Selling Side Effects - Big Pharma's Marketing Machine

Convincing people they are sick and need a drug is a multi-billion dollar industry. In 2015, Big Pharma dropped a record-breaking $5.4 billion on direct-to-consumer (DTC) ads, according to Kantar Media. And it paid off for Big Pharma. The same year, Americans spent a record $457 billion on prescription drugs. The U.S. and New Zealand are the only countries where DTC is legal. Americans also pay more for drugs and devices than any other country.

The bulk of these ads appear on TV at a rate of 80 ads per hour of programming, according to Nielsen. Behind the drug and device ads saturating TV, radio and digital media are hidden costs and devastating side effects that companies don't advertise, and critics say the ads drive up drug prices and erode the patient-doctor relationship.

With the price of drugs skyrocketing, politicians and health-care providers question Pharma's DTC spending, which exceeds money spent on research and development. Even presidential hopeful Hillary Clinton called for an end to tax breaks for drug ads and for tougher regulations.

But the money spent on DTC is just one small cog in Big Pharma's well-oiled marketing machine. Companies spend billions more on getting doctors to write prescriptions for their expensive brand-name drugs or devices for uses not approved by the Food and Drug Administration — a controversial practice called off-label marketing.

The darker side of pharma marketing involves creating clinical trials aimed at influencing doctors and educational courses to showcase expensive drugs for non-FDA-approved uses — even when there is no scientific proof of safety or efficacy.

Big Pharma has paid billions of dollars in criminal and civil settlements over the years because of marketing fraud that cost taxpayers billions and left others with debilitating medical conditions. For example, the Department of Justice accused Johnson & Johnson of spending billions to target children and the elderly for unapproved drug uses, exposing them to serious side effects, including death.

Supporters argue DTC ads educate the public and empower them to make better health-care choices and say the First Amendment protects them. Doctors and other critics say Big Pharma's sole purpose is to sell expensive products that may have unknown side effects.

The American Medical Association and American Society of Health-System Pharmacists called for a ban on DTC, reigniting the conversation about pharmaceutical marketing. But the facts behind Big Pharma's tactics show the issue is far more complicated.

Expenditure by Type of Pharmaceutical Marketing Sourced from Pew Charitable Trusts
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