OP-ED: The business of selling drugs
Only two countries on Earth let drug companies pitch their products directly to you and me: New Zealand and the United States. Canada dabbled in these direct-to-consumer ads but quickly tightened up their rules. The European Union, back in 2008, took one look and said, “Nope – not here.”
Here, however, the Food and Drug Administration requires the companies to list the risks and side effects. Consequently, pharma produces ads that are built around a warm Hallmark Movie family scene while a voiceover lays out a death march of side effects. It’s like watching a gentle Instagram influencer’s reel that was scored by a coroner.
Truthfully, every drug is a gamble. Pharmacology feels like it is about walking the tightrope between healing and harm. Right dose of the right drug? Fingers crossed. Wrong dose of the wrong drug? Your liver or kidneys might go haywire. Drugs aren’t exactly “controlled poisons,” but they’re not vitamins either.
I once had a pharma scientist tell me, “We’re like Hollywood – we only want blockbusters.” The difference? Hollywood’s blockbusters last two hours; pharma’s can keep you on the hook for life. Why eliminate depression when antidepressants pay them until the end of time? Thankfully, there are exceptions – hepatitis C treatments really did work – but the general business model seems simple: get lifelong customers.
When you watch streaming channels like Netflix or Hulu, you get to see the same pharmaceutical ads over and over, until you’re ready to wave the white flag and surrender. That’s not poor scheduling; it’s like CIA conditioning. Once you’ve seen that advertisement 23 times in a row, that pill with 50 ways to mess with your body starts looking like a good choice.
One cancer drug ad makes me want to throw my remote at the TV. A musician plays his instrument while a soothing voice casually drops phrases like “seizures,” “fractures,” “organ failure,” and “shortness of breath.” In their list of 50 things, they add the words “sudden death” in between “diarrhea” and “hot flashes” like it’s no big deal.
The FDA insists these warnings come from “clinically significant” data in trials and post-market reports. Translation: real people really did faint, seize, or die after taking the drug. But when you throw a pastel filter over it, the whole thing feels less like a serious warning and more like an invitation to join a family get-together.
What’s truly sad is how we’ve normalized this. We don’t even flinch anymore when ads warn us that the medicine meant to preserve life might prematurely end it. A 2020 study found less than 1% of patients on most cancer drugs suffer life-threatening side effects. Statistically rare, yes – but when you hear that list rattled off like the credits of a horror movie, it doesn’t exactly soothe the nerves.
And remember, we’re only one of two countries that think advertising prescription drugs like a can of Pringles is a brilliant idea. The rest of the world said no. America, of course, said, “Let’s monetize it.” The result? Drug ad spending was $6.58 billion in 2020, and 44% of Americans admit they’ve asked about a drug they saw on TV. What else? It also drives up costs, drives overprescribing, and drives home the idea that health is something you buy.
So, the next time your show is interrupted by smiling actors while a voice calmly warns you about seizures, strokes, or sudden death, remember: you are watching one of the only industries that can legally sell you something that might kill you.
In the end, maybe the most dangerous side effect isn’t in the fine print at all. It’s the fact that we’ve accepted this circus as normal, slapped a white coat on it, and called it health care.
Nick Jacobs is a resident of Windber.