[HN Gopher] How pharmaceutical companies find sick users on Face...
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How pharmaceutical companies find sick users on Facebook
Author : atg_abhishek
Score : 181 points
Date : 2021-05-07 06:49 UTC (16 hours ago)
(HTM) web link (themarkup.org)
(TXT) w3m dump (themarkup.org)
| unyttigfjelltol wrote:
| Facebook is disclosing to third parties that its users have an
| "interest" in a medical condition although FB purports not to
| disclose users' medical conditions.
|
| 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.
| yarcob wrote:
| I don't think it's an algorithm, I think it's a bunch of
| executives who think they are really smart because they found a
| loophole in the law.
| cebert wrote:
| I can relate to this from my personal experience of having a sick
| family member. Five years ago, my father-in-law was diagnosed
| with Multiple Myeloma, a rare blood cancer. I was close to him
| and joined several support and information pages on Facebook.
| Since doing that, I see ads on Facebook and elsewhere targeted to
| me as if I too had cancer. Now my father in law has passed, yet I
| still see ads that remind me of the horrible disease he battled.
| dhimes wrote:
| Can you not turn off certain ad types in facebook?
| jack_pp wrote:
| Have you tried telling Facebook to not show you these ads
| through the 3 dot menu in the top right? I don't go on Facebook
| much anymore, just curious
| joncrane wrote:
| Ironically, you are helping Facebook when you do this. Their
| algorithms get tuned by users saying they don't want certain
| ads.
|
| This is why I stopped doing this on Instagram.
| fighterpilot wrote:
| > Their algorithms get tuned by users saying they don't
| want certain ads.
|
| 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?
| fujidust wrote:
| I did this for ALL ads on FB over many months and am now
| relatively as free. It helps that I only visit FB from a
| browser that's isolated from other web browsing.
| pc86 wrote:
| Of course they do. But if you don't want to see a certain
| type of ad, especially one that brings up painful memories
| needlessly, why would you care?
| cebert wrote:
| No, but that's a great idea to try.
| durnygbur wrote:
| > How Big Pharma Finds Sick Users on Facebook
|
| 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.
| logicchains wrote:
| >Pharma industry is malicious scum and has to be kept on short
| tight leash.
|
| That sounds a bit anti-vax.
| pjc50 wrote:
| As usual, the scientific side is (mostly) fine, it's the
| marketing side that's a disaster.
| boomboomsubban wrote:
| The industry has repeatedly put profits ahead of people's
| well-being, Oxycotin being the easiest example. Their actions
| should be met with severe skepticism.
| nceqs3 wrote:
| Revlimid, Humira, Trikafta, I can go on and on. There are
| many, many great drugs that save people's lives. Obviously
| Purdue committed crimes with how they marketed the drug but
| remember Oxycontin was FDA approved and it had a massive
| black box warning that said THIS DRUG IS ADDICTIVE.
| bserge wrote:
| How is that different than any other ads? I'm more sick of car,
| credit/loans and insurance ads than pharma. I ignore all of
| them, anyway.
| durnygbur wrote:
| One example is actors looking like doctors advising
| painkillers as an anwser to back pain or headaches. Together
| with unavailable public and expensive private healthcare
| that's quite toxic mixture.
| toast0 wrote:
| Painkillers are generally effective against back pain or
| headaches. Much fewer side effects than amputation.
| mns wrote:
| I had to come back to my home country for a few weeks now,
| having been away for one year and a half, and it's absolutely
| insane how every ad on tv and radio is for drugs. They even
| target children for car sickness. Instead of educating people
| to avoid these things, everything is: smoke and bad breath, get
| breathazol, drink too much or eat only unhealthy stuff:
| forteliver plus. There was a movement to ban all pharma
| advertising, but the lobbying was just too strong and the
| project did not move forward.
| durnygbur wrote:
| Ah yes, the radio ads - forgot to mention these.
| geoduck14 wrote:
| So vintage!
| viviansolide wrote:
| I didn't know The Markup. The articles and the methodologies used
| are very clever.
| LorenPechtel wrote:
| My wife used to be an example of targeting going really wrong on
| YouTube. She used to only watch stuff in Mandarin (her mother
| tongue)--their targeting had absolutely nothing to go on and thus
| was nuts. I would say the majority of the ads she got were pharma
| ads, but for a whole slew of things. Everything I noticed was
| niche stuff, I would presume groups narrow enough that they did
| some ads aimed on age alone.
| Giorgi wrote:
| what seems to be a problem here? is not this the whole idea of
| the relevant ads?
| Fuzzeh wrote:
| You only have to look at the ads Signal ran to expose this, to
| see the sort of information facebook will give advertisers.
| moksly wrote:
| "If you're a drug manufacturer looking for patients".
|
| 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.
| _jal wrote:
| If you gaze long enough into an abyss, the abyss will gaze back
| into you.
|
| 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.
| [deleted]
| ximeng wrote:
| Interesting article on a Uber for cremations company:
|
| https://www.theguardian.com/global/2021/may/07/funeral-grace...
| gerdesj wrote:
| Replace the word patient with customer or "money".
| anjel wrote:
| I work in a (California) medical facility. "Patient" is now a
| deprecated if not archaic term, no longer used. Patients are
| now properly referred to as "clients" for at least 5 years
| now.
| Arrath wrote:
| While it's all semantics in the world of business speak and
| HR, this feels to me like it orients the relationship as
| any other business transaction.
|
| 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.
| frosted-flakes wrote:
| See also "passenger" vs "customer" on transit systems.
| CapriciousCptl wrote:
| In the US, it's legal to advertise drugs directly to patients.
| There's not a lot of places in the world where it happens, I'm
| assuming Scandinavia is one of them.
| spaetzleesser wrote:
| As far as I know direct to consumer drug advertising is
| allowed only in New Zealand and the US. In most countries
| it's illegal.
| rich_sasha wrote:
| One particularly funny side effect is that the narrator needs
| to read out a comprehensive disclaimer.
|
| 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.
| nkrisc wrote:
| It's bizarre even as an American who is used to it. The
| most amusing thing is they're clearly running out of good
| ideas for names. The names are getting stranger every year.
| They're basically just gibberish now.
| travisporter wrote:
| Otezla (O-Tesla pronounced) for arthritis. No ac current
| involved
| [deleted]
| sslayer wrote:
| It has to be a branding/patenting thing around
| uniqueness. I couldn't imagine trying to come up with new
| website names on a daily basis that would be expected to
| stick in a consumers mind.
| mattkrause wrote:
| There are whole consultancies around picking drug names.
|
| 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.
| dylan604 wrote:
| The big pharmas have a long list of gibberish names that
| has been created. These lists have already been vetted
| for uniqueness, trademark ability, etc. When a new
| product needs a name, they turn to these lists.
| bsenftner wrote:
| Like "Rebelius" - a diabetes treatment for all the rebels
| out there.
| jaywalk wrote:
| It can be even funnier because they only need to read the
| side effects if they say what the drug is supposed to
| treat. Because of that, you get the drug ads that never
| list side effects, but you're left wondering what the drug
| actually _does_ after seeing a bunch of people running
| through fields and hearing a bunch of vague things about a
| better life.
| eplanit wrote:
| Those ads are inadvertently revealing -- they make it plain
| that it's a medical and pharmaceutical _industry_. Let the
| patient be warned not only of side effects but to the
| nature of that industry.
| yardie wrote:
| It was a culture shock to me as an American that moved back
| to the US. Turned on regular TV only to see shows
| constantly interrupted by commercials. After that I put the
| STB in the closet and use streaming services.
| dhimes wrote:
| It reminds me of the "Happy Fun Ball" ad parody on SNL
| years ago.
|
| https://www.youtube.com/watch?v=GmqeZl8OI2M
| dylan604 wrote:
| There are other fun examples of these extremes. WebMD will
| pretty much always suggest cancer as a cause of whatever
| subject you researched. Most of the pharma ads will include
| "death" as a possible side effect. however, a possible
| death side effect was much less of a death knell than when
| olestra had to include anal leakage as a possible side
| effect.
| drdec wrote:
| My favorite part is when they tell you "Don't take
| Oprexmia* if you are allergic to Oprexmia".
|
| * 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.
| dylan604 wrote:
| I guess these would be considered as proper nouns thereby
| making them invalid Scrabble words?? Otherwise, hit a
| tripple word score, and essentially do a mic drop with
| these when played.
| moksly wrote:
| Maybe it's because of how we buy prescription medicine.
| You'll get the prescription from your doctor, and then go to
| a pharmacy where they will default to offering you the
| cheapest brand available at the time of your purchase, and
| ask if you're cool with that.
|
| 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.
| Broken_Hippo wrote:
| Honestly, the differences between filling something in the
| states and Norway isn't that big - get a thing from the
| doctor, go to the pharmacy, and get the cheapest option
| (with a few exceptions). The pharmacies usually ask me if
| the generic is OK (some people care, after all).
|
| 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).
| naturalauction wrote:
| I don't think it's only that - there are plenty of ads for
| medications with no generics. I think it's also because
| doctors may usually prefer one treatment for an issue, but
| if you mention another treatment you found (either via ads
| or your own research) they might be willing to prescribe
| that instead. Hence the common ad copy "ask your doctor if
| _____ is right for you."
| brianwawok wrote:
| Very few drug commercials are for drugs with generics. They
| almost always hold a monopoly position.
| [deleted]
| naturalauction wrote:
| Patients and doctors need to know about a medicine to prescribe
| it. In order to increase brand awareness, drug companies can
| either advertise to or incentivize (free trips to conferences,
| consulting gigs) doctors to prescribe a drug or get patients to
| directly ask their doctor for a drug.
| dan1234 wrote:
| Doctors do, but I'm not sure patients will ever have enough
| knowledge to be able to make an informed choice.
| moksly wrote:
| Do doctors prescribe brands in America? Here they'll
| prescribe you with the working substance, and unless it's
| still patented (which most of them aren't) then you'll just
| get offered the cheapest brand at the pharmacy by default.
|
| 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.
| theonemind wrote:
| They often prescribe brands in the sense that they will
| literally write the brand name in their own hand on the
| prescription, and that is technically literally exactly the
| prescription. However, the pharmacy can substitute a
| perfectly equivalent drug on its own recognizance based on
| the doctor's prescription, but the distinction seems to
| technically exist. (The pharmacist position takes a lot of
| study and licensing as well.) I believe a doctor can or
| could write "no substitutions", but things aren't quite bad
| enough that a doctor would risk their license to do that to
| bolster sales for a brand or block a patient from receiving
| generic medication--they'd need some kind of concrete
| reason, like knowing or suspecting a patient is allergic to
| an inactive ingredient. (It's all theory, because our
| doctors are overworked and would never pay that kind of
| attention.)
| Broken_Hippo wrote:
| Sometimes they do, but often they tell the pharmacy that
| they can use the generic (and most folks seem to want
| generic). Occasionally, they insist on the brand, but this
| is more often because while most generics are the same,
| sometimes there are differences. Lithium, used as a mood
| stabilizer, is the example I can think of, but is far from
| the only one.
|
| 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.
| Mauricebranagh wrote:
| For some specialised conditions in the UK - they actually
| do prescribe exactly the brand/version.
|
| For my posttransplant meds some of the are explicitly
| "must" be this version. Also some meds (anti rejection) are
| dispensed direct from the hospital
| Retric wrote:
| Few new drugs get invented each year and most are either
| slight modifications to existing drugs or highly specialized.
| Doctors can easily keep up with zero advertising needed.
|
| 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.
| Anarch157a wrote:
| I wouldn't like to be severed by a drug. I prefer my body
| to stay in one piece, thank you.
|
| 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.
| refurb wrote:
| I've interacted with a lot of doctors in my job and no,
| most doctors aren't that aware. You'll get the doctors
| involved in research who know all about the drugs years
| before they are approved, but those are a handful. Like
| most people who have jobs you focus on the here-and-now and
| while "yeah I'd love to read up on that new drug, but I
| don't have time".
|
| 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.
| naturalauction wrote:
| Oh I agree that it's a complete racket that hurts patients,
| I just wanted to provide some rationale from the drug
| company's perspective.
| smcl wrote:
| Did you fill your date of birth on any age-protected content
| (websites for distilleries or breweries, for example) as 1st
| January 1940 or something? They could just mistakenly believe
| you're 81 based on that :)
| moksly wrote:
| Well I've had a friendly hemorrhoid for a few years that I
| frequently see a lovely anal surgeon for and I probably have
| some "this might be cancer" search entries from a few years
| back, but it's been so long that I should've died by now if
| it was actually cancer down there.
|
| Other than that I have no idea heh.
| [deleted]
| designium wrote:
| But it could be similar to the case where Target was able to
| targets ads to women who did not even know they were
| pregnant.
|
| 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. -\\_(tsu)_/-
| ju-st wrote:
| The target story is nice anecdote but it's unlikely that
| they figured out that the daughter is pregnant:
| https://medium.com/@colin.fraser/target-didnt-figure-out-
| a-t...
| Accacin wrote:
| Yeah I can't believe people are still parroting this at
| all.
| kalleboo wrote:
| > _But it could be similar to the case where Target was
| able to targets ads to women who did not even know they
| were pregnant_
|
| In this case, _she_ knew she was pregnant. Her family didn
| 't.
| mbg721 wrote:
| For every "Big Tech figured out my diagnosis before I did"
| there are a thousand instances of "You just bought a fridge
| --I bet you love buying fridges, here, let me show you
| some".
| Retric wrote:
| People do take products back they don't like. So
| statistically it's not as unlikely as you might think.
| ipython wrote:
| More realistically you should tag the users profile to
| show them fridges in about 3 years when it first starts
| to either experience minor mechanical issues or starts to
| look "dated". Just tag with refrigerator_2025 or
| something.
| LorenPechtel wrote:
| The really nutty one I've seen--Amazon apparently only
| looks at correlation without regard for causation. Buy
| ink, it starts showing you printers that use that ink.
| nkozyra wrote:
| I'm in my early 40s and just got shingles. Based on my
| googling the past few weeks I expect AARP and mechanical
| stair chair ads any time I'm not using adblock from here on
| out.
| sildur wrote:
| I guess you will also start getting more "shingles in your
| area" ads.
| zo1 wrote:
| Only if Sean Connery is the ad manager.
| okareaman wrote:
| I like targeted ads. I just wish they were better. For example I
| am open about being in recovery for alcoholism on FB but they
| still show me ads for hard liquor.
| pjc50 wrote:
| No, that's definitely a targeted ad at you. You relapsing would
| be profitable.
| timoth3y wrote:
| > I am open about being in recovery for alcoholism on FB but
| they still show me ads for hard liquor.
|
| 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.
| okareaman wrote:
| I hadn't considered that. That would be evil, so I need to
| pay more attention to when this happens and try to understand
| it better.
| Razengan wrote:
| "Targeted" ads have _-never-_ shown me anything I actually
| wanted to buy.
|
| 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?
| jmfldn wrote:
| I guess a simpler fix here would be to explicitly opt out of
| certain classes of ads eg gambling / alcohol. It feels like we
| should have rights not to see ads for damaging products.
| andrepd wrote:
| I'm afraid you might not be seeing beyond the first-order
| effects: "ads are annoying, relevant ads are less annoying,
| therefore I like surveillance!" Consider all the implications
| that ubiquitous surveillance by unaccountable private entities
| carries.
|
| 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.
| okareaman wrote:
| Calling it surveillance is like Steve Ballmer saying about
| Google "we don't read your email." No human at Google is
| reading my email. They are scanning it and associating
| keywords to my account. Do this make me a marked man? Some
| might feel that way, but this technique is not very accurate
| and is only used to show me ads when they are going to show
| me ads anyway. Ads are part of the current reality whether we
| like them or not. Why not prefer relevant ads?
| TchoBeer wrote:
| >Consider all the implications that ubiquitous surveillance
| by unaccountable private entities carries
|
| 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.
| andrepd wrote:
| Many such examples:
| https://theintercept.com/2016/04/28/new-study-shows-mass-
| sur...
|
| http://www.gnu.org/philosophy/surveillance-vs-
| democracy.html
| benreesman wrote:
| Anyone who wants to can scroll through my comment history and see
| that on average I'm the ex-FB guy defending FB. And usually the
| claim or accusation is debatable, if not dubious.
|
| 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.
| [deleted]
| GuB-42 wrote:
| Is there some proof that big pharma really targets sick people?
| The article mentions targeting for things like "cancer awareness"
| as a proxy for cancer patients.
|
| 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.
| dave84 wrote:
| When I visited the US a few years ago it seems like every TV ad
| break there was a "Feeling X, ask your doctor about Y". Where X
| was some generic condition like bloating or feeling old, and X
| was a brand name prescription drug.
| senbarryobama wrote:
| This. Why is this the case?
| SargeZT wrote:
| I can categorically say that is untrue. While not a fan of
| direct pharmaceutical marketing, the FDA has strict rules
| about what needs to be in an advertisement. Chiefly, it must
| address:
|
| * 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.
| dave84 wrote:
| I'm sure the paragraph of tiny text at the bottom of the
| screen technically met the above requirements. Doesn't
| change the substance of the advert.
| meowster wrote:
| How can you categorically say that is untrue while not
| providing any evidence to the contrary, but in fact confirm
| the other person's observations?
|
| Essentially: they said commercials have A and B, you said
| that's untrue because comercials have to have A, B, and C.
| SargeZT wrote:
| The OP said 'generic symptoms.' There are no prescription
| drugs for 'generic symptoms', they must have a specific
| approved use and they must be mentioned verbally in the
| commercial. Here is the evidence to the contrary:
|
| https://www.fda.gov/drugs/prescription-drug-
| advertising/pres...
| kfarr wrote:
| Yeah but let's be real, while the "specific approved use"
| might be clear to a medical practitioner in a journal
| write-up related to FDA approval, the actual prescription
| ads shown to normal people attempt to use as general
| simple wording as possible to describe symptoms. To
| laypeople these start to blur together to very simple
| statements like "feeling tired? Worried about excessive
| weight gain?" While these might be symptoms of a specific
| FDA approved use of the drug, it results in an atmosphere
| of confusion for normal folks.
| designium wrote:
| The ads are effective to bring awareness. There are doctors who
| will "help" patients to discover if they have conditions to
| warrant the use of the drugs they saw on TV or social media
| ads.
|
| 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.
| GuB-42 wrote:
| So, in the end, it is not a bad thing if it gets patients to
| be treated early.
|
| 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.
| varispeed wrote:
| The patient can say to the doctor "I feel that X drug may be
| better for me than Y". Sure, ultimately it's the doctor
| decision, but if patient puts enough pressure and the doctor
| thinks that there is no material difference between X and Y
| except e.g. price, they may side with the patient for the sake
| of their peace of mind. You know the placebo factor etc.
| vanc_cefepime wrote:
| This is true, but not as frequent in my rural town in my
| experience.
|
| 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.
| Closi wrote:
| Is there a practical difference between intentionally targeting
| cancer patients and intentionally targeting proxy signals for
| cancer patients?
|
| 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.
| dools wrote:
| The article seems to suggest this is a bad thing, but my first
| reaction is "fantastic". Pharmaceutical companies create life
| saving medicines and then use advanced social media targeting to
| locate the people that need them.
|
| 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?
| thomasedwards wrote:
| Or, I go to a doctor, who is a medically trained professional,
| and they prescribe a medicine to me based on their experience
| and training, without any incentive for financial reward?
| jaspax wrote:
| Do you think that doctors don't have financial incentives to
| treat patients?
| Bancakes wrote:
| No, I don't pay the doctor, the healthcare pool does. And
| then, the doctor is incentivised to cure me, not keep me in
| a perpetual drug-purchasing lifestyle as big pharma would.
| varispeed wrote:
| Doctors get cash and hospitality benefits from big pharma
| though based on how they prescribe. If there is drug X
| from company Y and drug A from company B and then there
| is no difference in therapeutic benefits between two
| drugs, but company B gives doctor cash and has access to
| regional sales data where the doctor operates, they can
| modify the benefit based on sales. Then the doctor is
| incentivised to prescibe the A. This may be harmless, but
| if the doctor gets into a financial trouble or simply get
| overwhelmed by greed, this can quickly turn into
| something that harm patients. In my country doctors don't
| have to disclose those relationships and they don't even
| have to declare this as income.
| robbiep wrote:
| This is absolutely not true in most countries. Where I
| practice you can get into big trouble for this. You have
| do declare pharma affiliations, cannot accept sponsorship
| and the age of junkets through drug companies is long in
| the past.
|
| I could be deregistered if I was found to be accepting
| anything (travel, hotels, conferences) and not declaring
| it
| murukesh_s wrote:
| Wondering which country you are? can add it to the bucket
| list of countries to retire in.
| robbiep wrote:
| Australia. This is the rule in most developed world
| economies, although I have to admit complete ignorance of
| the US (... the largest developed world economy)
|
| 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!
| varispeed wrote:
| Great that your country stamped this out, but I am afraid
| you are the minority. Pharmaceutical industry is the most
| corrupt after politics and army and almost no doctor is
| immune to bad influence. Straight up denial is actually
| harmful in getting the truth out there and fixing the
| problem.
| Bancakes wrote:
| In my country, general practitioners can only prescribe a
| limited number of drugs and specialist visits a month, so
| as not to overwhelm the healthcare system. It's their
| moral choice to deem a person sick enough for a certain
| course of action.
|
| 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.
| throwaway3699 wrote:
| Not where I live. This is a uniquely US problem among
| first-world countries.
| mrweasel wrote:
| Technically I don't think it's unique to the US. In
| Denmark doctors get a fee per consultation. It's pay with
| tax money, but still the doctor is financially motivated
| to see patients. It might only apply to general
| practitioner though, I think hospital doctors are on a
| fixed salary.
|
| 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.
| varispeed wrote:
| The doctor can also put a generic name of the drug on the
| prescription and patient can tell the pharmacy to sell
| them a particular brand instead of a generic. So there is
| space where such direct advertising could work.
| isaacremuant wrote:
| Ireland is extremely for profit in everything they do and
| very poor compared to many places in Europe in terms of
| response and quality.
|
| People just assume a lot about the world.
| entropyie wrote:
| I don't think it's fair to put Ireland in the same
| category as the USA here:
|
| 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.
| nceqs3 wrote:
| Poor people in the US also get free everything...
| isaacremuant wrote:
| I was curious about another HN poster from Ireland so I
| looked at your other comments and you're defending RTE so
| it's safe to say we won't see eye to eye.
|
| 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.
| refurb wrote:
| A financial incentive to treat? No, that's pretty common
| across healthcare systems. It's being worked on as system
| move away from fee-for-service, but generally, the more a
| physician does, the more they make.
| johannes1234321 wrote:
| They should have an incentive to treat them, they shouldn't
| have an incentive to suggest specific medication.
| waterhouse wrote:
| For what it's worth, it seems doctors are heavily
| advertised to: https://slatestarcodex.com/2019/05/22/the-
| apa-meeting-a-phot...
| wiz21c wrote:
| My doctor is certainly not backed by investors who are
| putting her under pressure if she doesn't make 10% ROI.
| bmj wrote:
| _without any incentive for financial reward?_
|
| Except when they do get financial rewards?
|
| https://www.nytimes.com/2019/05/02/health/insys-trial-
| verdic...
| bserge wrote:
| You need to go to a doctor anyway. Not all of them are good,
| and imo they shouldn't have absolute say in what you take. If
| you suggest some medication you saw an advertisement for,
| they should take it into consideration instead of telling you
| to stfu about it. Yes, my experience with doctors has been
| terrible.
| lozenge wrote:
| You appear to be assuming the advertisement medically benefits
| a patient.
|
| 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.
| toast0 wrote:
| There's some benefit to the patient if the drug is effective
| treatment for a condition they knew they had but didn't know
| there was treatment for. Or if it's a new thing that treats
| something where the old treatment didn't work well or had
| bothersome side effects for the patient.
|
| 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.
| helloworld11 wrote:
| I don't know why you were downvoted into the grey zone. I don't
| entirely agree with your points about Big Pharma finding needy
| patients instead of doctors prescribing based on professional
| experience (though there's still plenty of room for bias there
| too) but overall, fully agreed, the pharmaceutical industry is
| a wonderful thing on the whole, and while it gets a lot of
| knee-jerk hatred from too many people, i'd love to see somebody
| suggest something practically better (as opposed to ideally
| better based on their limitless dreams of a perfect world).
| Ensorceled wrote:
| Maybe the bribery to get your Doctor to recommend a different
| drug than is probably best for you or your pocket book?
|
| 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.
| fighterpilot wrote:
| "Insulin is at least twice the price"
|
| That is the government's fault. What's the reason you can't
| import extremely cheap insulin from overseas? The
| government has endowed a local monopoly.
| Ensorceled wrote:
| I don't think you can entirely blame unethical, predatory
| behaviour on the government that enables it.
| fighterpilot wrote:
| It's not a government that enables it, it's a government
| that _enforces_ it through laws that guarantee and endow
| a local monopoly. Whenever you have an endowed monopoly
| without substitutes, you have extremely high prices. It
| 's econ 101 and will happen 100% of the time (that's why
| I call it enforcement instead of enablement). If the
| government just got out of the way, the price of insulin
| would _plummet_.
| yarcob wrote:
| What's stopping US companies from competing based on
| price? There's multiple producers of insulin in the US.
| Why do you need a foreign company to undercut them? If an
| international market would fix it, why doesn't the
| national market fix it? Why doesn't one of the US
| companies charge less than the others?
| fighterpilot wrote:
| Because of price fixing among the 3 big insulin
| providers, which is only possible in an environment where
| competition is heavily constrained by monopoly powers (or
| in this case, oligopoly powers) endowed by governments
| through the patent system.
|
| 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.
| pbhjpbhj wrote:
| So you think it's an accident that pharma corps make lots
| more money under the regime enforced by government? Or,
| possibly the pharma corps have engineered this situation
| politically (ie 'buying' politicians in some way -
| campaign donations, advisory jobs, etc).
|
| 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?
| fighterpilot wrote:
| It's as you say - crony capitalism and corporatism. The
| politicians/government are corrupted and bought by pharma
| corps to create a situation where competition and the
| free market is stifled, which leads to high prices as the
| inevitable consequence. It's a principal-agent problem in
| the context of having a large state/government with
| extensive powers to interfere in private business.
|
| 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.
| pjc50 wrote:
| Has everyone forgotten the OxyContin scandal? Or are we just
| all grateful that Big Pharma has saved us from the pandemic
| that we're going to overlook the past specific, illegal,
| actions of pharmaceutical marketing?
|
| 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.
| fabcomm wrote:
| The vaccine has me thinking of these things, and my reaction
| was closer to yours. I don't think ads here are fantastic. What
| I think is fantastic is companies wanting to remove the "dis"
| from "disease". But we must not rely on pharmaceuticals. They
| are just a few tools in the tool belt of healing.
| ceilingcorner wrote:
| Have you heard the expression, "A solution in search of a
| problem"? Because that what this is. Multinational billion-
| dollar corporations using their marketing dollars to convince
| people that their pill is the solution to all of your problems.
|
| This should be illegal.
| StreamBright wrote:
| Yeah so I guess the users have nothing to say in this. If I
| walk in to store they supposed to know what I want and a clerk
| puts the items into my basket and kicks me towards the
| checkout.
|
| Are you serious?
| refurb wrote:
| Let's go ahead and see what the FDA found out about direct to
| consumer (DTC) advertising of drugs as they've conducted
| numerous surveys[1].
|
| 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...
| rozab wrote:
| Why on earth should the patient choose whichever drug put money
| into advertising, rather than the one their doctor deems the
| most suitable? How could that possibly be beneficial?
|
| 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.
| s5300 wrote:
| If the blue tool you're talking about is an inhaler, I'm happy
| for yours being $6, as was mine I believe, but some still
| aren't so fortunate. They still go for $300-$500 for some
| people, in the U.S.
|
| 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.
| LorenPechtel wrote:
| In almost all these cases the doctor should know what the
| patient needs, pushing patients to ask their doctors about
| certain medicines.
|
| 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.
| Wolfenstein98k wrote:
| "How Big Auto finds users with car troubles on Facebook"
|
| "How Big Lighting finds users with blown bulbs on Facebook"
|
| "How Big Chocolate finds users with cravings on Facebook"
| Uberphallus wrote:
| You beat me to it. Digital marketing 101.
| cornel_io wrote:
| How anyone finds users that will buy their products on
| Facebook: serve ads, report revenue, and let FB figure out how
| the fuck to optimize it without you doing a goddamn thing.
|
| 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.
| paulcole wrote:
| > that's all that digital marketing should be (a button PMs
| press, not a division at every company
|
| 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?
| Ensorceled wrote:
| Regulation is pretty simple, ban collecting information on
| users behaviour for advertising.
|
| 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.
| kalleboo wrote:
| The difference is that Facebook says they specifically avoid
| sensitive health information
| https://www.facebook.com/business/help/361948878201809?id=18...
| Uberphallus wrote:
| And nowhere in the article it's said that they use sensitive
| health information.
| danpalmer wrote:
| A distinction without a difference.
|
| 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.
| Uberphallus wrote:
| > They don't explicitly provide data
|
| 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.
| bhalina wrote:
| Ughhhhhh
| bhalina wrote:
| Ughhhhh
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