March 25, 2016

Horse 2089 - Side Effects May Include Death

The reason for the lack of communication on this blog for the past few weeks is because I went to my sister-in-law's wedding, in the land of the free and the home of the brave. For a week and a bit, I saw not Her Majesty Queen Elizabeth II looking to the right on the back of the coins but people like Jefferson, Washington and Lincoln. I also saw freeways with adequate signposting, prices as though everything was permanently on special and bizarrely, a multitude of advertising for various drugs.

One of the fun things about visiting a foreign country and even one which isn't really that foreign like the United States is that you can see things which are similar but oh so slightly different. Television, the drug of the nation, in the United States, is already really similar to what we have in Australia because we import so much programming from that country. What we do not import, are the advertisements and other media furniture like interstitials and title cards (though admittedly, Channel 7 does use NBC's news fanfare "The Mission" for its news programs). Advertising though, is not imported into Australia for multitude of reasons.

Australia like the vast majority of the industrialised world has a universal health care system in the vehicle of Medicare. Even though general practices are privately owned and many specialist medical services (and even a few hospitals) are also privately owned, the fact that the state owns the majority of hospitals and furnishes the Pharmaceutical Benefits Scheme means that government is able to negotiate far better prices for drugs and medical procedures due to factors such as economies of scale and greater bargaining power.
The United States however, doesn't really have a universal health care system to speak of and because the system is largely private and profit driven, the actors within the system need to compete for business. In consequence, adverts for health insurance companies, health management organisations (HMOs) which run hospitals and clinics, and the drug companies themselves, appeal directly to the public in the search for business. And how they search!
At least in San Diego where we stayed, the three most common business sectors touting for business on television were the Auto Manufacturers, Insurance Companies and Drug Companies; in that order.

A typical drug advert will start out with a sad looking person who has some sort of disease and then gives a short testimonial about how the drug being advertised changed their life. Invariably there will be the phrase "Ask your health care professional if Example Drug is right for you" before a list of side effects is reeled off. This is where we enter the realm of the strange and pass through a rather broken looking glass.
The list of side effects listed in a lot of drug adverts make you wonder if the cure is worse than the disease. A list of side effects might include things like:
Irritability, change in mood, suicidal thoughts, dry mouth, bad breath, increased appetite, decreased appetite, weight gain, weight loss, involuntary limb movement, decreased limb movement, skin discolouration, sneezing, runny nose, inflammation of the sinuses, decreased liver function, decreased kidney function, increased urination, loss of bladder control, insomnia, blurred vision, hearing loss, rectal bleeding and death...

... yeah "and death". Like that sounds like a side-effect that isn't really going to affect you. Remember, death isn't the handicap it used to be in the olden days, right?

What's also rather sadly prevalent, are adverts asking people to join class actions against drug companies because of the side effects of various drugs. It only happened once but I saw an advertisement for one particular drug and the very next advertisement was for a class action against that very same drug.

In Australia we see very few advertisements for prescription only medicine because when you have the state itself as the biggest customer, then the pharmaceutical companies just deal directly with them. Companies who do business directly with the state put more effort into winning tenders for supply than wasting money on advertising.
In America though, where you have drug companies selling their wares on a more direct basis to the general public and to HMOs, then the advertising dollar seems like the path of lesser resistance to achieve the same ends; which is profits.

I personally think that there's something a bit scurrilous about turning a profit on the basis of exploiting the sick, especially when I consider that the chap who invented the polio vaccine (X), released that into the world and deliberately made it public domain. Whilst I do think that in principle that business should be allowed to chase profit because that does encourage innovation and development, that doesn't mean that the unfettered chasing of profits is necessarily best for society.

Drug adverts on television in the United States seem strange and weird to me because they actually are strange and weird. I'm thankful that for the moment that here in Australia we don't really have them on television. The fact that they are so common and prevalent in the United States is symptomatic of a system which is diseased and needs to swallow its own bitter pill or else risk killing the patient.

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