The United States and New Zealand are the only two countries IN THE WORLD that legally allow Direct-To-Consumer-Advertising, or DTCA, of pharmaceutical products.  Though 'regulations' are supposedly in place to limit the negative impact, the regulatory agencies, namely the FDA, not only have limited power over the machine that is the pharmaceutical industry, but are also deep in the pockets of those in power at the pharmaceutical companies.  It is commonplace for FDA regulators deciding whether or not drugs get approval to end up as high-up executives at those same companies, sometimes just a year or two later, where they make A LOT MORE MONEY than they did at the FDA.  Why is this allowed to happen in our country?  In our society?  Why is this not a major news story reported on by the mainstream media?  It's almost as if the same people hold power over all of these entities... again, all at the detriment of OUR HEALTH.

This unrestricted marketing of medications has led to the United States being unofficially the most over-medicated country in the world.  Big companies will tout the innovative capabilities of the system we operate in now, but declines to mention ALL of the individuals that are harmed as a result of producing mostly ineffective and potentially dangerous medications at the expense of the 1 in a 100 or 1 in a 1000 medications that truly are innovative in some way.  Most Americans don't realize that most of the good, well-respected, and conscientious doctors rely more on older medications, with clear safety and efficacy profiles, over new "state-of-the-art" medications, like Aducanumab or Lecanamab, monoclonal antibodies created to treated Alzheimer's that are doing a lot more harm than good... whose only saving grace is their massive price point so few can afford them.

One of the most excruciatingly close-to-home examples of this is Oxycontin's rollout by Purdue Pharmaceuticals in 1996/1997, shortly after a loophole was introduced that allowed for essentially unfettered DTCA in America.  By 2001, Appalachia was addicted to Oxycontin.  By 2023, more than 120,000 people are dying by overdoses every year in this country... and that's just the official number.  It doesn't include the millions upon millions that have been affected in non-fatal ways.  The emergence of DTCA paved the way for this to happen.

Watching pharmaceutical ads, as a physician, makes me mad.  Marketing an opioid as non-addictive and watching millions of people die in the following two decades is an egregious and obvious example.  But lesser evils also mount and become huge problems.  Seeing companies tout side effects of their medications as treatments for erroneously concocted diagnoses is infuriating.  Stigmatizing things like premature ejaculation in order to sell more antidepressants as a 'treatment' for 'erectile dysfunction' is ridiculous.  Some doctors and providers are wise to the pharmaceutical industry's games, but many others are not.  Many do what they're told and follow the 'guidelines'... when 'following all the 'guidelines' means Americans will be on handfuls to dozens of medications. 

It is affecting our health in such a negative way.  Our life expectancy is falling, lagging 4 years behind leading developed countries.  Whether its from the direct effects of marketing medications as safe and efficacious that are not, see Vioxx... see Oxycodone... see Aducanumab... (the list goes on and on), or whether its from the indirect and unmeasurable effects of being on 2 antidepressants, 1 antipsychotic, 4 supplements, an ADHD medication, 2 blood pressure meds, and 2 for diabetes, DTCA and marketing in healthcare IS KILLING US!  We've got to respond differently as a society and DEMAND CHANGE... elect officials who are conscientious of the horrid, terrible ways that our healthcare system operates.  We have to do things differently or we will not keep this sinking ship afloat.

-Ethan P. Short, MD

SOURCES for this series (in no particular order):

(history of advertising in healthcare)

Seroquel and AstraZenaca stuff

DOJ’s release about Seroquel/astrazeneca

Roche shares tumble after Alzheimer’s drug failure

Xanax XR study submit to FDA for panic d;o approval lasting 6 weeks,020813s009lbl.pdf


-over 1/3 of all state lawmakers nationwide used pharma industry cash to fund their campaigns, industry wrote over 10k individual checks of more than 9 million

-Many by trade groups, PhRMA (Pharmaceutical Research and Manufacturers of Amercia) and BIO (Biotechnology Innovation Organization)

History of smallpox vaccines

From guesswork to standards: The history of medicine quality

Questionable marketing practices of big pharma

Vioxx bullshit, Eric Topol testifying about Merck knowing about MI data long-before their discontinuation/pulling of it from the market

Ben Goldacre, 2013, Journalistic article on not publishing negative studies

Payments to US medical journal editors, J Liu, 2017

Henry Olders, retired geriatric psychiatrist, machine learning algorithm director, 2018, reveals a new trend of publishing “negative results” for cheap as fuck meds even though a closer look at the data reveals significant benefit

Aducanamab Robert Wang excerpt/response

BMJ opinion piece 2021

Study: Biogen’s Aduhelm caused brain swelling in over 1/3 of study participants, Mark Terry Nov 2021

Aducanumab clinical trial SE data

-DEAD: CT participants: 80yo man in Oct ’22, 79yo Florida woman and 65-yo woman in early stages of AD

Multiple cerebral hemorrhages in pt received lecanemab then treated with tpa for stroke

Donepezil CDR-SB data 1999, Burns

2019 Meller and Ahmed with Restoring Social Trust in Democracy, 2019, published in Center for American Progress (CAP)

-Journal of Law and the Biosciences finds 78% of new drug patents awarded in the past decade went to drugs that already existed, 70% of the 100 best-selling drugs extended their exclusivity protections at least once, and 50% extended twice/more

Disaster-to-Consumer Advertising: Facing the Dangers of DTCA, Palaniappan, 2020