Alicia: UnLeashed! January 2019 monthly article
One of my binge worthy picks on Netflix is a comedy social commentary show called Patriot Act with Hasan Minhaj. It’s funny, relevant and smart. And in a recent episode the topic was hype. The focus was how the fashion industry uses hype to make billions of dollars. Hype is one of the strongest forces in modern commerce. From sneakers to purses; phones to cars, and yes diabetes management. Hype is when branding and marketing create buzz and bring a lot of attention to a product. Hype pushes the value of a product up by making more people want it. We can buy sneakers for $20, but because of hype we will also spend $200. There is no real difference between the two sneakers except hype. Hype builds through two routes, the public and the “buyers”. When Nike comes out with a new Jordan sneaker they put a lot of resources into social media and marketing, building anticipation. Anticipation drives up demand and gives the public the perception that the sneakers they are buying have a greater monetary value. This is how a sneaker that costs $15 to produce sells for $200. A second piece of the hype machine is buyers. Stores are courted by companies to sell their products. Nike gives stores better prices on their products so that the stores can make more money with markups. The more marketing Nike does, the more stores want their products because they can mark them up even higher.Meanwhile, the stores become places people want to shot because they carry recognizable brands like Nike. Hype makes Nike a brand worth in excess of 20 billion dollars!
So what does media hype have to do with our diabetes management?
No one can watch television for long these days without seeing advertising for diabetes medications. Pharmaceuticals companies have massive marketing budgets. From sponsoring events to tv commercials and print adds, pharmaceuticals companies are building hype! Diabetes technologies companies go even further in working the hype machine. New products are promoted years ahead of their release, raising anticipation. With the recent release of hybrid closed loop insulin pump programs we heard hype like “artificial pancreas”, “won’t have to think about diabetes” and “making diabetes management easy” if those aren’t some seriously over blown hype I’m not sure what is! When I was a kid we were sold that wearing Jordans made you “like Mike” but sneakers never gave me a decent layup (full disclosure, neither did hours of practice, but education and practice have given me mad management skills)! From sleek print adds and flashy websites to massive sales forces and huge social media blitzes technologies and pharma companies depend on hype to dive up sales.
Pharma also has its own version of store buyers. These are physicians and to a greater extent insurance companies. Pharma companies spend a lot of resources marketing their products to prescribers. Any prescriber’s office has multiple sales representatives, or as they are called in the industry clinical managers and clinician educators, each week. The official purpose of these visits is to teach prescribers about medications and technologies, but in reality the goal is to increase visibility of products to increase prescription rates with those prescribers. This is no different from Supreme slapping its label on everything and anything. Psychologically we assign trust and cache to brands that we see frequently. It is assumed that a product that everyone knows is the better product, so companies work very hard to make sure that their names and logos are part of our routine experiences.
However, the bigger “buyers” that pharmaceuticals companies are really aiming for is insurance companies. Nike works with retailers giving them better wholesale pricing if they sell more shoes, the retailers then mark up the prices as far as the market can possibly bear and pocket the difference. In the medical world pharmaceuticals companies offer “rebates” or cheaper pricing to insurance companies who agree to list their medication or devices are “preferred” these rebates are pocketed by “buyers” prescription benefit managers. Again, it is not the benefits, efficacy, safety or patient use of a medication that dictates what we get to buy at the pharmacy, it is the hype! (For more information on PBMs and how they determine medication prices and accessibility read our article: Why is insulin so expensive and what options do insulin users have?)
There is nothing innately wrong with hype. There is nothing wrong with someone deciding to buy a $200 pair of sneakers, or the best marketed insulin pump. That is the free market, and that freedom to sell gives us the freedom to choose. What is important is that, as patients with purchasing power, that we recognize the roll of hype. We can not blindly buy what we are told to buy by the hype machine. After all a pair of Jordans is not going to work for everyone’s budget, for everyone’s athletic needs, for everyone’s style! Likewise medications and technologies are not one size fits all, and we can’t make our treatment decisions based on hype. We have to look behind the advertising, our insurance company’s preferred lists, and prescriber’s familiarity to see what really works for us. The fashion marketing hype machine is also really good at making us think that we can not live without their products. Just ask a parent of a young person who is begging for the newest coolest. The pharmaceutical industry has latched onto this strategy too. We have all seen the commercials that ask vague broad sweeping questions like “Have you ever had pain in your head, eyes, legs, arms or teeth, talk to your prescriber about ….” These commercials are designed to make us think that we need these medications. The fact that they are on our TV means that this issue must be so common that it must certainly apply to me too, and the fact that it is on during my favorite show makes me more likely to trust it and remember to ask my doctor about it. We are being primed and manipulated to seek medications just like shoes, cars and tacos! What is most important is that we remain aware of the fact that we are being marketed to. Never let the hype outweigh a sound working relationship with a trusted and experienced medical team. Before you and your prescriber make a decision about medication, or technologies do the research to see what all of the available options are and make a really educated decision. If the decision that is best for you is not a preferred medication on your insurance ask your doctor to help you fight the hype machine and do the extra paperwork it might take to get your prescribed treatment covered. The first step to being a smart consumer is to cut through the hype and make informed decisions.