The Drugs Don't Work... Let's Hope the Adverts Don't Either

Imagine the scene, heavily sedated reader: you've been sent to your local chemist to buy some painkillers. You're expecting to have to choose between Ibuprofen and Paracetemol, perhaps, and maybe capsules versus something soluble. My guess is you're not expecting to have to choose between buying 1000 Ibuprofen and 500, because you probably live in a country where the obvious downside of letting people buy 1000 Ibuprofen over the counter with no questions asked means it can't be done.

Well it turns out we don't.

Who even needs 1000 Ibuprofen? Ibuprofen is a drug that you probably shouldn't take habitually, yet even if I took one of these a day for 2 years, which isn't advisable, I'd still have more than 200 of these left. This, of course, is not how you think when you're in the chemists; you think, "hmm, 1000 is only double the price of 100! It's a deal! Buy the 1000!".

And this, of course, is why sensible countries don't allow unbridled free markets in even non-prescription drugs. In 1998, the UK made it illegal to sell most painkillers in anything other than blister packs of relatively small numbers, and it was proven to reduce suicide rates. The fact is, no-one needs 1000 Ibuprofen.

Yet this is the tip of the iceberg here, where the value of a healthcare consultation (and after all, you are paying for it directly) can be measured in the quantity and cost of the medication you were prescribed. The self-service nature of the health... provision here extends to drugs too: prescription drugs are, bizarrely, advertised heavily on TV.

Don't worry, we can make this painless for you in all sorts of ways!

So we're offered Ozempic for diabetes, Voltaren for arthritis, Botox for migraines, Humira for Crohn's Disease, Rexulti for depression, Skyrizi for psoriasis, Entresto for heart disease, Dupixent for eczema, even heart implants to reduce stroke risk, and no doubt a bunch of others I've forgotten. Now call me naive, but I prefer to only put chemicals in my body when advised to do so by someone who spent at least 7 years learning about why and whether I should do so, and ideally someone who is not going to gain financially if they can convince me to take the drugs. "Talk to your cardiologist about Entresto," the adverts say. Do they expect your cardiologist to reply, "Oh yeah, I'd totally forgotten about that one!"

Isn't allowing the unqualified consumer to choose their drugs on the basis of some adverts just a tiny bit dangerous?

Well, it turns out the good people of America have worked that out. Unfortunately, the simple solution of, oh, I don't know, a functioning integrated healthcare system is not something which has popular support here, so instead, they run the adverts anyway, but with long and disturbing-sounding lists of potential side-effects narrated over the end of the ad. This often results in a 60-second ad, where 10 seconds tells us about how great the drug is, and the other 50 seconds tells us that despite that, it could also cause suicidal thoughts, headaches, heart palpitations, a loss of bowel control, suppression of the immune system, etc etc. Yes, we're in the middle of a global pandemic of an infectious virus, and they're still advertising stuff that can result in unintended suppression of your immune system. A particular favourite of mine is this disclaimer: "Do not take Ozempic if you are allergic to Ozempic". What an insight!

I'm continually fascinated by the differences between our two countries, and in particular the unintended consequences of the raging power of the market on this side of the pond. Advertising drugs, and selling them over the counter in industrial quantities, is just considered normal here. Personally, I'm going to keep taking my medical advice from qualified professionals rather than TV adverts; but hey, whatever works for you, America!