Now
I Am Really Confused: TV Ads for the Blind

By

Leonard
Zwelling

     For a while now, I have found it curious
that the major pharmaceutical companies advertise their prescription drug products
on television.

It is not curious because television networks choose to broadcast the ads.  The leaders of TV
have been well-compensated for attracting the advertisers. It’s curious because
the vast majority of the people who see the ads cannot buy the product on their
own. This is a distinctly different ad model than the one used for selling corn
flakes.

Rather, prescription drugs (unlike corn
flakes) must be obtained via a doctor or other health care provider. While it
is true that the Jaguar advertised by all the British actors playing evil
characters is out of the reach of most viewers on financial grounds,
prescription drugs are out of the reach of virtually everyone on legal grounds.
You still need an intermediary to get Crestor. (This is not true for many
physicians because they are visited by shapely detail women with free lunches
for the nursing staff and roller bags filled with free prescription drug samples
so the docs don’t have to buy the drugs either).

     Obviously, these prescription drug ads are
aimed at pushing demand for these products via patients to their doctors. The
doctors comply and prescribe the requested drug or drugs for fear the patient
will get the drugs from the doctor’s competitor in the next high rise office
suite if he or she does not prescribe the demanded drug, whether indicated or
not. (Personally, while I haven’t been in medical school since 1973, I don’t
remember a lot of classroom time being spent on the diagnosis and treatment of
low T or erectile dysfunction, so I am grateful for all of the education I
receive through these TV ads).

     I thought I had come to terms with this
craziness. Not quite yet.

     Recently a television ad has appeared for a
drug to treat non-24, a sleep disorder of the blind that is due to the
inability of the sightless to perceive the circadian changes of light and dark.
Guess what? They can’t perceive the picture on their TV set either, if they
even have a TV. This commercial from a company called Vanda for a drug called
Hetlioz (tasmelteon, a melatonin agonist) is aimed at docs and or patients’
friends or relatives. If the majority of ads for prescription drugs are pushing
the product once removed from the presciber source, this is pushing demand
twice removed. The message has to go to a surrogate for the patient before the
patient can then demand the drug of his or her physician. I guess it’s like
advertising Cocoa Puffs to parents via the grandparents.

     I know nothing about non-24 although the
logic of there being sleep disturbances in the blind makes good sense. I was
just struck with the craziness of advertising a drug, exclusively for use by
the blind, on television.

     Let’s see what other craziness we can
expect?

     I suppose it is only a matter of time
before the TSA advertises on TV, trumpeting how safe they have kept you (if
they hadn’t you probably would not be watching television any longer). My hope
is that the TSA will finally offer free physical exams to passengers paying a
premium. If they are going to grope us, why not have it do us some good and
save us a visit to the doctor’s office? Will the ACA cover this? It’s sort of
prevention.

     We have doctors and lawyers pushing their
wares on the air. The docs tend to be specialists like hand surgeons. Some docs
also use magazine ads, especially plastic surgeons with barely legal pictures
of their successful patients (almost always women, almost always augmented) published
in throw away rags one can acquire at most of Houston’s gyms and fitness
centers. The plastic surgeons figure they’ve got you if you are willing to pay
fitness center membership dues to lift weights to look better. They are now
trying to separate you from what ever is left in your wallet for a shape
reconstitution  plan based on your vanity,
indolence and impatience. They figure you want to look like a movie star—NOW!
Nip/Tuck!

     My favorite lawyers are Jim Adler, the
Texas Hammer, a really quiet nice Jewish man with whom I have attended
synagogue. And I also love the firm that labels itself Christian attorneys. I don’t
get that at all. What kind of counter-programing is that supposed to be? Are they
a response to Adler standing on top of an 18-wheeler screaming at the top of
his lungs? WWJD? Is that what would Jesus do, what would Jim do or why wait for
a juris doctor?

     I am not sure what to make of all the ads
for the various “universities” that will guarantee you a better job, but never
display the price tag. It’s a big number and the job isn’t guaranteed—if you
even finish the training and graduate on the internet. (www.capandgown.com)

     And, finally, returning to our friends in
big pharma, their ads are now used to create diseases that their advertised drugs
treat. My favorite is, of course, erectile dysfunction (why are the man and the
woman in separate bath tubs?) which was a far less common diagnosis when I was
in medical school suggesting a somewhat anti-evolutionary drift toward lower
male potency since the 1970’s. Anticoagulants, anticholesterol drugs and a host
of psychoactive agents are hawked on the airwaves and being used to treat all
kinds of diseases that never existed before. (When I was correctly prescribed
Xarelto recently for my atrial arrhythmia I asked the drug rep who happened to
be in my doctor’s office whether I got a free trip to New Zealand with the new
prescription. Alas, no. Maybe he did.)

Nothing like advertising to rev up demand.
We’ve gone from disease prevention to disease creation. I guess I just mind it
less when the ads are for fast cars instead of fast-acting reflux relief.

     I just wanted my readers to be aware of the
fact that a drug for the blind was being advertised on television. Look for the
radio ads on hearing aids coming to an iPod near you!

     Or as I say in my house—Heh? I can’t hear
you. Pass me my glasses. And will you please turn up the volume on the
television? I can’t see either. The ad for the blind person’s drug is coming
on.

Leonard Zwelling