I guess this is a pretty US centric question but I see so many commercials for drugs to treat very specific and/or life threatening conditions. If I had one of these conditions, I would hope I wouldn’t need to “Ask my doctor about…” a drug, but rather they would just, ya know, *prescribe* it to me. Are there really enough people with diagnosed conditions who’s doctors haven’t prescribed them the corresponding treatment that these commercials are effective? I’ve never really understood it but obviously they must be effective if there’s so many of them on TV.
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Well, docs may or may not. You don’t see ads for antibiotics, because docs will just go prescribe them. But like I used to get lots of ads for a psoriasis drug. My doc didn’t prescribe or even mention it to me. So I checked it out—it’s very expensive, not too effective, has side effects, and only for people who have a really, really bad case of psoriasis. So my doc rejected it on those ground and didn’t mention. So the pharma *needs* patients to go in and ask for it. The doc may then discourage it, or the doc might say sure, here’s a scrip.
Likewise there were a lot of ads for Latisse, a drug that causes you eyelashes to be fuller. No doc is going to prescribe that of their own initiative—whispy eyelashes are not a disease. So they need me to become self conscious about my lack of lashes and then go bug the doctor.
So they tend to be drugs for things you might overlook or that your doctor doesn’t mention.
Though also, what you may not be aware of is that these big pharmas have an enormous advertising budget and they spend a lot of it on seminars for doctors in places like the Bahamas. They give a few lectures on how great their drug is, and then the docs are free to enjoy the beach. When there are like 20 different antidepressants out there, this is an effective way to get docs to prescribe it. It’s *advertising*, but it looks like neutral medical education and many docs believe what they’re being told and it puts the drug top of mind so they think of Zoloft the next time a patient comes in who seems in any way unhappy, and push that drug on them rather than prescribing something else.
And there’s diagnosis creep, encouraging more diagnoses of a given disease so the doctor can prescribe the meds to a new person who previously they may not have recognized as having a disease or not met the criteria for the disease. That’s part of why the opioid crisis in the US is so bad—they encouraged a focus on diagnosing pain, made pain too of mind even to the extend of making it a vital sign for docs to ask about, promoted the lie that you couldn’t get addicted to the stuff they were selling, and encouraged use for stuff that didn’t really require such powerful painkillers.
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