A reader recently wrote in about drug advertising.
“I used to work in production of TV commercials,” she emailed. “Unless I am mistaken, the U.S. is one of only 2 countries IN the WORLD that allow television advertising of pharmaceuticals. It is outrageous and it is clearly one of the reasons that our drugs are more expensive than any country in the world.”
I checked. It’s true that only the United States and New Zealand allow direct advertising of prescription drugs to consumers, while Brazil allows some advertising of nonprescription, over-the-counter medications.
This reminded me of a very special episode of the ABC sitcom “black-ish” a few months back. The father of the family, Dre, got a diagnosis of diabetes. He understandably freaked out a little bit. He couldn’t even bring himself to prick his finger with a drug applicator.
Then his troublemaking dad got involved. “You don’t need to be bothered with this mess,” he said, before showing his son a documentary on natural healing that was conveniently queued up. There were clearly some hard lessons coming. “Why didn’t my doctor tell me about this?” Dre asked.
Right after that scene, my television cut to a commercial for Victoza, a diabetes treatment from Novo Nordisk. There were scenes of a woman in a doctor’s office, an older couple gardening, women painting sunflowers. There were side effects: “nausea, diarrhea, vomiting, decreased appetite, indigestion and constipation.” At 90 seconds, it felt almost infomercial length, until the next commercial came on. For Victoria’s Secret.
My family are faithful “black-ish” viewers — funny show, great cast. But a season earlier we had endured what Vulture called “essentially a long commercial for Disney World,” the obligatory episode where a Disney sitcom goes to Disney World.
Now it was time for Diabetes World, brought to you by Novo Nordisk.
In the United States, when the Food and Drug Administration eased the advertising rules in 1997, it paved the way for an explosion of TV commercials pitching prescription drugs. Drug makers have had less success lobbying in other parts of the world.
I asked Novo Nordisk about this. Anthony Anderson, who plays Dre, has diabetes in real life and is the company’s paid spokesman. His story is compelling. Not only did he struggle coming to grips with the disease, but his father died of complications from diabetes a decade ago.
“One of the things we felt was important was it needed to be natural and it needed to tell his story, but it also needed to be medically accurate,” said David Moore, a senior vice president at Novo Nordisk. “We had individuals from our medical affairs really review the script, in the context of this is what a conversation would really sound like with a clinician.”
ABC declined to comment.
I don’t know how I feel about a drug company’s collaborating on a sitcom script, though it’s a little weird that the story and the commercials ran together. More important, it probably doesn’t help the soaring cost of prescription drugs. Companies spend more than $6 billion a year on this kind of advertising, according to Kantar Media.
Advertising budgets are by no means the biggest factor in drug costs. There is blame to go around.
Drug companies are stretching out their patent protections by seeking approvals for existing drugs to treat different diseases. There is also no nationwide body negotiating drug prices as you’ll find in other countries, and insurers are often looking out for themselves rather than patients. Sometimes buying a drug with insurance is even more expensive than without it, or insurers refuse to cover the cost of a generic drug.
This past week, UnitedHealthcare, one of the largest insurers, said it would stop keeping the rebates it got from drug companies, an issue that is of particular concern to the Type 1 Diabetes Defense Foundation, an advocacy group. “Any serious political conversation on economic incentives and prescription drug cost must begin from the market distortions created when insurers and other payers negotiate rebates,” said Charles Fournier, the foundation’s vice president.
If nothing else, advertising brings us closer to how the drug business works, even if on a subliminal level.
“The conditions that are being promoted change over time in conjunction with the patent cycle,” Jon Swallen, chief research officer at Kantar, said. They also change with public health trends and research and development investments.
The closer a patent gets to expiring, the less enthusiastic companies can get about advertising. Hence the era of erectile dysfunction commercials for Viagra and Cialis yielded to omnipresent spots for Humira and Enbrel, used for rheumatoid arthritis and a range of other conditions.
Groups like the World Health Organization and Public Citizen have raised concerns. The drug industry, as you might imagine, wants to keep advertising.
Commercials “can benefit health care professionals, as well as patients,” said Holly Campbell, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry trade group, in an email. She cited a Harvard University/Massachusetts General Hospital survey from 2004 that found that “one-quarter of adult patients who visited their physician after seeing” a commercial “received a new diagnosis of a condition,” and “nearly half of the diagnoses were for ‘high priority’ conditions.”
Back to “black-ish.”
Hard lessons were indeed learned on the show. Dre’s venture into natural healing led him to pass out at a party, crushing a tower of champagne glasses. His wife, Rainbow, a doctor, explained to him that he had to take the medicine. “Look, Dre,” she said, “the important thing to know is that diabetes is not going to dia-beat us.”
“How long have you been holding on to that one?” Dre asked, rolling his eyes.
She had a lot more in her pocket: “It’s do or dia-beat-us!”
The show promptly cut to a commercial for a Novo Nordisk long-acting insulin called Tresiba, which had a snappy jingle refrain — “Tre-siba ready!”
I’m not going to stop watching “black-ish,” but could we stick to the show, people?