TUESDAY:
The Strange Economics of Drug Advertising in the Only Country That Does It This Way
At 9:14 p.m., my dog, Sofia, was asleep, the dishes were done, and the television was selling leukemia.
Not bluntly. Not with a price tag. A woman in a linen shirt stood in a field of high grass, smiling at a horizon we couldn’t see. A calm voice described a rare blood disorder most Americans will never develop. She once felt tired, the voice said. She once worried. Now she lifts her grandson and laughs.
Then the voice shifted registers.
“Serious infections… organ damage… possible fatal outcomes…”
The warnings came at auctioneer speed while the golden retriever bounded through sunlight. The price was never mentioned.
I reached for the remote and muted it. I watched the tiny white type crawl across the bottom of the screen and realized I had a question I’d never quite formed:
Why are we advertising half-million-dollar drugs to people who don’t have the disease?
Only two countries on Earth allow prescription drugs to be marketed directly to consumers on television the way Americans know them: the United States and New Zealand.¹ In most wealthy democracies, if a medication requires a physician’s gatekeeping, the persuasion ends at the clinic door.
We chose differently.
In 1997, the FDA clarified how drugmakers could meet broadcast disclosure requirements—allowing television ads that named a drug and its use so long as viewers were directed elsewhere for full risk