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Comment by joshuaheard | Hacker News Reader

I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker. You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. The doctor, in turn, may give in to the patient's emotional pleas, since they are, in effect, in a customer service business. This would be an ethical violation. This rule would remove the ethical temptation of doctors

Further, it will be nice not to hear about an erection lasting over 4 hours, and not being too old for sex, in front of my 11 year old daughter while watching the news after dinner.

From a policy perspective, since the patients are not usually paying for the meds (you and I do), it makes sense to keep demand and prices low, as the doctors assert.

As for the free market, we do not have a free market in medicine. It is highly regulated through insurance and government regulation. So, I don't see a problem there.

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"I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker."

Plenty of logic is there.

Part of the purpose is to make the Doctor pay attention to the advertising that they see in a journal. [1]

How?

Patient goes in and "asks their doctor" about a drug.

Then another patient. And another.

So now when the doctor sees an ad (or the detail man comes in) the doctor pays more attention and perks up. Similar I guess to the way once you buy a particular car model (or a friend buys one) you start to notice them all over the place. Same reason Pepsi puts ads in football stadiums. Builds general awareness and adds to reinforcement of the product as being "current".

HN works in a similar way for YC by the way. Repetition and current relevance very important in advertising.

[1] Edit: And of course Physicians also watch TV and read mainstream magazines and an ad is likely to stand out and get noticed just for that. (As a tech person imagine if you saw an ad for some software or SAAS that wasn't mainstream on the nightly news. It would certainly get your attention and stand out (more than if you saw it on Techmeme)).

Patient goes in and "asks their doctor" about a drug.

I wonder if this really ever happens. I mean, for many of the ads, it's hard to tell even what the drug does, so going to your doctor and asking for that med would amount to a random question.

Well let's say you have a discussion with your doctor and they note there is a drug for your gastroparesis.

They might mention some names or might not.

You aren't ready so you basically don't ask for a script.

Later a week a month whatever there is an ad for Reglan on TV and you think "hey that was what the Doctor mentioned".

The ad is an ad, well done, so you in theory are now more receptive to taking the med. Especially since your symptoms haven't gotten any better. You are more willing to consider a solution to your problem.

So next appointment you ask more questions and walk away with the prescription.

Most of these are for chronic conditions, where people are seeing their doctor on a fairly regular (once every few months) basis. And yeah, at least some patients absolutely do ask, "hey, I heard about X, is that good for me?"

There are of course also the extreme cases of specifically asking for a given prescription, but like the parent mentioned, just having a few patients persistently ask the doc about X is enough of a motivator to get the doctor to pay [marginally] more attention to the doctor-facing literature/ads/sales force.

Oh hell yes. The main one peaople ask me about right now is Marcumar/Warfarin, a drug many patients with atrial fibrillation have to take for the entire rest of their life, despite the fact that it has awful side effects and requires them to go to their doctor every two to four week to have a blood test done. Many patients are quite excited to hear that there's now new alternative drugs (NOAKs) that let you skip the biweekly blood draw. I get asked about Pradaxa, Eliquis and Xarelto so often, my standard Marcumar pitch now includes a whole paragraph about how those alternatives are just as bad. This is getting harder to sell as new studies are coming in and my arguments against the new drugs are steadily being reduced to "They're a lot more expensive." Patients really do NOT want to hear about how they have to get stuck with needles every two weeks so their doctor can save a few Euro a month in the prescription budget.

The whole NOAK advertising scheme seems like a huge win for the pharma companies to me. (Possibly also for the patients. Not so much for the affordability of our medical system.)

Slight OT: How much more expensive does the stuff have to be that biweekly doctor visits for blood tests are cheaper?

(Not even getting into the topics of "how much is not having to do that every 2 weeks worth" and "can't the patient pay the difference if they want to?")

Judging from their comments; that doctor lives in Germany, which seems to have a national health care system (in addition to private insurance).

(In the US, a 15-minute doctor's visit could easily cost an end-patient $150-$200 out of pocket if their insurance doesn't cover it or has a high deductible; doing a blood draw every two weeks can get very expensive at that rate.)

Several of the the thinner drugs cost $10-20 a pill or in the range of $5000 a year. Assume anything you see on TV is a mi imum of $300 a month, perhaps more. The roll-on testonerone is $500 a month. Bushes generous medicare drug bebefit maxes out at 90%. It can still break you with a couple big ones.

>Patients really do NOT want to hear about how they have to get stuck with needles every two weeks so their doctor can save a few Euro a month in the prescription budget.

This doesn't make much sense as an American.

> and requires them to go to their doctor every two to four week to have a blood test done.

Can't that be done digitally now?

http://www.thenorthernecho.co.uk/news/14030069.Warfarin_scre...

https://twitter.com/CDDFTNHS/status/666205891629359104

https://twitter.com/NHSIQ/status/666240577877499905

EDIT: Also http://www.nice.org.uk/guidance/ta249

As an ICU physician, I hate the NOAKs. The data may say that they bleed less. However, when they do bleed, I've got nothing that really reverses the bleeding.

Of course, novel reversal agents are coming and each one will likely only reverse one drug... and each one will cost an arm and a leg.

I understand why patients do it. I just don't like bleeding that I often can't directly control.

I will never stop being impressed at the breadth and depth of the HN audience. Thanks, you two, for your comments.

In Denmark you are not allowed to advertise prescription drugs, so they will just advertise the illness and symptoms and end with a "ask your doctor about this illness".

Yes, this is pretty much how it works. Brand drug makers buy data to track how well this is working, for their drugs vs competitors.

Indeed, it is based on a well known psychological phenomenon:

https://en.m.wikipedia.org/wiki/Availability_heuristic

> I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker.

"Surveys conducted by FDA and private organizations consistently show that DTC advertisements have an impact on whether consumers request and receive a specific brand-name prescription from their physician. [...] In several of these surveys, consumers were asked whether they had seen an advertisement for a prescription drug and whether seeing the advertisement resulted in discussing the medication with their doctor and receiving the prescription. Most consumers (65 to 85 percent) remembered seeing a DTC advertisement. A subset of consumers who saw an advertisement discussed the medication with their doctor. The percentage of patients asking their physicians about a prescription for a specific drug was consistent across studies, about 30 to 35 percent of those who remembered seeing a DTC advertisement. One study estimated that the 32 percent of consumers in a 2001 survey who had discussed a DTC advertisement with their doctor translated into approximately 61.1 million consumers asking about specific medications. In the consumer surveys we examined, the percentage of consumers who, in response to a DTC advertisement, requested and received a prescription from their physician for a drug they were not currently taking was generally about 5 percent (ranging from 2 percent to 10 percent). By our estimate, this means that about 8.5 million consumers received a prescription after viewing a DTC advertisement and asking their physician for the drug in 2000."

source: http://www.gao.gov/new.items/d03177.pdf

The data doesn't care whether or not you see the logic behind it.

I wonder how much data there is against the First Amendment. I'm not saying the ads aren't a problem, I'm saying censorship isn't the solution.

My comment was descriptive, not normative.

Your comment, in context, seemed to imply that customers making bad decisions due to imperfect (mis)information could be corrected by censorship.

> The data doesn't care whether or not you see the logic behind it.

This is true only if corporate executives are amoral automatons running hill-climbing algorithms. Rather than, say, citizens who use logic to make responsible decisions not just for their short-term profits but for the long-term good of their community.

Corporations care a great deal more about short term profit in general.

Corporations don't care about anything. The people running them do, as do the people working in them. Those are the morally responsible actors here.

Well, the system we have now really encourages that short-term, profit-finding behavior for corporations and the people who make decisions in them.

Many of the side-effects are just not part of the accounting, and therefore are not important to investors.

Money, money, money.

> Rather than, say, citizens who use logic to make responsible decisions not just for their short-term profits but for the long-term good of their community.

You say this as if there's no relevant data available. But again, if you can Google the actual answer, your 'opinion' doesn't matter.

In the US, the consumer drives a lot of the healthcare decisions.

This has positives, as consumers can be more active participants in their health, but can also lead to people shopping for doctors who will prescribe the drugs that they want based on flimsy research and marketing.

Additionally, this is a great backdoor way for consumers to be "educated" about conditions they didn't know they had. Consumers then would go to their doctor to talk about these things.

These advertisements are extremely effective at getting patients going to doctors about conditions they hadn't necessarily discussed with the doctor before.

> This has positives, as consumers can be more active participants in their health, but can also lead to people shopping for doctors who will prescribe the drugs that they want based on flimsy research and marketing.

Turns out, people suck at being intelligent healthcare consumers. Its not their fault though.

http://www.nytimes.com/2015/11/02/upshot/why-consumers-often...

http://www.nber.org/papers/w21160

Disclaimer: I am a strong advocate for single payer.

Demonstrating that consumers have trouble with insurance decisions implies nothing about their ability to make care decisions.

Most healthcare consumers don't shop around by cost for their healthcare, either because they can't (emergency services) or because its too damn hard (example below).

I encourage you to call your three closest hospitals, pick three surgical procedures, and ask them what the cash rate is from their chargemaster. You may get an answer from one hospital, possibly.

Most healthcare consumers don't shop around by cost for their healthcare because they don't pay the bills.

True! But the healthcare market is grossly inefficient. Prices are hidden from users. Drug makers can pitch straight to consumers, who aren't medical professionals.

I'd agree that consumers would shop around given the proper incentives, and as long as those incentives didn't diminish the healthcare they receive (or their health in general).

Single payer seems to be the better option. It streamlines collecting revenue for the program, and the program is large enough that it can bargain or set pricing with healthcare providers.

You could easily argue that "Most healthcare consumers don't shop around by cost for their healthcare because they don't pay the bills" is a good argument against single payer.

Honestly, I think if we treated medical insurance more like we treated car insurance, home insurance, et al, then the cost of medical goods would go down.

You seem fixated on price. "Active consumer" (the words in the post you were replying to) means more to me than finding the best deal. It means allowing the consumer to ultimately decide what is best for them, where price is one of several factors.

As far as the specific price question, with respect to drugs I can easily get that information from my pharmacist, whether it is the cost difference between a name brand and generic or just the prospective cost of a medication.

Have you ever lived in a country with single-payer healthcare? Let me tell you it's not all roses.

- Months long waits for anything requiring a specialist unless you're literally about to die.

- Arbitrary exclusions like dental and optical.

- Doctors taking in ~50% of the entire provincial budget and whining that it's not enough.

And at a typical tech worker salary this all this ends up being more expensive in additional taxes than just buying the insurance outright would be in the US.

If you're not poor, there's really no reason to prefer single payer.

Many (most?) private employer based healthcare plans in the US don't provide dental/optical. Those are each separate plans and premiums that you and/or your employer must pay for.

Your point about doctors taking ~50% of the provincial budget seems exaggerated (please provide a reference to support it). Even if healthcare takes 50% of the budget, it's not all going to doctors, probably not even the majority of that. There are a lot of expenses other than doctors in a health system (nurses, administrators, buildings, equipment, materials, etc, etc, etc).

In the US, the big "single-payer" system, Medicare, is far more cost efficient than private insurance: http://healthaffairs.org/blog/2011/09/20/medicare-is-more-ef...

And I can think of at least one good reason to prefer single-payer if you are a not-poor tech worker: Job flexibility. Since insurance comes from the govt instead of the employer, employees don't jeopardize or destabilize their health coverage by switching employers or switching to being self employed.

Edit: wording

> Your point about doctors taking ~50% of the provincial budget seems exaggerated (please provide a reference to support it).

It's actually 42% in my province: http://wpmedia.news.nationalpost.com/2015/04/programexpenseb...

The average doctor makes $350k and the medical association is suing the government because they think it's too little (http://www.theglobeandmail.com/news/national/ontario-medical...).

That 42% is the Healthcare Sector's share in the entire provincial budget.

It absolutely does not support your claim that doctors take in 50% (or even 42%) as it has already been pointed out that there are far more expenses in healthcare than simply doctors (e.g. drugs).

I misspoke. s/doctors/the healthcare industry/.

Drugs, like optical and dental, are not covered under health insurance in Ontario.

yeah I live in the usa and it took me over 3 months to see a specialist, i don't see how this is some inherent flaw of single payer

also people have an invisible waiting period in the form of not having the money to get things fixed so they put it off until it gets worse :^)

> If you're not poor, there's really no reason to prefer single payer.

There's the whole "I am not poor but I have compassion for those who are and don't want them to die and suffer for lack of medical care" angle that you might want to consider.

The first rule of sales is to pitch the decision maker.

You may need a prescription from a doctor to get a drug, but that doesn't mean you aren't the decision maker.

After finally getting a proper diagnosis for my condition, doctors began asking me "What typically works for you?" or "What drug do you like/is your preference?" I had a long history of health problems, thus lots of experience with what worked for me. After they gave me a proper diagnosis (and thus quit acting like dismissive assholes), I could walk into a doctor's office and say "I am having Yadda problem. I want (this list of meds) and am open to suggestions as to what else you think might help me." And get it.

Ultimately, I was the decision maker. The doctor's job was, in part, to inform me what my options were. But no one just crammed their medical opinion down my throat, even before I had a proper diagnosis and doctors were routinely being jerks to me and acting like I was some kind of hypochondriac.

It would be hilarious if commercial platform vendors had ads targeted to software development clients: "Ask your developer about .NET technologies for your next project".

Twilio has "ask your developer" ads:

https://twitter.com/tsunderji/status/579053680919347200

Not sure if I'm missing some subtext though...

I don’t think you are! :) I’ve seen these too, and I think they are a little funny, and fairly true. A dev will know Twilio is just how you do phone and SMS, and non-devs generally don’t!

The unfortunate truth is that a huge number of doctors are downright incompetent, and the healthcare system only allows you to see a limited selection of doctors. So until the system fixes itself, the onus is still on the patient to try to treat themselves.

* Source needed.

Have you ever sought a particular prescription from a doctor? Many general practitioners in the United States are glorified drug dealers. You will probably get whatever you ask for if you can afford the copay.

Disturbingly easy to get class II drugs without any proof of need.

I have no direct experience seeking a prescription, but I do know a doctor who has repeatedly complained to me about patients coming to him with the expectation of receiving a particular drug. He's considered giving up his DEA license to reduce this problem.

One I see in the field as a paramedic?

"Any drug allergies?"

"Aspirin, Tylenol, Tramadol, etc"

"Oh, so you're allergic to 'all' non-narcotic pain medication? That must be ... inconvenient."

How do you respond to such a thing? If a patient is allergic to aspirin, concerned about liver toxicity from APAP, doesn't want stomach issues from NSAIDs, etc.? Do they just have to suffer or do you "give in" and provide them desired relief?

There's certainly a cynicism present in some providers - we're definitely not a perfect bunch, and some areas will have more explicit policy on the use of narcotic pain relief.

For me: I look at physiological symptoms. You tell me you're in 10/10 pain (the "worst of your life"/"worst you could imagine") and you're in no visible distress with normal vital signs, then I'll factor that into the decision.

That being said, I believe it is unethical, immoral to withhold something that could benefit a patient who is in genuine distress, regardless of anything else. For those patients, we have options, too. Fentanyl, for one, is used a lot pre-hospital as it is both an effective analgesic with a short lifetime in the body.

There used to be (probably still is) doctors in the ED who don't want a patient to come in with pain meds onboard because they want to see a "baseline presentation". Again, I think this falls into the realm of poor provider care. We have diagnostic tools for objective analysis, and having a patient in pain just so we can measure it is inhumane.

Bottom line: if a patient requires pain medication, they will get it from me, subject to analysis of circumstances. In your example above, if it's not "drug seeking" but concerns about side effects, then the patient and I can have a discussion about benefits versus risks (the flip side to that being if a patient has a broken femur, for example, that conversation is likely to be limited to 'give me the damn drug!").

"Do they just have to suffer or do you "give in" and provide them desired relief?"

No. There are plenty of other options for treating their pain without using opioids -- first I would educate them about the relative risks and benefits of, say, acetaminophen/APAP. I could use something like intravenous lidocaine or low-dose ketamine, or if it's a traumatic type of pain some kind of regional anesthesia. If it's more neuropathic, you can use tricyclics or drugs that work on GABA pathways. Beyond all that, I try to talk to people about the harms associated with opiates/oids such as hyperalgesia that develops in many long-term users, which is a really significant and underappreciated harm alongside things like addiction and potential respiratory depression.

I was taken in an ambulance to the hospital once for a dislocated limb. I never understood why the paramedics seemed to find new satisfaction in life when I rejected the narcotic painkiller. Must have come as a pleasant surprise.

I was hospitalized for a bit a few years back. Several nurses commented passionately on what a relief it was to take care of someone who actually needed help, instead of the many people they have who come in complaining of pain just so they can get their morphine fix.

Then maybe you should hold off on statements like "Have you ever sought a particular prescription from a doctor? Many general practitioners in the United States are glorified drug dealers. You will probably get whatever you ask for if you can afford the copay." until you have direct personal experience with this.

Most of what a Doctor uses to make a choice on "proof" of need is oral testimony from a patient.

This is a good thing in one way. People should be free to buy chemicals at will. The disturbing part is that it's a forced tax paid to doctors to get RX's written each month.

Even worse, this further kills equality. A worker desiring to boost performance can easily afford top-notch medicines -- speed's only $20 a month for a starting dose at a pharmacy. But the prescription alone can be 10x that, and sometimes may be required every month. Not to mention the cost of a higher-end doctor that will assist customers. Poorer patients are thus denied medicine, creating a negative feedback loop.

> People should be free to buy chemicals at will.

this would introduce a myriad of acute public health issues and do great harm to the public good, costing taxpayers billions of dollars for remediation.

Edit: the DHHS's report on prescription medication abuse is good reading in this area: http://www.cdc.gov/drugoverdose/pdf/hhs_prescription_drug_ab...

I don't claim this myself, but I believe his or her argument is that the freedom to choose should take precedence over the cost to taxpayers, regardless of the cost.

I really don't think it would, alcohol is pretty heavily used in the USA and it's a pretty dangerous substance.

There are definitely more dangerous drugs than alcohol but legalization of all drugs isn't going to destroy society.

Are you not aware that 88,000 people die from alcohol-related causes every year in the US and that alcohol is the third leading preventable cause of death?

http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-con...

Do you support banning alcohol?

No, but I also don't think people should be free to buy any chemical at will. Alcohol is heavily regulated and still causes massive issues for society.

Alcohol is mostly regulated for taxation, not usage. (To the point of poisoning untaxed alcohol to make sure you get hurt if you sneak around the tax.)

it is most certainly regulated for usage. Widespread restrictions exist on consumption (usage) of alcohol in public places as well as within motor vehicles. It is illegal to purchase alcohol in the US if you are under 21 years of age, as it is to purchase alcohol on behalf of someone under 21 years of age; drinking is outright illegal for people under 21. Many counties around the country are "dry" counties where selling alcohol itself is entirely illegal. Regulations exist on bars as to when they can sell alcohol and when they can't, under what circumstances. Restaurants need special licenses in order to sell alcohol. All of these regulations are again in the interest of public health and the public good.

To claim that alcohol isn't regulated on usage or that most alcohol regulations are for taxation purposes only is pretty far off the mark.

The primary rationale for the taxation of alcohol itself is to counterbalance the public health issues that alcohol causes. Public health issues cost money to remediate.

Taxation is one reason. But we also regulate it so that only 21-and-over can buy it, that it can only be consumed in certain locations, and we also make illegal many activities that are performed while intoxicated.

Taxation affects usage. The increased price due to the taxation reduces people's will to buy alcohol.

> People should be free to buy chemicals at will.

Any chemicals? In any arrangement?

Good? They're at least getting informed consent and an opportunity to be diverted towards harm reduction. Ideally if a patient stubbornly demanded a particular drug they'd be warned in graphic detail of why that was a bad idea, asked to sign a "Prescription AMA" form, and that'd be the end of it. If nothing else it would keep them in the system and out of the grasp of hucksters and literal druglords.

The guys in the park selling opiates at unspecified dosage and purity are available 24/7 and don't even ask questions.

> The first rule of sales is to pitch the decision maker. You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. The doctor, in turn, may give in to the patient's emotional pleas, since they are, in effect, in a customer service business. This would be an ethical violation.

I think most of these ads are targeted to people who are already taking a drug for a condition. They want people to ask their doctor to switch to their drug - something a doctor would have far less ethical issues with.

The problem of course is people switch away from a drug that has worked for 40 years to something new because of advertising and their insurance (and in turn, all of us) ends up picking up the cost for something that may have no benefit whatsoever to the patient.

Some of them.

Others are so brutally generic that they could apply to almost anyone: "Do you feel tired regularly? Have trouble getting going? Talk to your doctor about xxx".

Whilst I realize a lot of this is coded talk for "Do you suffer depression?" for people who might not have realized or be willing to acknowledge it as such, the sheer number of conditions for which "lethargy" is a symptom...

Not everyone thinks that the health problem they're having is treatable - an ad can let someone know that there is a drug for condition X, prompting a trip to the doctor that would otherwise not happen.

One aspect that I haven't seen mentioned here is that these ads are also designed to improve patient adherence. So you have 30 million prescriptions of zoloft prescribed in the US every year (crazy right?) but there's a lot of money left on the table when folks don't refill. The ads are reminders to these people to go get that refill and get back on their meds. For people with asthma, diabetes and hypertension, non-adherence can be really unhealthy and leads to hundreds of billions in unnecessary cost to the healthcare system.

I think this needs hard evidence to back up - is adherence much worse in the UK where ads like this are banned?

You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need.

FWIW, I asked my GP about this when I went in for a physical recently. He said he really doesn't get patients coming in asking for specific drugs in response to TV ads, and said he doesn't think it is an issue. Of course that's just one anecdote, but it shows that doctors are hardly in unanimous agreement on this.

Though the majority of AMA members voted for it.

I do think advertisements make a difference. For example for a given health condition if the advertisement says X is cutting edge, then automatically the patient who receives something else from this doctor would think he is not receiving the best medication possible.

This also explains why VISA and MasterCard advertise so much when you as a consumer simply take whatever the bank offers you.

It's the same principle at work when advertisers educate young children about how to nag more effectively.

Patients will go to their doctor and ask about a specific medicine and too many doctors will give in to this pressure if they feel that the medicine will not outright harm the patient. Patient happy, doctor can move on to someone who deserves his/her care more.

> As for the free market, we do not have a free market in medicine. It is highly regulated through insurance and government regulation. So, I don't see a problem there.

Plenty of us do.

The absence of a "free market" in this situation isn't merely a difference of driving economic theory, but of bodily sovereignty.

> The first rule of sales is to pitch the decision maker.

Or to pitch the influencers --- for example, grocery stores' putting sugary cereals on lower shelves, where kiddies can see them and ask mom and dad to buy them.

We have these ads for the same reason that bright sugary breakfast cereal is placed on the lower shelves in the grocery store. Children pester their parents for the cereal, and people pester their doctors for Viagra. But the children/people have to know about the product before the pestering can happen.

Clearly there are some ethical challenges. My doctors office is littered with Crestor clocks, clipboards, pads, exam table stirrup covers and medical models.

You can't say that seeing that logo 500 times a day doesn't influence picking Crestor over, say generic Lipitor.

You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need.

Same logic as for advertisements for children's toys, games and movies.

Its the same logic as with toy commercials aimed at children. Children influence their parents by nagging, and patients influence their doctors by nagging. Parents don't want unhappy kids, and doctors don't want unhappy patients.

> The first rule of sales is to pitch the decision maker.

McDonalds advertise at children so they'll harrass their parents into buying crappy food. Drug companies advertise to encourage people to harrass their doctors for prescriptions.

Well, drug companies also market directly to doctors. Only about 12% of pharmaceutical marketing money is "direct to consumer."

The logic is that they make a vast amount of money.

>I've never understood the logic behind prescription drug ads.

Pull marketing.

>watching the news after dinner

Found your problem right here. The news no longer serves to inform. It's little more than a conduit for fear, terror, and doubt. Switch off the TV and go read some websites or books to find out what's happening in the world other than the latest development in a terrifying incident in which a handful of people out of nine billion died.

Better yet, take your daughter down to city hall or a county government meeting, and get involved with what is actually going to affect you tomorrow.

Flip side is that it's vile that we need a "doctor's authorization" to even buy chemicals. While there certainly should be regulation to curb abusive advertising (e.g. fraud), it's sad anyone would find it wrong to ask a doctor for drugs. The way things are set up, that's exactly what many people are forced to do.

Also, nitpick, but the news and ads in general are almost certainly far more harmful (for your daughter; perhaps you, too) than hearing about ED meds.

Antibiotics are an obvious counter example to this.

Sure, things that are cause for large scale disease/biohazard might be a good exceptions. The medicines patients seem to be seeking most (psychedelics, relaxants, stimulants, painkillers, erection-assistants) don't seem to fall into this category.

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