How pharmaceutical companies find sick users on Facebook
themarkup.org
themarkup.org
Maybe I’m just too Scandinavian to understand, but wouldn’t it be the other way around?
Now I also wonder if I should see a doctor. I’ve been getting a lot of “is your will in order” commercials from law firms on Facebook recently. I sure hope big tech advertising doesn’t know something I don’t.
I was once on holiday and with US TV, and saw a few times an ad for performance enhancement for older gentlemen. The ad showed an older couple, who first are not very happy, then much happier with each other, frollicking in the long grass and disappearing off shot etc.
While that was happening, the narrator was reading in an impassioned, but also somewhat undulated voice: "side effects include headaches, blurred vision, hypertension, liver failure, paralysis and death" [I can't quite remember the list, basically it went from minor to death, as most drugs do].
For someone not at all used to serious drugs being advertised on prime-time TV, this was quite a thing to see.
The name isn't supposed to make an actual claim about effectiveness--you can't call it "cancercurazine"--but they often try for something vaguely suggestive: Viagra sounds like it makes you 'vital', Wellbutrin makes you feel well, Zyban keeps you away from nicotine, etc.
I've heard--but can't find a source saying--that this is why varenicline is sold under two different names: someone felt like 'champix' was too suggestive.
* My first attempt at a made up drug name was Xaljenzia (my thought process was they seem to love the letters X, J and Z) but apparently there is a Xaljenz so I ended up with this.
So we sort of have a culture where you only really stick to certain brands if you’ve ever had a bad reaction to a copy product. I’ve got a hay fever for instance, and for the past many years I’ve stuck to the same brand of antihistamines because I once bought a box that made me nauseous and I just went back to what I had previous used. This is anecdotal of course, but it took me almost a decade to learn the name and not just ask for the ones in the green box.
The bigger difference I see here is that in the US, I generally got loose pills in a pill box, and here in Norway, I'm more likely to get a standardized amount of pills in blister packs or manufacturer packaging.
Quite simply, prescription drugs advertise in the US because they are both allowed to do it and the name-brand drugs get more people insisting on the name brand because they advertise, even though it costs the person more (sometimes, a lot more).
In this case, the above commenter could be doing things signaling that he may need a will soon due to diseases or life situation that he is not aware of. Or he/she has looked into content similar to those people in need. ¯\_(ツ)_/¯
In this case, she knew she was pregnant. Her family didn't.
Other than that I have no idea heh.
Depending on what you personally get up to, opsec is increasingly vital for normal people. I'm not talking about serious stuff - everyone has secrets.
Well, had.
I want to be a patient, in to see a doctor for diagnosis and/or treatment. I don't want to be a client, I'm not here to iron out a SEO contract.
Both words are derived from Latin and have seen some service. Patiens - "sufferer" seems appropriate for someone who is suffering - they tend to gravitate towards Doctors. A client "cliens" is more of a legal term - it was used to denote someone who had a lawyer or was "protected" by a patron.
I think that patient is the more appropriate term for your customers (originates from Latin - "tax gatherer.") 8)
I guess commercials would still work if you branded yourself hard enough, but our culture is more like the Velcro thing, where when people ask for a “panodil” or a “pinex” they don’t really care if it’s actually a panodil or a pinex as long as it’s a headache pill with that the same sort or working chemical.
More people want brand name for over the counter - like panodil/pinex - but sometimes this is because folks don't realize that the generic is the same drug.
For my posttransplant meds some of the are explicitly "must" be this version. Also some meds (anti rejection) are dispensed direct from the hospital
Drug companies advertise to convince doctors that drug X is better than it actually is. Which is obviously bad for patients who are better served by an objective approach to prescription drugs.
I worked on one drug where we had to go to and tell them to stop buying it (they were still buying lots and if they return it a year later it would mess up our accounting) because there were far superior drugs available. We’re talking malpractice not to use the new drug. They thanked us for letting them know.
But I agree that doctors don't need advertisement. Just publish a technical magazine 2 to 4 times a year with a technical description of the drugs available and let the doctors make the call.
https://www.theguardian.com/global/2021/may/07/funeral-grace...
The only bad thing about it is if those people targeted can't afford the medication, which is why healthcare needs to be a universal right.
People love to bitch about Big Pharma but I have a magical little blue tool that completely relieves my asthma, and I can buy them with absolutely no trouble at the pharmacy for about $6. My brother got diagnosed with MS recently. My aunt got diagnosed with MS 40 years ago. Thanks to the research that happened in the last 40 years, my brother's experience with MS is worlds apart (mostly because we live in Australia and he has free access to tens of thousands of dollars of treatment).
Pharmaceutical companies are responsible for developing vaccines for a global pandemic at light speed. They're great! Let's celebrate Big Pharma!
But let's also make sure that the gains from these amazing advances in technology are shared equitably.
And maybe, just maybe, if the medical companies find they need to use Facebook to shift their product, we should be looking at a more formal and closely regulated method of distribution that isn't so commercially driven.
I mean, the private sector is great at commercialisation, but is it really the be all and end all when it comes to such a crucial social function as healthcare?
I could be deregistered if I was found to be accepting anything (travel, hotels, conferences) and not declaring it
What industry do you work in where those at the top of the companies aren’t maximizing their ROI and profit seeking? That COVID shot in your arm ID from the scientists that worked feverishly to invent it, and should be celebrated like the ones that solves medical mysteries across all different disease classes. R&D is not free period.
Why not have the government subsidize medical costs, why punish the inventor who have huge R&D overhead? The corruption you talk about starts and ends with the government.
I was invited once, by another doctor, to speak (paid gig, curtin closer) at a conference being put on by a pharmaceutical company. It was on digital health and the company I think may have had an interest in anaesthetic drugs or supplies or possibly it was surgical - (I’ve just trawled my records and without spending an hour or more I don’t think I’m going to find it) either way there were lots of Anesthetists and surgeons there, mostly because for only $100 they could knock off 20 CPD points by coming and listening to something half interesting in a nice venue for a while and get a meal and catch up with each other.
I had to fill out pages of forms with the company to get paid, firmly renounce that I would be promoting any drug or product, resolve to declare my affiliation with them for a minimum of 12 months, etc etc (this was in around 2018).
The company’s logo was on the pull out banners and the projection screens obviously but there wasn’t even a hint of drug or product anywhere in the room. No tote bag, just some mints and the pad and pen.
The ethical bar has been raised so high that medical companies are now reduced to running paid conferences on adjacencies that clinicians may possibly be interested in, that align with their college’s professional development goals, and can’t even mention their products!
So why do they even do it anymore? I pondered this as I filled out my forms - I believe it is due to residual infrastructure and marketing apparatus and budgets from the days when they could offer the world. Now they’re like vestigial organs, floundering to maintain purpose but knowing that a KPI is eyeballs on logos
The kicker is, if it was anaesthetics, there are only probably 2 makers of sevofluorane in the world anyway!
Whatever pill the doctor writes me up, I always end up asking the apothecary or looking up online the cheapest substitute. This is how the elderly here cope, they can barely pay bills, let alone choose which pills to skip. I've personally not had any problems with big pharma substitutes so far.
One issue, that could excuse medical companies going directly to the patients would be a lack of knowledge among doctors. Doctors contently write prescriptions for medication that's no longer available and is often not as updated as a pharmacy on new medication. This means that at least some doctors aren't suggesting the best treatment, simply because they aren't aware of it.
People just assume a lot about the world.
1. Zero ads for prescription medication anywhere 2. Medical card for everyone on low income covering everything 3. Never pay more than EUR114/month for prescriptions, no matter how much you medication you need or your income.
I've never had doctors pushing any kind of medication on me or my family.
You're a glass half full type of person, to put it in polite terms.
I could rant all day about media and health in Ireland. Specially from a migrant perspective but it's not really the place.
What is undeniable is that Ireland ranks amongst the worst in Europe and it's very much for profit. It's just Irish people don't know any better and they look at the wrong place (USA) and only at the money aspect, not the quality.
Quality wise, I'd much rather be in USA than Ireland because treatment here is terrible in many cases and there's always a sea of excuses and bureocracy.
Except when they do get financial rewards?
https://www.nytimes.com/2019/05/02/health/insys-trial-verdic...
I don't believe there's any evidence for this and ads for prescription drugs are banned almost globally for good reason. "Ask your doctor about" may bias the doctor away from a different drug that is more appropriate but has a lower profit margin, for example.
Major new drugs may get news coverage or may be brought up if a doctor sees something on your chart at a checkup, but ads may (or may not) reach more people.
This should be illegal.
Go look at peer reviewed studies and clinical trials data to make an informed decision on medical treatment options.
Maybe the campaigns pushing opioids on doctors and patients to the point of crisis?
Insulin is at least twice the price (depending on type might be 3 or 4 times) in the $US as anywhere else in the world.
There's that famous case where a Turing Pharma skyrocketed price of Daraprim that only they were manufacturing because, well, they could get away with it.
"Insulin is at least twice the price"
If we have an international free market that encourages 10+ competitors that aren't banned from producing insulin due to patents, then price fixing becomes impossible.
So if government just got out of the way (in this case - patents and banning imports), you could import cheap insulin from anywhere and the problem would be completely solved.
Why else would gov arrange things this way of not at the direct [but covert] behest of the pharma corps? Do you think they're doing it (having overinflated prices for age-old life-saving medicines) to help citizens?
You see this playing out everywhere; e.g. agriculture subsidies in rich countries, which just serves as protectionism for domestic farmers at the expense of poor-country farmers. The fundamental causal factor here is the large and powerful state - private, autonomous actors will always try to corrupt and co-opt the state's powers for their own benefit (whether that's farmers, pharma corps, oil companies, hedge funds, tech firms, or whoever), so laying the causal blame at their feet is misguided since their attempts to do so are inevitable. It's a government problem.
edit: reading further down the article, there is an advert for an antipsychotic medication which offers a $15 discount on your copay. This particular medication has serious discontinuation effects, it's not something you can just stop taking and it's not something that is prescribed lightly in the first place. Offering a discount for the first few doses is plainly exploitative.
Let's say the most common, first prescribed drug for your condition is available in a generic, for $0.30/month. That's not entirely hypothetical, that really happens.
A naive person would say "ok, if the generic is so cheap, then the brand name can't be much more, can it?" - free market competition, the FDA ensures they're all equivalent, blah blah blah.
However, I noticed that in recent years, the alternatives to the dirt cheap first-line option are way more expensive and going up. So I thought about why.
It occurred to me, that a simplistic view of competition ignores the fact that the different options are not exactly in competition at all. Because everyone tries the cheap one first, and then if they have problems or it's ineffective, they try another.
This means that fundamentally the drugs which are supposed to be in competition are not in competition practically speaking. If you have a drug that is not the first option, then you might as well charge $1000/month because everyone who is a possible customer already by definition has given up on the cheap one.
And even worse, in order to justify (for example) $1000/month, you don't have to have something better, just different enough to give people a little hope. They proliferate, but it's not progress.
Not all bad it seems!
- Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit.
- Many physicians thought that DTC ads made their patients more involved in their health care.
- Physicians thought the ads did not convey information about risks and benefits equally well.
- Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked.
- The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated.
- Doctors believe that patients understand that they need to consult a health care professional about appropriate treatment.
[1]https://www.fda.gov/drugs/information-consumers-and-patients...
https://www.health.harvard.edu/blog/millions-skip-medication...
"Died because couldn't afford inhaler" will bring up some fairly good hits.
Things have been fairly good, and are always mostly getting better - but damned if we couldn't be so, so much better than we are given the other things our country fronts billions upon billions of dollars for is the idea always lingering in my and others minds.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/
> When Purdue Pharma introduced OxyContin in 1996, it was aggressively marketed and highly promoted. Sales grew from $48 million in 1996 to almost $1.1 billion in 2000.1 The high availability of OxyContin correlated with increased abuse, diversion, and addiction, and by 2004 OxyContin had become a leading drug of abuse in the United States.
The one case I think drug ads are legitimate is when it's a dramatic improvement in treatment for a live-with-it type condition. The prime example would be Viagra--before Viagra there were not any good options, a patient very well might not mention it to their doctor so the doctor wouldn't know to suggest it. Thus "talk to your doctor about new options for erectile dysfunction" ads should have been acceptable to run for a while. I'm not sure what the medical situation was when the overactive bladder ads were coming out, that one might also be acceptable. I can't think of anything else right now.
Are you serious?
This is why I stopped doing this on Instagram.
Do they increase or decrease the targeting of ads towards the types of people who say that they don't want to see these ads?
"How Big Lighting finds users with blown bulbs on Facebook"
"How Big Chocolate finds users with cravings on Facebook"
I suspect that this is how Facebook justify some of these things. They don't explicitly provide data, anything that advertisers choose to intuit from data is up to them. But I think this is a fundamental misunderstanding (or unwillingness to understand) privacy.
Privacy needs to be treated like a security concern. It basically is one. In security any place where more information is disclosed than intended is considered to be a security flaw in some sense. If there's a correlation between likes and health concerns that allows for statistical inferences about users health, that's a security flaw.
The thing about security like this is that it takes active work to solve these sorts of problems. Facebook are only doing the "passive" work of not giving advertisers the exact data. A counter example is Apple's "differential privacy" which does a lot more work to only preserve very specific tracking information and statistical properties.
Because first and foremost, FB doesn't have explicit health data.
> If there's a correlation between likes and health concerns that allows for statistical inferences about users health, that's a security flaw.
Then any information is a security flaw.
Just being male/female or age alone allows for significant inferences about users' health. Not many 18 year old women are gonna click on those prostate exam ads. Similarly, those interested in body building probably won't be interested in "fat burning" pills, and those following transgender-themed pages are gonna be more interested in HRT ads.
Frankly that's all that digital marketing should be (a button PMs press, not a division at every company), I'd rather one or two highly regulated and excruciatingly scrutinized companies manage all the details than millions of small shitty ones that nobody pays attention to. I fully agree with everyone including Kara Swisher that FB is not as regulated as it should be, but that model does seem ideal to me if we can figure out the regulation.
If advertising is forced back into being based on the content you are currently viewing or the site you are currently on or the key words you typed into the search bar ... this levels the playing field for all advertisers and ends the adtech arms race.
Who writes/designs the ads that are served? Who decides how much revenue is spent? Who interprets the reported revenue? Who decides whether the ads are working? Who sets the strategy for the next round of ads?
But why target patients? Patients usually don't decide on the drugs they take, doctors do, they should be the target, not patients.
So maybe we can take things at face value, big pharma is not targeting cancer patients, instead they are targeting those who are the most likely to have an interest in cancer besides patients: health professionals.
Note: I don't live in the US, and generally, only doctors get ads about prescription drugs, I heard the situation is different in the US for some reason.
* At least one approved use for the drug (the actual medical condition that it has been tested for)
* The generic name
* Nearly every side effect the drug can give you. There are some side-rules on that one.
Essentially: they said commercials have A and B, you said that's untrue because comercials have to have A, B, and C.
https://www.fda.gov/drugs/prescription-drug-advertising/pres...
This is the whole part of internet marketing targeting right? You don't know for certain if someone is a cancer patient without their medical records, so you record a load of signals and infer that someone is likely to require cancer medication in the absence of absolute information.
Most have terrible insurance plans or no insurance at all and I have to use whatever is cheapest on Walmart/Publix/Winn-Dixie standard formulary.
Other towns or specialists may have different experiences.
Source: me, small town MD.
This brings patients to doctors, then they get lab work done and finally the use of drugs. That activates the full value chain of the system meaning that all the participants in that chain get paid.
Sure, the goal is to sell stuff and make money, but if it makes people healthier, we shouldn't complain. It is only a bad thing if it results in a less effective treatment.
Per @refurb in the comments, when people have an "interest" in a medical condition, they almost always actually suffer from that condition.
It's almost like the algorithms are in charge over there, unsupervised.
Living in a country where advertisements of pharmaceuticals are allowed, it's unbearable. Basically Facebook in real life - in TV, on billboards, in newspappers, YouTube ads, omnipresent leaflets. All flavours of dietary suplements, Rutin and Ibuprofen products, cures for fungal and intimate infections, wonder cures for liver and joints, "digestion catalysers". They're throwing the most awkward and malignant stuff at everyone. Pharma industry is malicious scum and has to be kept on short tight leash.
That sounds a bit anti-vax.
They lied in their submission to get it FDA approved. And that massive black box only appeared 20 years after the introduction of the drug.
As I said, they place profit over the wellbeing of people. That doesn't mean they don't save lives, but if it's more profitable to save fewer they'll generally prefer that route.
Yes, I provided just one example. Here's another one, trying to ensure patent rights on the covid vaccine. Or the common practice of releasing a slightly different version of a medication when the patent expires.
>just trying to pay the scientists to create the discoveries and profit to fuel even more molecule research and discoveries?
Then why do they have a marketing department and a lobbying budget? They have repeatedly shown they require heavy regulation.
Plus, the fact that you can advertise extremely harmful drugs such as alcohol (or gambling) at all, not to mention do so precisely to those you figure are more susceptible to this manipulation is pretty disgusting in itself.
I've legitimately never seen an implication other than "I'm uncomfortable with it" that isn't illegal.
>Plus, the fact that you can advertise extremely harmful drugs such as alcohol (or gambling) at all
Yeah, advertising those things at all should be illegal.
On the other hand, whenever I really wanted to spend spare money, say on new games or movies or music, every fucking company tries to put as many hindrances in my way as possible: The search systems of almost all stores is terrible and their filtering options are crippled.
With the exception of Steam, every store I’ve tried makes it really hard to find items matching some specific criteria.
Way to go ya Silicon Valley nincompoops. /clappingemoji
How about instead of pillaging my privacy to try to inaccurately infer what I like, why the fuck not just let me TELL you what I like?
Or perhaps you see the ads because you are open about your recovery. If the relapse rate is high, you will be blanketed with such ads.
FB's targeting AI is pretty good. Even people recovering from alcoholism were being targeted, the advertisers might not even know it.
Take a look and good luck man.
But as someone who’s got a lot of sweat equity in seeing FB ads pay for all that long-haul fiber that HN smart asses take for granted, FB is on legitimately thin ice here. It’s possible for someone with a blog to learn things about a cookie that shouldn’t be shared. What FB can know and what FB should know, and what FB will admit to knowing are potentially all different things.
FB should learn to forget medical data, sexual data, political data, etc. etc.
The short term erection some lit major at an agency gets from seeing some intrusive targeting option is not worth the trust that FB has somehow managed to maintain with most real users. And if you’ve got a new take on why FB sucks and turned down an offer, feel free to take it there. The world has more than enough “I’m angry at leetcode” deep threads.