Mondays with Mike: Selling drugs like laundry detergent

Beth and I exercise at the local Hilton Hotel, that one made famous during the riots at the 1968 Democratic Convention. It’s about our working-out speed—that is, no Crossfit zealots and not much spandex.

Our gym is nestled in this grand hotel.

Plus, we always get a little flavor from whatever conference is being held at the hotel, or from the big shows that are held at McCormick Place and use multiple hotels. The convention of school band directors for example, is easily discernible from, say, pharmaceutical sales people. Usually there’s a welcome sign, somewhere, that identifies the group(s) meeting there.

This week, though, like every year, one doesn’t need to go in to the hotel or visit McCormick place to know that the rollicking conclave of oncologists has hit town. Every year the American Society of Clinical Oncologists’ (ASCO) meeting draws 35,000-40,000 cancer doctors, drug company representatives, and other professionals to Chicago. And if you have any question about how much money there is in cancer, you wouldn’t if you simply took a walk in certain downtown neighborhoods. Like ours—Printers Row—where the two nearest bus stops are covered with giant ads for the likes of Keytruda, new gene therapies, and other cancer treatments.

One of the cancer-related ads plastered around downtown during the oncology conference.

I’m all for eradicating cancer but I wonder—

• Is everyone living with cancer able to get their normal treatment over these five days?
• Does anyone understand that, you know, while taking a pleasurable stroll down Dearborn Street, Michigan Avenue, or in River North, that one might not want to see a blown-up image of pancreatic cancer cells?
• And, for that matter, do the advertisers understand that people living with various types of cancer might not want to be reminded of that by the posters and billboards as they enter the subway?

I’m nostalgic enough to fondly remember the days when there were no drug ads. Not for failing erections, bad skin, wrinkles, IBS, cancer, not for anything. You went to the doctor to find out. But advertising to the doctor took longer to make sales than the industry liked. And the industry successfully pushed its agenda to advertise directly to consumers. From a Thrillist article:

Fast-forward to the 1980s: while Ronald Reagan was telling Americans to “Just Say No,” the feds cozied up to the pharmaceutical industry, and relaxed their legal restrictions. Direct-to-consumer marketing (DTCM), what you probably know as “drug commercials,” was first given the seal of approval in the US in 1985.

Even though pharmaceutical companies were legally allowed to advertise new drugs directly to consumers, the law still required a full list of side effects; this mandate meant DTCM ads were mostly restricted to print, then the only medium that could provide enough space to tell people they might get night sweats and night terrors and night cravings and night terror cravings.

Drug commercials as you know them really only began in 1997, when constraints were further loosened, and new meds began to feature in television commercials. For its part, the FDA notes that no federal law has ever outlawed drug ads, justifying its progressively lax regulation.

The ads work so well that Pharma now spends $4.5 billion a year on them. But there’s solid evidence that DTCM is more effective at making consumers aware of benefits than risks, and that they have a sort of power of suggestion—they manufacture illness.

And then there’s this: The United States has the highest prescription drug costs and highest health care costs in the world.

I’m sure it’s all coincidence.