of the world, the US is more an outlier

Exactly right. Because consumer marketing of prescription drugs is an utterly crazy idea, both in general theory, and in its present unethical incarnation.

Last time I checked there were exactly two developed nations which allow so-called DTC (direct-to-consumer) advertising of prescription medications at all. Namely: USA and New Zealand. Apparently every other country got the memo. Not us!

Every few years they talk about getting rid of it here in NZ. As you'd expect, public heath officials tend to support that idea, and industry shills tend not to.

I mean it took Big Pharma until 2008 to even adopt some basic ethical guidelines in producing these ads. I'm talking things like not using actors to play doctors anymore, and making sure that endorsers who said they had used a particular drug had actually used it. Yep, those kindly old men in white coats telling you to "Ask your doctor if this drug is right for you" weren't even real doctors.

Moreover, surveys carried out in NZ and in the USA show that when a patient asks for a specific drug by name they receive it more often than not. "The truth is direct-to-consumer advertising is used to drive choice rather than inform it," says Dr Dee Mangin, associate professor at the Christchurch School of Medicine. "In an era of shared decision-making, it’s much more likely that general practitioners will just do what the patient asks."

Professor Les Toop from Otago University says: "Internationally there have been many reviews of DTCA from health professional groups, academic institutions, governments and importantly many independent (non industry funded) consumer and patient groups. Without exception they have come to the same conclusion: the partial and potentially misleading information and the accompanying medicalisation caused by DTCA is of net public harm."

The AMA says: "Direct-to-consumer advertising inflates demand for new and more expensive drugs, even when these drugs may not be appropriate."

End the madness, I say.

> Last time I checked there were exactly two developed nations which allow so-called DTC (direct-to-consumer) advertising of prescription medications at all. Namely: USA and New Zealand. Apparently every other country got the memo. Not us!

I think when almost every other country does something different than you and it is not something you introduced first, you should have to prove why of all these you are the different one.

For Germany it is a general speed limit, but trying to introduce that would be like a general gun ban in the US: If you really think about it, probably a good idea, never going to happen.

> For Germany it is a general speed limit, but trying to introduce that would be like a general gun ban in the US: If you really think about it, probably a good idea, never going to happen.

And, most importantly, for now the speed limit isn’t even necessary – all the dangerous areas already have one, and the Autobahn is still one of the safest highway systems in the world.

(And as liability goes up a low the faster you go, there’s already a kinda speed limit anyway)

I was astonished by that too. Vox had a short documentary about drug ads https://www.youtube.com/watch?v=_5jnn1AIt7Q

The AMA says: "Direct-to-consumer advertising inflates demand for new and more expensive drugs, even when these drugs may not be appropriate."

Doctors have the final say on whether or not a patient gets a drug. It's funny to hear the AMA say that it's a problem when they could stop overprescribing entirely on their own.

The AMA is part of the problem, sure. But advertising and the pleas of patients who have been 'educated' by those ads are always going to have some affect on doctors, even if they don't recognize it themselves.

If you stop this madness at the root, (consumer advertising of prescription drugs) the part that doctors play in this also dissapears.

You realize that the FDA closely regulates what pharma marketing can say about drugs, right? Unless it's supported by clinical trial data, the drug company can't say it.

Absolutely. I was including pharmaceutics only for the second part of my comment (essentially a way to gradually socialize commodities).

Marketing regulations can be great. In Germany (physical) mail and phone spam is already quite nicely regulated, but it could go even further, I think. I heard phone spam is a thing in the US.

Which sounds perfect.

But then you have pharma companies paying for research and these studies - but only if they yield favorable results. At least in Europe it is close to impossible doing a study or any other research without having a "sponsor", i.e. a big pharma company who pays for it. And why would they? Because good results are good for business. Everything else? Pay it yourselves. Oh, you had two PhD students working on it for 3 years? Not my problem.

Better than nothing, but a lot of people are screaming for all those unfavorable results, as the available publications obviously only paint a partial picture, one in favor of the sponsors.

Bad results can be good for business if it is about a competitor's product.

I agree with everything you said, but it's a different set of problems.

Only publishing favorable results should be prevented with preregistration and requirements to publish. Ideally more (or all) pharma research should be done by independent researchers and not by pharma sponsors.

Ideally more (or all) pharma research should be done by independent researchers and not by pharma sponsors.

You do realize that pharma might be paying for studies, but independent physicians are actually running them, right?

So these independent physicians are only paid for by pharma sponsors, but otherwise independent? Like with members of parliament? This concept of independence seems to catch on.

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