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We dive into the controversial world of direct-to-consumer (DTC) advertising with health reporter Martha Rosenberg. Drawing from her extensive knowledge, Martha unpacks how DTC drug ads manipulate consumers, fuel hypochondria, and create demand for obscure medical conditions. We also explore the alarming tactics behind soap product advertisements, revealing how fear-based marketing plays on common insecurities to sell products.
Martha Rosenberg is a health reporter and the author of Big Food, Big Pharma, Big Lies and Born With a Junk Food Deficiency.
She discusses the KevinMD article, “How drug and soap commercials are manipulating you.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Martha Rosenberg. She’s a health reporter and she’s the author of the book, Big Food, Big Pharma, Big Lies. We’re talking about the KevinMD article, “How Drug and Soap Commercials Are Manipulating You.” Martha, welcome to the show.
Martha Rosenberg: Thank you, Dr. Pho. I’m so happy to meet you after all this time. And thank you. I’m always interested in hearing your perspective. You’ve always written great pieces on KevinMD, and we’re going to talk about one of those today. But before we do, just briefly share your story and journey with my audience.
Kevin Pho: I surely will.
Martha Rosenberg: So, basically my background is in advertising, and that’s why I’m so critical of ads. Especially on TV. However, I also studied pharmacology in medical school, so I’m very well informed on pharmacology.
Kevin Pho: Today’s article, we’re going to talk about how drug and soap commercials are manipulating you. Before talking about the article itself, tell us what led you to write it in the first place.
Martha Rosenberg: OK, well, I listen a lot to radio and TV. And I, they used to call the press, which I’m a member of—the press—I’m a reporter, the fourth estate, but I really believe drug makers and big pharma have become the fourth estate. They have so dominated the news waves that that’s why I wrote my recent article for you about drug and soap. It’s every, it’s every single ad—it’s either for fragrance beads, which I wrote about—
Kevin Pho: All right, and tell us about the article itself for those who didn’t get a chance to read it.
Martha Rosenberg: Well, I’m talking about how I’m offended as a former creative director at McCann Erickson, which is a big ad agency. I’m offended by the manipulation of these ads. I believe that I’m, I’m against direct-to-consumer advertising in general, and what I’m seeing happening is they’re spreading hypochondria.
They’re telling people who feel fine that they have a disease, OK? They take diseases and they give them snappy little initials like EPI or COPD, or even ED is a snappy initial, to sell the disease. But even worse, Dr. Pho, is what we call in advertising the unbranded disease advertising, where they’ll talk about a disease that you might have, and they don’t tell you that they have a drug to treat it.
To me, it just spreads hypochondria.
Kevin Pho: So you’ve been on the advertising side. Just give us some insight. What is it like on the advertising side when it comes to creating a campaign for a disease, a drug, a soap product? What’s some of the thought process that goes on on the advertising side?
Martha Rosenberg: Well, that’s a great question, Dr. Pho. When I was in advertising, we didn’t have DTC yet—direct-to-consumer. But generally speaking, we want a relationship between the viewer or listener and the product. And so there’s a lot of use of the word “you.” And back when I was in advertising, we’d say, “Is your beer working for you? Is your antihistamine working for you?” And the idea would be that you, you know, that you have a relationship with a product.
And I worked for an ad agency fairly recently marketing a diabetes drug. I was asked to change the copy—I won’t go into details—but I asked my supervisor, “Why are we changing the copy to embrace more patients?” And she said, “We make more money.”
Well, obviously in the ad industry, of course, we’re out to make money, but the idea would be to establish a relationship between the listener and the product. And also, in the case of DTC, to scare. You know, you may, there’s so many examples where you may feel fine, but you may be suffering from… I mean, that offends me as a viewer, as a, as a human being, as somebody who tries to stay healthy and doesn’t want to keep running to a doctor saying, “Oh, I might have this, I might have this symptom,” you know?
Kevin Pho: So, you alluded to this earlier, but let’s drill down and go into more detail. Tell us about some specific psychological tactics that a lot of these drug and soap commercials on television use in direct-to-consumer advertising. What are some of the most common psychological tactics they use?
Martha Rosenberg: Well, OK, first of all, online there are what we would call—what they call—symptom checkers, which means if you have any doubt that you need this drug or are suffering from this disease, you go online and it says, you know, “Do you have a cough? Do you have trouble sleeping at night?” So, there are symptom checkers.
And secondly, a really obtuse area of advertising that follows from when I was in advertising is the list of side effects. You’d think that the list of side effects—like death, brain bleeds, epileptic seizures—you’d think it would unsell the drug. But what my research tells me is it produces a hypnotic state where the drug actually sells better.
OK, so there’s a subtlety. Some things I’ve read say that if a drug might cause irritation at the injection site, because they seem to always be biologics, that that’s what the viewer might remember versus, oh, let’s say, a lowered immune system or something like that. So, the side effects are very much a part of the sell. They make viewers kind of go into a hypnotic state, and they reduce the scary side effects or overwrite them with more minor side effects.
And mostly, I have to say this, Dr. Pho, people enjoy DTC ads because they’re high-budget. They show the shuffleboard, the people going like this, the singing, the hand—you know, they’re very manipulative. I know, I made TV commercials.
Kevin Pho: So, you’re saying that specifically with the side effects, because that sometimes could last 10 to 15 seconds of a 30-second commercial, it produces a hypnotic effect, and there is data showing that not only does it minimize major side effects, it actually helps sell the drug. There’s data behind that?
Martha Rosenberg: There is. There are certain researchers who have exposed it, and I believe I’ve written that on your own website. I’ve written about that on your platforms because it’s insidious. It works. I mean, I’ve gone—I’ve gone to medical conferences where physicians actually have to enroll in refusal skills, because patients will come in with a coupon and they’ll say, “Well, I have this disease. I know it because I saw it on TV, and I need this drug.” And so it very much sells the disease, and I believe it’s an insult, not just to patients or potential patients, but to physicians.
Kevin Pho: So, let’s talk about that. How do you think that the influx of direct-to-consumer drug ads is affecting the doctor-patient relationship?
Martha Rosenberg: Well, you know, it’s taken diagnosis and treatment out of the office and put it on the general airwaves. Everybody’s an expert. I think it’s insidious as heck. And I know that we’re never going to see the end of it because it works.
Drug makers and big pharma have really been able to reduce their drug reps and just rely on DTC. So, they love it. But frankly, websites and especially news sites love it too. That’s their main revenue. You will never, ever see it go away. It is like the ultimate advertising goldmine right now—DTC advertising.
One thing that I get so mad at, Dr. Pho, is what these drugs are. These are all biologics, which means they’re injected, right? They’re all what we call large-molecule monoclonal antibodies—cheap for the drug makers to make, very resistant to generic competition. Almost all of them lower the immune system and invite other diseases. They’re terrible drugs. OK. They take a very minor side effect or minor condition and give you an immune-reducing drug. So, I’m very against them. They’re very, very expensive. And they’re obviously a goldmine right now for drug makers, which is why we see so many of them.
But what we have—I’ve joked about this even on your platform—is we have a whole group of people now, Americans especially, injecting themselves with drugs. I mean, what the heck, you know, for like eczema. I’m not saying eczema doesn’t exist, OK, but some of these conditions are so over-marketed to sell drugs.
Kevin Pho: So, in terms of the effectiveness of direct-to-consumer advertising, you said they clearly work, or else companies wouldn’t do it. Do you have any ballpark figures in terms of how much revenue it pushes, how persuasive they are, what kind of studies or data you might cite off the top of your head that shows how effective they are?
Martha Rosenberg: Well, at my fingertips, I don’t have anything, but I have written in the past about the huge increase in how many adults report taking more—four or more drugs every month. In other words, DTC has increased the number of chronic drug-taking adults. And I think that’s a way to measure it. And another thing we haven’t even talked about yet, Dr. Pho, is the kids. Don’t get me started on the kids and how there’s all these drugs, you know, your child—he’s eight or he’s six and he runs around, he doesn’t have ADHD, you know?
Kevin Pho: So, let me actually get you started on the kids. Tell me about how kids could be a potential target for the drug makers.
Martha Rosenberg: OK, well, I had one. I’m a cartoonist, and this is the book I really wish people would look at on Amazon. I won an award for a cartoon where the little kids were asking their mom, “Can we take the purple pill?” OK. Kids are very—just like I was—we’re very affected by advertising. And I personally believe children are very over-medicated.
Kevin Pho: And when it comes to health-related products, it’s not only drugs. You also talk about things like laundry detergents as well. There’s a lot of manipulation when it comes to something as simple as laundry detergents, right?
Martha Rosenberg: Well, you’re absolutely right. And I thank you for bringing that up. I noticed in the last couple of months, there’s just been a deluge of fragrance ads. You know, your laundry detergent could smell better, or your whole body smells, not just your armpits. And this whole thing is driven by what we call big chem.
The reason I’m offended by it on many levels is, first, that these fragrances—they were once moving towards being fragrance-free—are now back and are highly correlated with endocrine-disrupting chemicals and even cancer. They’re not safe. And so I’m very offended by the deluge of these ads. And if you watch TV, it’s constant. They say, “No matter how many times you wash your clothes, they still smell.”
Martha Rosenberg: They still smell. What is this all about? I mean, this is as bad as drug advertising, you know? And it’s just selling you fragrance beads that probably stay in the environment for years and certainly are endocrine disruptors. Years ago, they really pushed Tide and Gain and soaps, and that’s why many shows are called “soap operas”—they were literally supported by soap advertising. And it’s almost like this has come back.
Another thing that I find offensive—maybe I’m wrong—but I feel like these ads are racist. They often show people of color in ads about needing these products, and it just offends me. It offends me because we don’t stink. For big chem, it’s like drug advertising in the sense that it sells self-doubt.
Kevin Pho: So, what are some of the answers that you have here? What are the roles of some of the regulatory agencies?
Martha Rosenberg: Well, I’m not real hopeful about the FDA. I think there’s a lot of really nice websites out there and Substacks that report on this; I’m certainly not the only one talking about this. There are many sites you can subscribe to or support that offer consumer-friendly insights into these issues.
Kevin Pho: Reflecting on your time in the advertising industry, do you think there’s an ethical way to advertise drugs and health products without exploiting consumer fears or manipulating their behaviors?
Martha Rosenberg: Wow. No, I don’t think so. I think the very act of advertising a drug is inherently wrong. It’s inherently wrong. That’s why we’re the only country, except New Zealand, that allows it.
Kevin Pho: We’re talking to Martha Rosenberg. She’s a health reporter and the author of the book Big Food, Big Pharma, Big Lies. Today’s KevinMD article is “How Drug and Soap Commercials Are Manipulating You.” Martha, we’ll end with some of your take-home messages to the KevinMD audience.
Martha Rosenberg: OK, well, I’d like to say that I did a lot of research for this book, and I looked at old ads from before DTC consumer advertising was legal. I included many old ads from medical journals in my book, and you can see they’re very anti-patient. They couldn’t run today—they’re misogynistic and offensive—but I also included 27 cartoons to bring some humor, because let’s face it, it’s not a happy topic, and sometimes we need to laugh a little.
My take-home message would be this: I recommend a website called Ask a Patient. You can go there, post your experiences with medications, and there’s no filtering or advertiser bias. I also love Public Citizen, which is a great consumer advocacy organization. I would encourage people to seek out consumer-driven sites because this is very much a consumer issue.
Kevin Pho: Martha, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.
Martha Rosenberg: Well, thank you, and good luck with everything you’re doing. I love how you showcase so many different voices.
Kevin Pho: Thank you, Martha. Thank you so much.
