The People's Perspective on Medicine

Do NOT Trust People Smiling During Drug Commercials

Do you ever watch drug ads on TV? It's hard to avoid them. If you pay attention you will discover a lot of smiling during drug commercials. Why is that bad?

Have you ever smiled at a stranger and received a smile in return? It inevitably makes you feel good. Everyone loves a smile. It disarms us and makes us feel warm and fuzzy about the person smiling. But there are times when a smile is totally inappropriate. For example, you would not smile if a friend told you about a scary diagnosis. How about cancer? That is why it is so unsettling to see people smiling during drug commercials for potent cancer medications.

Why Are People Smiling During Drug Commercials for Verzenio?

There is an advertisement for a new medicine to treat metastatic breast cancer. Verzenio (abemaciclib) is promoted as

“an everyday treatment for a relentless disease.”

When the announcer starts rapidly listing the side effects, we see women enjoying delightful family time. Here, watch the commercial for yourself at this link. There are at least two dozen smiles during the following recitals:

“Diarrhea is common, may be severe and may cause dehydration or infection. Before taking Verzenio, tell your doctor if you have fever, chills or other signs of infection.

“Verzenio may cause low white blood cell counts, which may cause serious infection that can lead to death.

“Serious liver problems can occur. Symptoms may include tiredness, loss of appetite, stomach pain and bleeding or bruising more easily than normal.

“Blood clots that can lead to death have also occurred. Talk to your doctor right away if you notice pain or swelling in your arms or legs, shortness of breath, chest pain or rapid breathing or heart rate.

“Tell your doctor if you are pregnant, breastfeeding or planning to become pregnant.

“Common side effects include nausea, infections, low red and white blood cells and platelets, decreased appetite, headache, abdominal pain, tiredness, vomiting and hair thinning or loss.”

Here’s another Verzenio commercial. How many smiles can you count?

Side Effects And Drug Commercials:

The FDA requires drug companies to list serious side effects during commercials. They do the same thing in magazine ads.

We are not complaining about the requirement to inform the public about dangerous adverse reactions. Most people realize that drugs to treat cancer often have very serious side effects. We think it is important for people to be well informed about toxicity before they are told to ask their doctors to prescribe drugs they see advertised on TV.

The Problem with Smiling During Drug Commercials

We are outraged by the way pharmaceutical companies have attempted to distract viewers from the dangers of the drugs that are being advertised. We suspect that the industry has figured out successful strategies to overcome scary words.

We object to the way in which these adverse reactions are presented. The rapid voice-over coupled with images of people having fun divert attention from the seriousness of the potential side effects. The frequent smiles take the sting out of the bad news.

These commercials are very sophisticated. In a few seconds an appealing story unfolds. We learn about people who are suffering from severe conditions like cancer, Crohn’s disease, diabetes, psoriasis, rheumatoid arthritis or goodness knows what else.

Trelegy: “The Power of 1-2-3”

A less serious condition than cancer is COPD (chronic obstructive pulmonary disease). Don’t get us wrong. COPD is very serious. The CDC says 16 million Americans have this chronic lung condtion (CDC’s COPD stats). It is the third leading cause of death after heart disease and cancer if you don’t count deaths from medications. In other words, COPD is no laughing (or smiling) matter.

A commercial for the inhaled medicine Trelegy (fluticasone furoate, umeclidinium and vilanterol) also shows people smiling. The catchy jingle featuring 1-2-3 is reminiscent of the number one hit in 1970 by the Jackson 5.

Don’t tell me you can’t remember this tune! It is unforgettable. Once it gets inside your head you will not be able to get it out. Here is a link to Dick Clark and the Best of Bandstand with the Jackson 5 singing “ABC” to refresh your memory.

The COPD commercial uses the catchy “Trelegy 1-2-3” jingle to drive home the message. Here, take a look at this commercial and see what you think:

Go back and watch again and see how many smiles you can count while cautions or warnings are mentioned. We caught at least 10. How many did you see?

Here’s another Trelegy commercial

Smiling During Drug Commercials Distracts:

Once again, the warnings and side effects are read while people on the screen are having a great time. There’s a birthday party, a walk in the park with dogs, and a pleasant backyard scene with a paper airplane flying.

For people to really understand the potential risks of highly promoted prescription medications, the FDA should not allow ads to be so distracting. In an ideal world, side effects would run in print on the screen without any appealing images while the voice-over is read.

Fighting Back Against the Distractions:

Until the FDA changes the rules, however, we suggest closing your eyes during drug ads. That way you can better focus on the important information rather than the amusing diversions that currently steal the scene.

If you have your eyes open and spot a smile, pay extra-close attention to the words. Chances are, the advertiser is trying to distract you.

Reader Responses:

Many of the visitors to our website find prescription drug commercials annoying. In response to our post: Are TV Commercials Pushing People To Take Too Many Pills?

We received this comment:

Pat points out something important:

“Have you also ever noticed the pleasant, light-hearted music playing in the background while the folks in the commercial are dancing and laughing, even when the overvoice is talking about ‘fatal events’?”

Speaking of light-hearted music and a catchy jingle, check out this Ozempic TV commercial. Don’t forget to count the smiles during the warning phase of the commercial.

D.C. in Seattle notes that the bottom line is a powerful motivator:

“I find only one positive aspect to the irritating prescription drug commercials. If people stopped to really listen all the way through, they would learn about the many negative side effects, including death.

“Hopefully that will motivate people to really think before taking a drug. People should do their own research whenever a physician writes a new prescription. All we see on television are the expensive name brand drugs that in many cases insurance won’t even cover.”

Revealing the Cost of Prescription Drugs:

There is a new proposal from Health and Human Services (HHS). Under this plan the pharmaceutical industry would have to include the cost of the medicine being advertised in the television commercials. Not surprisingly, drug companies are not thrilled with this idea. You can read more about this concept at this link:

What Do You Think?

Share your own feelings about prescription drug commercials on TV in the comment section below. Do you find that the constant smiling during drug commercials is misleading, especially when the announcer is describing side effects like liver damage, heart attacks or death?

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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It’s false advertising!!!!

I am distressed at the incessant advertisements for drug cure-alls. I do not trust any ads, especially with all the disclaimers. Further, I am distressed by the millions it must cost for their incessant advertisements. My question is: why aren’t drug companies spending those same millions for research?

I find these commercials very disturbing. The constant smiling, slow motion camera shots, and beautifully dressed people enjoying family time while a litany of side-effects is being read is objectionable but, even more problematic to me, is the juxtaposition of older people with young children (presumably grandchildren) that suggest the older person SHOULD take the medicine to buy more time with the younger generation. It’s guilt-inducement to take the drug and, in reality, the side effects can be so severe that any “extra time” with loved ones the drug provides may be the opposite of quality time.

I have told my doctor not to give me any drug that is advertised on TV or in magazines! I HATE, HATE,HATE. These commercials!

We are the most over-diagnosed, over-treated, over-dosed, over-charged people in the world. But don’t expect much change, just because we are sick of TV ads. Everyone wins: Big Pharma, the drug stores, TV networks, ad companies–everyone but us, the hapless (and powerless) consumers.

I WAS SO HAPPY TO SEE THIS ARTICLE IN YOUR COLUMN IN MY LOCAL NEWSPAPER! I HAVE OFTEN COMMENTED TO MY HUSBAND, WHO AGREES, THAT THESE ARE RIDICULOUS- SO TO SEE MY SENTIMENTS IN PRINT WAS SURPRISING BUT VALIDATING.- I HAVE SEEN 3 OF MY DEAREST FRIENDS USE THESE DRUGS TO GAIN A SHORT PERIOD OF TIME AND THEIR EXPERIENCE WAS NOT THE HAPPY PICTURE PORTRAYED IN THESE ADS. THEIR SYMPTOMS WERE MANY AND SEVERELY LIMITED MOST OF THE THINGS THEY SO HOPED TO CONTINUE IN THE TIME LEFT TO THEM. HEARTBREAKING FOR THEM AND DISGUSTING TO US WHO HAVE TO SEE THESE CONSTANT ADS IN OUR FACE EVERY DAY.

Pharma ads should be banned for the simple reason that we are not qualified to make those decisions ourselves based on showing us happy people. Only our doctors are. A capitalistic-based health care system such as ours makes as much profit from their product as they can. Happy faces is the way to get us to ask our doctor for it. Some European countries do not allow them to be aired. They also have a single payer (medicare) style healthcare system that gives better results at lower costs.

The drug ads should actually show the TV actors experiencing the side effects of the advertised drug (would make a funny SNL skit) with an annoying soundtrack in the background. If one of the side effects is potential death, then show a funeral scene. Also show a range in price per dose. That will not distract the audience. It would also cause big pharma stocks to plummet, and only then will they pull their distracting ads.

I read that pharma companies spend more on advertising than they do on research! Imagine a world where the current advertising dollars were spent on making better drugs, and marketing focused on providing fact-based information to those who prescribe and dispense them. My MD says he’s bombarded by patients wanting the latest prescription med they’ve seen on TV, without regard for potential side effects, drug interactions, or cost. We no longer permit ads for tobacco products on TV so why not, for example, limit drug ads for the general public to print media so people are more likely to notice the warnings without being distracted by smiles and music…

My thought: I heard somewhere that there are only 2 countries in the world that allow advertising for medications, the US and New Zealand. Can someone find out if this is true? I think they should be banned entirely and the money used to bring down drug costs and subsidize medications for the poor. They seem less intrusive without the sound, so I mute them.

People who are so stupid they cannot distinguish between the happy music/smiling faces in those ads and the horrible content of the overlying message should probably just take the darn medicine and suffer the consequences in confusion and consternation. Survival of the fittest, as Darwin would note.

The commercials must cost billions, they should rather reduce the price of their medications.

It seems an excessive abuse for commercial profit for a pharmaceutical company to advertise a drug for treating an illness when only one’s doctor can do that. Their enormous advertising budgets could be reduced in favor of reducing the costs of medications.

The worst part is they do not tell you the price of the drugs. I have seen the prices and they are exorbitant. Most of them are not covered by your insurance and yes they do not tell the quality of life during the short extended period of life.

Even the drug I can easily afford to suppress estrogen after my breast cancer surgery makes life too miserable to be worth taking it for 5 years.

With due respect, ( and believe me, MUCH respect is due to the Graedons), in an ideal world NO drug ads would appear on public media at all. In an ideal world true health would be the goal, not an unending parade of phamaceuticals.

Drug companies are a VERY powerful Lobby. Ask any FDA employee.

I think we should go back to the days when all kinds of pharmaceutical drug ads are banned!
The majority of ads are deceiving and push drugs with more harmful side effects than benefits
This is big pharma spending billions they overcharge people for overpriced drugs for advertising!
I always check if a drug I am told to take is available in Europe first now
If it is not available or banned in Europe my family will not be taking it no matter what it is for
I had several horrible experiences where my poor Mom was prescribed severely harmful drugs that harmed her health
I learned all of the drugs she was given that did this were banned it already pulled from the market in Europe!
Sad that Americans can not trust the FDA to protect us from harmful drugs and foods etc!

Yes yes yes! Make drug companies include the retail cost. Great plan they will fight tooth and nail. (Old expression from an old person who recalls the good ol’ days when such drug advertising was verboten).
Are people really just “Consumers” though? Is critical thinking not even a thing anymore so that the smiling happy folks on drug propaganda ads totally distract these sheep/er folks from the hideous effects? I prefer to call them effects instead of side effects, btw, because it is a cause and effect proposition. Semantics I realize…….
Personally i find all tv ads so unbearable that I can barely watch any commercial tv at all. Is it because I do remember the lovely days of long ago when there was ONE commercial at a station break? I am 78, a working oldster and trying to be savvy about the need for toxic substances in my body.
Aging is reality. Things go awry. I have several chronic conditions but choose the least drug treatment possible and hope others will research heavily before jumping into new drug territory.

The people in drug commercials look so happy that I almost wish I had their disease.

I mute commercials and get up and do something. I haven’t watched commercials for years. I also don’t watch much TV. (It’s marketing) Ever noticed how much louder commercials are?

Besides the smiling and the pleasant scene, another irritant is the small print indicating that the medication has allowed a person to live 9 months instead of 6 months without it. All the while the happy voice-over says “Doesn’t everyone want to live longer?” Also, no mention of the quality of life during those few months.

Deciding which drug one needs based on a TV advertisement seems like a very odd way to make medical decisions. Perhaps one should research the available options, including generic versions of older drugs that are much less expensive and are likely covered by one’s insurance. Then one should consult with one’s doctor to find out which of these options are most advisable for one’s individualized case. Keep in mind that some insurance companies do not cover new drugs for a specific period of time after they come on the market. This generally pertains to new brand name drugs, and not new generic versions of existing drugs.

Ads for breast cancer medications are very confusing. Many do not understand that there are many types of breast cancer, and some meds are for a certain type only. It leads to anxiety when patients are most vulnerable and feel that they have to ask their physician for these drugs. In the ads friends and family members suggest to patients that they need those drugs: “See! You can play with the grandkids, go to yoga and have a lovely time with your husband if you take this drug!”

Cynic that I am, I am annoyed by the smiley faces and sentimental images I see in advertising for all products. I don’t have a TV, but ads encouraging me to feel confident about the product abound all around, producing the contrary reaction in me, but I have no intention of buying what is proposed!

I wish we could program our TVs to automatically Mute when it hears the phrase “moderate to severe”!

Why should pharmaceutical companies be allowed to advertise drugs at all? Shouldn’t that be the role of the doctor? I realize it’s nice to have knowledge of what’s available, but advertising drugs like they’re soft drinks that can jazz up your life and make everything perfect is just wrong. If they are going to be allowed to advertise them, then they should simply be a short, factual blurb about the drug, what it’s for, what it costs, and a list of potential side effects.

Many years ago, drug companies could not advertise to the public. The price of drugs has skyrocketed since they have been allowed to advertise. Advertising is expensive.

The amount of advertising by pharmaceutical companies only indicates that they are making way too much money from the sale of over-priced drugs. Most countries do not allow tv advertising by drug companies; neither should the United States. Americans probably spend more time seeing drug ads than they do seeing their doctors.

I’ve noticed that I see a new drug advertised on TV nearly every week. Drugs I had never heard of before. Yep, pretty much the same theme on all of them: smiley and happy people doing fun things. I guess we are supposed to believe that these drugs will turn your life around and make you a happy, healthy person having the time of your life.

But no wonder drugs are so expensive as the companies must have huge advertising budgets.

Tthe ‘smiliing ads’ resemble the models in drug ads who wear white coats with a stethoscope over their shoulder, smiling as they pedal the product. Reminds me of the cigarette ad with the so called doctor smiling as he held the product: “More doctors smoke Camels than anyother cigarette.” As we have come to learn: FOLLOW THE MONEY.

I always use Closed Captioning on my TV. When these commercials talk really fast about side affects I can read how dangerous they really are. Beware!

Thank you so much for this article! I too have been very annoyed by these commercials for quite some time. All medications have side effects, and if someone is suffering from diarrhea while taking cancer drugs he or she will NOT be smiling. My sister-in-law could not endure the side effects of her cancer drugs and passed away years ago. I rarely saw her smile, and she just finally gave up. She could not live with being sick all of the time.

These jingles and catchy tunes are so annoying that I will walk out of a room or just mute the sound if I am alone. I take an injectable diabetes 2 medication and ever since I suffer quite frequently from digestive issues. One commercial has a man using a type 2 injectable dancing around his office, at home, while mowing the grass and bathing his dog. My experience has not been similar. Lets’s get rid of the smiles, as they are not helping at all.

I am about finished reading “The China Study.” It gives a pretty disturbing view of the pharmaceutical industry. It’s ultimately about profit. That’s understandable and not all bad. But, it creates a natural culture towards doing whatever is going to maximize profits. So, ethics has a lot to do with culture, in this case business culture. I think it’s unintentional but, profit is an easy motivator to prioritize over human well being when the lines are unclear. This culture is always evolving and changing.

The question is, will people demand something else? I kind of doubt it. It’s about policy and economic growth and all the smoke kicked up within that discussion. It’s very much like the issues with what food products are allowed to be sold to the public in the USA vs. what is legal say, in Europe. In America we consume food(s) that are illegal to be sold in Europe. It’s not because Americans care less about our health. It’s because we, as a whole, value economic power more than the risk we take in the process, as if common sense food and drug legislation would have a widespread negative economic impact. Point is, until we, on a large scale, demand our health be protected at that level, we will get the shaft. Some of us will pay with poor health, suffering and early mortality.

It’s not just about drug commercials. That’s just a symptom of a wider illness.

I once found a TV drug commercial highly enlightening when I had a lung infection that had my PCP, her staff, and a pulmonologist stumped. Neither my psychiatrist nor anyone else on staff at the institution where I was hospitalized for severe depression had told me that the antidepressant prescribed should never be taken with aspirin due to the risk of excessive bleeding. When I went back to work, I was taking aspirin every four hours all day long for back pain. Had it not been for a drug commercial about Pristiq I would never have known that a steady drip of blood from a 24/7 nosebleed was the cause of the lung problem. My PCP thought I had walking pneumonia and the pulmonologist had to ask *me* what the drug was. He apparently never bothered to look it up.

By the way, the depression turned out to be due to a statin drug lowering my cholesterol to a dangerous level, a red flag that every medical person involved missed even though the risks of too low cholesterol were known by then.

And so, I do find drug commercials useful for their recital of possible side effects, although I prefer to look up drugs on the Internet. I wish that everyone would research prescriptions before swallowing anything!

Just remember ads are just that: ads. Smiles make sales. Everyone should always keep that fact in mind. We shouldn’t take them too seriously. Rather than taking the ad’s word for it, look up the drug or product for a more unbiased description.

I think you are overreacting. It is a commercial. What do you expect?
You also know how any “side effects” that occur during testing are required by the FDA to be listed. For example, headaches, nausea, diarrhea, etc.that occur during a drug testing will have to be listed as side effects, even if they are not attributable to the drug. For some studies, these same “side effects” occur in the placebo side of the studies!

Mute or switch channels when drug commercials come on, or any commercials for that matter. Use the time to reflect on something positive; visit the restroom; play with a child or pet; have a short conversation with someone in the room; look at a magazine or read a book; get up and walk around. No one has to listen to commercials!

I have heard that only in the US are drug companies allowed to advertise drugs like this. Is this true? I love your information and keeping us up to date on many harmful things in medicine today! We are our own worst enemy because we want instant relief, and we want it NOW! Thank you for being so faithful in keeping us informed

I think the solution to the high cost of drugs is to make it illegal to advertise prescription drugs to the public. Won’t happen, but it is obvious that the high cost of advertising is included in what we pay for them.

Pharmaceutical companies are the second most powerful lobby in the country. The United States is the only county in the world (besides New Zealand) that allows direct to consumer advertising. Is there any wonder that they have such a powerful influence?

The smiling strategy in advertising medicine tries to convince the viewer that he or she will be happy and feel good after taking the product. It’s just a sales pitch! I mute these commercials.

Use the remote to turn off the sound; use the remote to hit the menu button, and the whole scene will become smaller so you don’t have to listen to it or look at it. I am so disgusted with tv commercials I hardly watch tv anymore except forBBC news, stock market report, Wheel of Fortune, and Jeopardy. Then I thankfully turn it all off and go to bed and read or get on my computer to chat with friends and family.

The advertising world does us a favor by driving us to other forms of entertainment!

Along with the happy smiling people and catchy music, I’ve also noticed that the drug names themselves have become more ‘upbeat,’ most with three syllables that trip off the tongue easily. Clever marketing?

Big pharma and their drug ads disgust me. In addition to the above-mentioned strategies, notice how they manipulate lighting. Some of them show bright, colorful, happy scenes with successfully treated “patients” in contrast to dark, shadowy, sad scenes with miserable “patients.”

Thanks for these comments on the visual and auditory distraction of loving or pleasant scenes in addition to smiling! Many ads also say not to take the brand name if you are allergic to it or any of it’s ingredients – how would you know you’re allergic until you have life-threatening symptoms or death!?? AT LEAST specify the ingredients that could result in side effects that are potentially dangerous. That could be a real contribution to deciding if the drug is appropriate for your condition and something the FDA should include on the warnings.

Another separate problem is the nickname assumed known to the viewer like A1C or others. Some ads never say the real name of the condition or symptoms or disease. Thus, the ads are too catchy and often on purpose use an insider term or acronym! Thanks again.

Yes, I always shut my eyes and just listen to the side effects. I am appalled at how they try to manipulate the consumer into believing that this pill will solve their physical complaint and make them feel happy. SAD, this love of money over caring for other humans. I am fortunate that I do not have to take any medicine, and I hope to keep it that way for as long as I can.

The ads that got me were the ones for Lipitor. They pulled the one purporting to be Dr. Robert Jarvik rowing across a lake. It turned out it wasn’t him but a body double. The side effects for Lipitor are scary. It can effect the liver, promote diabetes, can trigger fast heartbeat, can cause hives, can cause wheezing and coughing, and so on. I told my doctor, “No, thank you. I am not overweight. I don’t have high cholesterol, high blood pressure, or any other of the prerequisites for a stroke.” He said, “Okay, just take the 81 mg aspirin every day.”

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