The Answer to Your Question.

Didja' ever wonder why those drug companies are running all those high-zoot commercials on TV for diseases you ain't got?

I'll betcha' you've asked yourself that, right?  Well, Fellow Patriots, I have the answer.

I was hired way back when by a division of the Pfizer Pharmaceutical Corporation.  To travel to all those small towns in Kansas and Nebraska, just me and my company car, pitching their drugs to small town doctors.  Usually old-timers, set in their ways, who don't like to be told how to practice medicine by some young whippersnapper.  Like I was.  It's sort of like being a reasonably well-paid traveling masochist in a suit.  They called me a "Pharmaceutical Manufacturer's Representative."  

The doctors called me a "Detail Man."

And that's what I was paid to do.  Try and "detail" all the country doctors on why my stuff was better than the other guys' stuff.  All the gory details, like why my stuff won't cause the patient's kidneys to shut down while curing his infection.  Or also make him go blind while trying to fix his arthritis.  

Oh, and also drop off trunk loads of samples for him to give as starter doses to his patients.  Giving away expensive drugs.  Which he can use to keep his patients loving him.   

So I was driving about 50,000 miles a year, from town to town, staying in crappy little motels, eating in "Maude's Diner," handing out samples and talking medical jargon to the doctors.  Many became friends.  Some were frankly dismissive of us "detail men" as a group.  Can't see why?  After all, I had two full weeks of training on how sell supremely complicated stuff to doctors in a 33-story skyscraper in Midtown Manhattan!  

Even though I won a .30-30 rifle and a set of Delft Blue China and a trip to Las Vegas, 1st class, for being the tippy-top salesman, I thought the whole thing was a goof.  I only went through these motions as a stepping stone to other greatness to follow.  Which it most assuredly did.  More on that later.  But in the meantime, I thought it was a waste of time, effort, energy and money for all concerned.  

Apparently the drug companies ultimately did as well.  Because once the Federal Gubmint loosened the regulations concerning the advertising of prescription medications on the airwaves, the Big Drug Companies began shifting their promotional dollars to TV and away from detail men.  Here are a few examples of the expenditures on TV adversing for 2023:

     -  Mounjaro.  Eli Lilly, $184,000,000

     -  Rinvoq.  Regeneron, $315,000,000 

     -  Duplixent.  Sanjo, $305,000,000

     -  Jardiance.  Eli Lilly, $145,000,000

     -  Rybelsus.  Novo, $123,000,000

     -  Ozempic.  Novo, $157,000,000

And once again, that's annually!  Just exactly what, you might reasonably ask, could advertising a drug on TV at $25,000 a spot, for a disease you don't have, nor does anyone you know, and you can't even pronounce, can possible make any sense at all (yes, I love long sentences)?  I mean, some of these drugs are for "1 in 10,000" population diseases!  The really rare illnesses for which there has been few treatments.  Well, Fellow Patriots, here's how:

It now takes an average of an astonishing $1,000,000,000,000, that's with a very Big "B," to bring a new drug to market.  And it can take as long as 20 years to identify a novel drug for a specific illness, and then test it over a series of multi-patient trials to find out if it actually works.  And then hire well-respected physicians to write articles for the peer-reviewed periodicals proving its efficacy.  And then, if it works, determine the cost of manufacture and distribution, in differing quantities, against the anticipated utilization if actually prescribed.  And then run it through marketing to determine if, and only if, there's a market out there for what the drug purports to affect. 

Not necessarily "cure," just positively affect.  

And after all of this, perhaps $800,000,000 to $1,000,000,000 of investment and years and years of testing, upper management has to decide whether to take the plunge.  To gamble.  To bring it to market.  And then HOW to bring it to market.  Over what period of time and using which marketing tools.  And most importantly, at what cost?  

Some of these drugs fail.  But some win.  And BIG!  And I argue that the ones which win most for their corporations are the ones used for other than their primary indications.  So called "off-label" uses.  And the doctors have to prescribe those medications for those "off-label" uses!  The ones where the market actually exists.  Knowing they're doing so!  They're in on it!  They're complicit!  

And the Big Drug Companies have become smitten with the idea that a new drug for Bacteroides Melininogenicus, or Chronic Inflammatory Demyelinating Polyrediculopathy, or some such, will find enough citizens suffering from the symptoms of those diseases, because of a TV commerical, to make it all worth while.  Especially if they have a team of fat dancers and a whole chorus of singers blasting out great original, catchy tunes!  So they'll run right down to their doctor's office and demand this new drug!  Today!  

The Ozempic TV commercial, the one with the fat babe in the blue pantsuit, cost more than $1,000,000 to produce!  Get it?

And their doctors, generally a bunch of spineless wussies (sorry, I've known over 10,000 of them, and truth hurts!), will acquiesce, figuring it's better to just grant their whiny wishes and keep the patient.  Which can be worth $Big Bucks.  And because he knows they'll go find another doctor if he doesn't write the script.  

Like Ozempic!  Which is for diabetes.  But has a "side effect!"  It keeps the gut from adsorbing nutrients.  Forcing the pounds to fall off while you keep on stuffing your fat face.  By basically starving you.  And making you sick to your stomach all the time.  And retching up bile.  But Oprah lost like 700 pounds on it, so why not?  Get it?  "It's better to look good than to feel good!"  So all of Hollyweird is main-lining Ozempic, and Novo Nordisk's stock has doubled.  And it's CEO just ordered a new Mega-Yacht.  Thanks to those annoying commercials.  You know, the ones you just tune out.

Another?  Of course.  Ever heard of Sildenafil?  You might know it under another name:  "Viagra."  Sildenafil was developed to lower blood pressure.  But they discovered during the drug trials that it gave male patients gigondo erections!  Hence, they marketed it for blood pressure, but "wink-wink," the doctors all prescribed it for Erectile Disfunction.  And it became a $1 Billion Dollar Drug.  A home run!

Ya' get it?

So they no longer need poor schlubs like me out there to try and pitch their products mano-a-mano to folks who don't like them anyway.  They spend their $Millions micro-slicing and dicing the TV watching public, looking for that tiny few who can $Ring Their Dinner Bell.

Thankfully I moved on before this earthquake took place.  I spent an entire career thereafter providing "Mobile Acute Hemodialysis, Hemoperfusion and Therapeutic Apheresis" to dozens of Los Angeles and Orange County hospitals.  My sainted wife and I created an entirely new category of healthcare delivery by bringing hemodialysis to the hospitalized patient, rather than the other way around.  Benefiting not only the patient and his family, who could remain local, but also the smaller, community-level hospitals who retained the revenue stream.  And we treated more than 10,000 patients over our nearly 40 year career.  And many of those patients are still alive today solely because of our services.

We also had more than 50 Registered Nurses and 3 technicians, as well as 4 office personnel as staff members, and 3 doctors on call during this period.  Not  bad for a country boy from upstate Missouri and a Polish girl from New York City, right?    

I'd just think of it this way:  Be happy the Big Drug Companies are paying the TV conglomerates over $One Billion Dollars a Year to air their commercials.  For drugs you should be happy you don't need and likely never will.  And pay for all those game shows and situation comedies and dramas set in fire departments and police stations you love to watch.  

See?  It's amazing what you can learn by driving from town-to-town, talking to country doctors who don't like you...