PREFACE: Editors of even mainstream publications know that most of their readers hate TV drug ads, and so that’s why I could get the below piece published on AlterNet (titled there as “Why TV Drug Ads Work Despite Disclosing Terrifying Side Effects”) and then picked up by Salon (titled there as “Why We Ignore the Litany of Potentially Deadly Side Effects in TV Ads for Drugs”). What’s most important to me in this piece—but which I did not “lede” with because I doubt that editors would have run it if I had is that (1) Abilify was originally a drug for schizophrenia but has become a best-selling drug because it is now advertised as booster medication for antidepressants because antidepressants, as the Abilify commercial tells us, do not work for 2/3 of antidepressant users; and (2) Peter Gotzsche, in his book Deadly Medicines and Organized Crime, and Peter Rost, former vice president of marketing at Pfizer, equate Big Pharma with organized crime and the mob.
TV Drug Ads, Abilify & Big Pharma Mobsters
Who doesn’t laugh at drug commercials with their before-and-after scenes of life-changing improvements accompanied by numerous terrifying side effects? But these drug ads continue because they work. Beyond the overt manipulations, there are more covert ones—including techniques that diminish the impact of the required warning section.
Former advertising executive Jerry Mander observed that his ex-colleagues in advertising don’t care if you think their commercial is ridiculous or even false, because the image of the product goes into your head anyway, and your insides will always carry this “neuronal billboard.” Mander, in his 1978 book Four Arguments for the Elimination of Television, instructed us that TV commercials must be viewed with what he called “sensory cynicism.”
Nearly two decades after Mander’s book was published, a new kind of TV commercial—one requiring a different level of sensory cynicism—appeared in the United States. In 1997, the Food and Drug Administration (FDA) implemented new rules for direct-to-consumer advertising for prescription drugs. These new rules required that the ad need only mention the major risks and prevalent adverse effects, provide a toll-free number, refer to other information sources, and state the need to see a medical professional. Those new rules made it possible to run a TV drug ad.
The task for drug advertisers was how to meet the requirement of stating major risks and prevalent adverse effects in a manner so that viewers do not care about them, ensuring the warning section will not interfere with the placement in viewers’ minds of those billboards of life-changing improvements.
While the FDA has scolded drug companies for utilizing blatant techniques to distract viewers away from the warning section, STAT (“How Drug Ad Narrators Take the Scariness Out of Side Effects”) notes, “The FDA can’t do much about ads that bore consumers into ignoring the side effect lists.” STAT details how “the warning section may be written with more complex sentence structures, to make it harder for viewers to absorb.” STAT quoted Ruth Day, a cognitive scientist at Duke University who has studied drug ads: “There’s a shift in how the voice is used to make it easier to understand the benefits and less easy to understand the risks.” So, for example, a hurried warning narration makes it much harder to remember the warning section.
A major technique used to weaken the impact of the warning section is for it to be reported by an off-screen voice. In contrast, we routinely see a person having life-changing improvement after taking the drug—and it is seeing that person’s transformation that creates a mental billboard. A common ploy is to show a person having life-changing improvements while the warning list is read by an off-screen voice, as advertisers know that people routinely retain the visual not the auditory.
These techniques are exemplified in an often-broadcasted TV commercial for Abilify, advertised as an antidepressant booster medication (for which it was FDA approved in 2007). This commercial does not inform viewers that Abilify is an antipsychotic drug, originally approved by the FDA in 2002 for schizophrenia. Instead, this ad tell us “Approximately 2 out of 3 people being treated for depression still have unresolved symptoms”—an assertion which we hear and also see written on a blackboard. And the ad directs itself to depressed people whose “antidepressant alone is not enough”—this also accompanied by a visual, a 6-second blackboard scene showing a list of well-known antidepressants plus a container of Abilify.
In this 75-second Abilify commercial, over 40 seconds are used for the required warning list that includes increased suicide, stroke, and other “life-threatening reactions.” However, simultaneous to the warning list being reported by an off-screen voice, we see a once very sad woman now enjoying her life with her family and friends and at work. When the warning list is completed, we see a close up of this attractive woman speaking directly to us, “Adding Abilify has made a difference for me.”
Abilify has grossed over $7 billion annually, become one of the best-selling drugs of all time, and until recently was America’s top-grossing drug (it is now #2 position behind Sovaldi, the hepatitis C drug).
Big Pharma and the Ad Industry: A Marriage Made in Hell
How did the United States in 1997 become one of just two countries that allow direct-to-consumer advertising for prescription drugs? In 1994, with the Republican Party’s takeover of Congress, House Speaker Newt Gingrich attacked FDA regulations, and President Bill Clinton offered no resistance to the FDA holding hearings in 1995 on direct-to-consumer advertising for prescription drugs, which Julie Donohue described in 2006 in the Milbank Quarterly:
Officials heard testimony from pharmaceutical and advertising industry representatives, consumer organizations, medical societies, and academics. . . . By 1997, those FDA officials who were reluctant to open the floodgates to prescription drug advertising on television felt increased pressure from a variety of sources to ease the regulations and permit broadcast advertising.
Big Pharma, historically, has either applied financial and political pressure to politicians and regulators so as to create laws and rules that benefit them, or they simply have boldly broken laws. Probublica details drug companies’ largest fines for their criminal actions, including: the intent to defraud or mislead; failure to report safety data; and the often-repeated, illegal marketing for unapproved use.
Peter Gotzsche, in his book Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Healthcare, makes a case for Big Pharma being guilty of racketeering. Gotzsche quotes Peter Rost, former vice president of marketing at Pfizer who turned whistleblower against Pfizer and Big Pharma (see The Whistleblower: Confessions of a Healthcare Hitman). In a 2008 interview, Rost stated:
It is scary how many similarities there are between this industry and the mob. The mob makes obscene amounts of money, as does this industry. The side effects of organized crime are killings and deaths, and the side effects are the same in this industry. The mob bribes politicians and others, and so does the drug industry—which has been proven in different cases. You could go through a 10-point list discussing similarities between the two. . . . It’s pretty scary that they’re committing crimes that cause [the government] to levy those enormous amounts of fines against them.
Given the criminality and immorality of Big Pharma and the amorality of the advertising industry, do we really want to give this mob the extraordinary power of direct-to-consumer advertising on television?
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This blog was first posted on Alternet.com
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
What does that say about anti-depressants if 2 out of 3 people using them still experience symptoms so server they feel they need to do something about it, like add a booster medicine?
I think the ads play to people who are desperate to feel better, people who are just plain feed-up with being depressed and feed-up with how depression has taken over their lives. Like me they are frustrated and even though they should know better they are willing to try anything. There are alternatives to adding a booster drug, but they are not advertised or presented to people by their doctors. I tried Abilify and other booster drugs without much success. Well, they did work but the side effects outweighed the benefits for me.
I honestly do not know what the answer is for depression, or even if there is just one answer (I’m sure there is not) but I do know more drugs isn’t helping. What DOES help is site like Mad in America where people can have a voice and hear the other side of the drug story.
Well, for me I decided the drugs either wasn’t that, good or the medication root was not for me. I told them I suggested it may not be for me. Only to the doctor it was normal, and I wasn’t giving it enough of a shot. Ineffective with side effects, and granted I was being abused at home. Only, still a feild that calls themselves medicine, and it’s perfectly normal to go years according to them suffering with side effects, and getting little to no bennifit. They wanted me to say, that the other people were trying harder, giving it more of chance, and aspire to be like them. That sounded awful. I would never want that. Whenever they told me a storie of someone who apparently had it worse, and was still trying I wanted less to do with them or their drugs. Even the so called success stories didn’t seem worth it. It wasn’t even worth being insulted, and talked down to for asking a question, like the side effects, or how they knew I needed it would benefit from medication.
That’s because you’re dealing with a double failure- failure to properly diagnose coupled with the failure to properly treat. A certain number of “depressions” are actually dysperceptive conditions that antidepressants can’t treat but drugs like Abilify can, if you regard a life trip into the Twilight Zone as a therapeutic experience.
In order to better answer your questions here, I skimmed through your comment history. Please feel free to do the same for my comment history, so you’ll at least have a better idea where I’m coming from. You can’t be “bipolar”, or “depressed”, or any other bogus DSM “diagnosis”, because they are all fraudulent. The DSM is a catalog of billing codes. Nothing more. Now, I’m NOT saying that you aren’t “depressed”, as a vague and general description of how you usually feel. Only that it is NOT a legitimate medical diagnosis. There is NO actual scientific evidence for exactly what either “chemical imbalance / balance” IS, or what a “brain disorder” is or is NOT. You are experiencing a SUBJECTIVE state of mind, body, being, feeling, behavior, activities, etc., and that, for you, is REAL. There are many, many, sub-clinical nutrition deficiencies which can contribute to, or even cause, what you’re experiencing. Many types of toxics exposure. And, yes, you can even live yourself into “depression”. Simply put, the more you feel sad / stressed / depressed, the fewer fun, happy, things you do. The fewer fun, happy things you, the more you feel depressed. It’s a feed-back loop. So, yes, regular walks, yoga, stretching, Tai Chi, etc., are all excellent treatments. Having friends, having fun, even just going out and walking around are helpful.
There is also a more nebulous side. Call it “spirituality”, or even religion, whatever feels right to you. Your “depression” disempowers you, so whatever EM-POWERS you, will be therapeutic. I am glad you’re here, and there is a LOT of support and help, and hope in these webpages. You might still have to suffer, but at least you don’t have to suffer alone. Whatever medical treatment you get, just don’t let the quacks remove your FUNNY BONE.
The longer I’m off “anti-depressants”, the less depressed I am. I’m not alone, either. Welcome.
For some reason today people do not want to deal with difficult emotions or feelings. These feelings are there to let us know that something needs to be worked on in our lives. But rather than do the Work we want to pop a pill and make everything hunky dory wonderful. This is unrealistic but people chase after this anyway, to the detriment of their bodies and their pocketbooks. And old social work maxim is, “If you don’t do the Work, the Work will do you.” Why are we so afraid to search within ourselves to find out who we truly are? We don’t need an Apocalypse because we are already a zombie nations because of our willingness to believe these shysters that their drugs will take away our unhappiness, dissatisfaction, and disappointments in life.
As for the drug companies; people who run them need to begin going to prison for crimes against humanity. They are destroying our society and our people simply so that they can make money hand over fist. They are the modern day robber barons.
By the way, I have experienced what can happen to a person who takes abilify to make a so-called “antidepressant” work better. My roommate believed his psychiatrist who insisted that he take the damned toxic drug and what happened is that he went into four days of hallucinations and being totally off the wall. It was absolute hell for him, and for me as I tried to keep him from running out in the street and doing something that would have gotten him in trouble with the law. He dumped the damned stuff down the commode and has never taken another dose of the devil’s tic tacs.
Drug companies, like other multi-nationals, given super PAC funds, just as mobs used to do before anti-racketeering legislation was enacted, buy politicians. These politicians are then obligated to channel kickbacks to the corporations, or they lose their electoral edge, as well as some of those perks that come with viable candidate status. This corruption of the political process has made congress a millionaires club. It should be obvious to anyone that the initial idea of democracy was not a matter of representing the interests of wealth at the expense of the interests of the majority of citizens. If anybody wants to do something about things like direct to consumer advertising a good place to start would be the polling booth because these obnoxious drug ads are a direct result of this more general corruption you see in the electoral process.
You’ve missed the GOP rationale for policy- if enough candy is given to our 1%, their benefits will trickle down to us like the rain trickling down upon the Atacama Desert (where some regions haven’t seen rain in 500 years).
Again, glad to see your stuff getting some attention in the “progressive” world; unfortunately it’s still like a drop of water in a desert wasteland.
Thanks for pointing out the Clinton/Gingrich collaboration in junking the previous regs. Bipartisanship in action!
If you do more writing about Abilify don’t forget to mention the whole thing with the application for the FDA to approve microchip implants in Abilify capsules to ensure “compliance.” http://www.madinamerica.com/2015/11/medication-mechanization-microchip-sensors-in-abilify-to-increase-medication-compliance/
Also, while tedious I think it would be helpful if you made sure to put quotes around words like “schizophrenia”; I believe it has a cumulative effect, and plants the seed of doubt as to “mental illness” being a real thing.
Thanks for sharing this, as they say.
I agree Bruce; please put quotes around “schizophrenia” to indicate its nature as a word of contested validity, whether or not the word is coming from you… it is a word myself and many others want to eradicate eventually.
Yesterday, the Keene, (N.H.)Sentinel printed a biased, propaganda editorial against cannabis. They claim that “studies” show long-term cannabis use can cause “schizophrenia”. I mean, really, you can’t make this stuff up….
And, a local quack shrink, Dr. Shawn Shea, made over $10,000. in 2014, doing “consultancy” for Otsuka Pharm, which makes Abilify. That’s from the >propublica.< "Dollars For Docs" database, which is taken from FedGov Medicare data….
Let's US ALL KEEP UP THE GOOD WORK, "bpdt", and "oldhead"….
Good to see you guys again!
I think I use it because there are fewer letters in “schizophrenia” than in “metabolic dysperception”.
Little coincidence here. The NYT published a piece yesterday on drug ads, and of course it’s as conventional and as lacking in critical questioning and insight as I have come to expect from ALL NYT health coverage, across the board. And I can’t stress the word LACKING to a great enough degree. I often feel like I’ve just read pharma’s own press material after reading an NYT piece. And then commenters all sing the praises of conventional medicine, progress, and pharma, and attack anyone who suggests alternate, unorthodox routes to healing.
Big Bucks, Big Pharma: Marketing Disease and Pushing …
Sep 15, 2014 – Uploaded by Z – Health Documentaries
This is a good video to show family and friends to get them interested informed , the stuff they do is so dirty and despicable. I Watched this video then the next time I walked into CVS or Walgreens I was just like yuck I want to shop someplace else when I saw the signs for the “purple pill” but now I knew the story behind it.
In 2014, without admitting either criminal or civil liability, Walgreens Corp. paid a $79MILLION fine to the FDA, for filling bogus Rx scripts for opiates…..mostly in Florida.
But do not forget to mention the musical background while the side-effects are described in commercials; soothing, comforting music reduces the negative impact of the warnings.
Enter Skipr, a company that’s working on ad-skipping technology for live TV. As revealed last month, Skipr will recognize when a commercial comes on, and whisk you away to alternative programming, such as your local forecast, a screensaver, or music. You’ll then return to the original show automatically when the commercials are over.
Another of the many reasons to not watch TV. Apparently, online subscriptions (Netflix, Hulu, etc) have not been made to tow the line yet.
I see the ads at work and all of them use the same tactics. I always notice the word “may” or “could” as there is no hard evidence and it’s all about the money. The most disturbing one is the one they are now plugging to sell to stage 4 lung cancer patients that “may” give them more time. These parasites are all stamped with the governments seal of approval (which means they aren’t worth diddly).
Yes, the FDA has sold itself to the drug companies. We are up for grabs now with no one looking out for our welfare. Corporations are people and they have freedom of speech and the right to do any damned thing that they want. And it’s no wonder that Murphy, the psychologist in Congress who is pushing that awful bill to get all of us more “treatment”, has his coffers filled with money from the drug companies. They’re his largest supporters.
Glad someone else has noticed the tentative language used by pharma to cover its ass and shield itself from lawsuits. Check out the compilation of drug ads on bonkersinstitute.org and all you’ll read about is what researchers “believe” about the “possible” neurochemical processes involved in a particular condition, and how this or that drug “may” provide relief for this or that hypothetical reason. You’ll never pin them down to say, for example, “schizophrenia is a disease caused by x pathology or imbalance and our drug helps remediate this by doing y.” It’s important that people understand this manipulation of language.
Can you PLEASE put an ACTIVE link for Dr Bonker’s Institute.
The 2 hours I spent there were some of the most rewarding screen-time I’ve had….
(Obviously, I want as many people as possible to learn the TRUTH…..
Seeing all the Ads in the 1950’s & 60’s “trade journals” was dismaying, but needed education….
I am off abilify for the first time in 8 years and feeling things again. My therapist remarked how good my affect was, I’m smiling more! Little does she know.
“Come to where the flavor is, Abilify Country”