A couple of years ago, I found myself in a doctor’s office for a routine visit — the kind required simply to continue prescribing a medication for a condition I’ll have for the rest of my life. After the poking and prodding, we sat down to talk.

“Say, Doc,” I said, “do you think we could switch to that new XYZ drug I’ve been seeing on television? The commercial says it’s better than the ABC I’ve been taking.”

She said she’d been hearing good things about it and was just starting to prescribe it. She wrote me a prescription.

Long story short, the medication burned the nerve endings in my stomach. I’ve been dealing with gastrointestinal issues ever since. I turned out to be part of the roughly 15 percent who couldn’t tolerate the drug — a fact mentioned briefly, cheerfully, at the end of the commercial.

I learned a lesson I won’t forget:

I will never again ask a doctor for a medication I saw advertised on television.

The United States is one of only two countries in the world — New Zealand being the other — that allows pharmaceutical companies to advertise prescription drugs directly to consumers. Most countries looked at the idea and decided it was absurd.

We embraced it.

As a result, Americans are inundated with drug commercials day and night. It feels impossible to watch a program without seeing at least one smiling couple walking on a beach while a narrator calmly explains that the drug being advertised may cause internal bleeding, suicidal thoughts, organ failure, or death.

My favorite line from those side effects is when the commercial warns that the drug may cause “unusual or abnormal thoughts,” which feels like something you’d want defined before you swallow the pill. Unfortunately, the ad never circles back to clarify whether this includes something like developing a fondness for small monkeys, acquiring a taste for rap music, texting your ex, or even in just believing the commercial itself.

But those side effects aren’t meant to be understood. They’re meant to be endured — long enough for the logo to sink in. The warning satisfies lawyers, not patients.

I once believed doctors received kickbacks for prescribing certain medications. That’s not entirely true as direct kickbacks are illegal. But pharmaceutical companies legally pay doctors in other ways: lunches, speaking fees, consulting arrangements, advisory boards. All of it disclosed. All of it legal.

And studies show that doctors who receive these payments are more likely to prescribe the sponsoring company’s drug over its competitors and generics.

I’ve sat in a waiting room and watched a drug rep carry lunch into a doctor’s office. Most other countries don’t allow that either.

Doctors are highly trained professionals. They practice medicine. Drug companies sell products — and in this country, they sell them at extraordinary prices.

Research consistently shows that direct-to-consumer drug advertising increases doctor visits and increases prescriptions for advertised drugs but does not reliably improve health outcomes. The ads create demand, not wellness.

Advertising is expensive – billions of dollars expensive  – and those costs don’t vanish. They’re baked into drug prices, insurance premiums, and public healthcare budgets. Ordinary life becomes medicalized. Mild symptoms become disorders. Aging becomes something to “treat.”

In 2024, the global pharmaceutical industry grossed roughly $1.65 trillion. The U.S. accounted for about $613 billion of that — roughly a third of global sales. Johnson & Johnson generated nearly $100 billion in revenue, netting about $14 billion. Merck earned about $17 billion on $64 billion in sales.

The most egregious price gouging in modern medicine isn’t restrained at all — it’s a philosophy: life-saving drugs priced as luxury goods simply because patients have no alternative. When a decades-old drug like Daraprim, used to treat toxoplasmosis in cancer and AIDS patients, jumps from $13 to $750 a pill, that isn’t innovation. It’s extortion.

At the same time, the pharmaceutical industry is among the most powerful lobbying forces in Washington, spending enormous sums to shape legislation and limit Medicare’s ability to negotiate drug prices. Much of the foundational research behind these drugs is publicly funded by taxpayers. The profits, protected by patents and pricing power, are not.

We pay once to fund the research. We pay again at the pharmacy counter.

So when you see those drug commercials, understand this: they are not there for your health. They are there because a powerful industry wrote the rules governing how drugs are marketed, and they work exactly as intended, for the benefit of shareholders, not patients.

I learned that the hard way.