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Jun 10, 2024, 06:27AM

The Little Pill With the Big Story to Tell

Psoriasis medications have taken up the cultural position formerly occupied by beer. 

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During the current NBA and Stanley Cup playoffs, psoriasis medications (Skyrizi®, Otezla®, Tremfya®, Cosentyx®, Enbrel®, Stelara®, Rinvoq®, Entyvio®, and so on) have been a continual presence. And though Miller Lite has engaged in a series of "tastes great/less filling" pointless throwback ads in their residual or legacy attempt to sell beer, the culture has moved on. Men used to watch sports, mow lawns, and suck on Bud. Now sports fans have transcended gender, all Americans have psoriasis, and no American has a beer belly, thanks to Rybelsus®.

We've come or gone or floated or sunk a long way in some particular direction. But which? Perhaps you’re under the impression that the cultural role formerly occupied by beer is now performed by fentanyl, and if you thought that you'd have a point. But fentanyl's economic effects are muted, because it can no longer be effectively marketed with brand names such as Actiq®, Duragesic®, and Sublimaze®. The pharmaceutical companies have moved on to other compounds. Not better, mind you, just different.

It's amazingly hard to figure out pharmaceutical advertising budgets, but as far as I can quickly gather from Google or Bing, Pharma was spending at least $1 billion a month on advertising in 2022. Judging by the "Skyrizi® NBA Finals" vibe, they've doubled that in the past year. Pharmaceutical advertising and pharmaceutical advertising alone has kept the cable news industry afloat for the last decade, but it hit saturation in 2021; you just couldn't jam another Dupixent® ad onto CNN without admitting that the whole network was an infomercial. That's when Big Pharma went looking for new horizons. Soon, ESPN had a whole new formula: making book, and advertising Ozempic®. It seems to be going great.

If psoriasis medications are selling the way beer sold in the 1970s, one might wonder why. It's possible, I suppose, that alcoholism causes psoriasis, and the whole culture lurched from one to the other in 2012. Watching the NBA or NHL finals carefully will lead us to some stunning conclusions, beginning with the insight that all Americans have diabetes, obesity, and psoriasis. And thank God we do. What manufacturing was to the economy of the 1950s, psoriasis is to ours: the basis or underpinning of the whole thing. Where once we made Edsels, now we make side effects and Vraylar®, developed to treat the side effects of anti-depressants.

And pharmaceutical advertising performs an important service in informing the public. With regard to each drug advertised over the last 10 years, for example, I've learned dozens or hundreds of times that I ought not to take that drug if I am allergic to it "or any of its ingredients." I appreciate that, though admittedly it leaves me wondering which among my many allergies I can really pursue. Most of pharmaceutical advertising consists of devastating lists of side effects, including deaths, which "have been reported" or "are possible."

The merger of the advertisement and the warning as genres shows why the American economy is recession-proof, but also something profound about the very meaning of America itself. (See, I had to wind up toward some deep shit: this is punditry, baby.) We’re a culture that wants what kills us, a culture for whom the cure is fatal, every time. The better we get, the deader we become. I don't know what that means, but it's some yin yang karma cosmic justice-type jive. It doesn't matter how you feel about it. You're going to have to swallow it.

The good part is that though pharmaceutical advertising, with its devastating lists of effects and side-effects, causes anxiety moment by moment and severe depression in the long run, we have just the pills for that. It's a perpetual motion machine, an economy that makes nothing but psychosomatic illnesses and pills, and is all the more productive for it. Biden should thank his lucky stars. If he gets reelected, he'll have Skyrizi® to thank.

You may be bored or even irritated by all the production numbers, touching stories, terrible music, and gratuitously-introduced pseudo-people to which you’re subjected as you watch television. But by sitting there absorbing it like a Bounty® paper towel, you’re participating in the great economic and cultural experiment that is America. 

—Follow Crispin Sartwell on X: @CrispinSartwell

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