I remember the very first time I saw a commercial for Remicade on TV in 2004. I was shocked.
In Germany (and most other western countries), only over the counter products can get advertised on TV. So, I was familiar with Aspirin commercials, or cough syrup. But Remicade?
I didn’t have TV for a long time, so I haven’t paid attention much, but recently, it was discussed in a bunch of forums and it got me watching, and thinking. My personal, not-backed by data perception is that it has gotten worse! I don’t see that many Remicade commercials anymore, but a whole lot of Humira, Cimzia and others.
I also understand that commercials are lies. Or projections. Or alternative realities- whatever you may call it. I have yet to see someone happily telling their kid to “make a mess” because they love doing laundry so much, and just for the record, Apple- people in Greece know what an iPhone is, and people in Greece don’t listen to yodeling (that’s a Swiss thing- different place!- check out my friend’s analysis of that particular commercial here).
Still, with prescription medication commercials, it is even worse. Attractive people interrupt some sort of physical activity in the sunshine, surrounded by nature, talk about how bad their life was before, and then ta-dah, once they started taking xxx, it was all gone. The commercial usually ends with them either running through a finish line, hugging loved ones, or doing important work again.
Philosopher Roland Barthes wrote an amazing essay called “the rhetoric of the image” (1964) analyzing ads in magazines and newspapers. He spoke about the linguistic message, the symbolic message (or connotated image), and the literal message. In a commercial, these lines are somewhat blurred, but I’ll try to tease them out.
We have the linguistic message– the sentences are not overly complex, people are friendly, they suggest that this is an everyday thing. They openly talk about how they were depressed, or in pain, and couldn’t participate in life. People like you and me can have a little stomach boo-boo, right?
Then we have the symbolic message: It’s usually white middle class women, shaking their heads about what a little worry wart they used to be. They are either in nature (because being sick is not natural!), a fun fair (because being sick means you’re a spoilsport), or surrounded by kids (because Moms need to function).
Finally, the literal message: “With my moderate to severe ulcerative colitis/Crohn’s Disease/Arthritis etc”. The literal message is there, we are talking about moderate to severe conditions. Sometimes they even have little subtitles, like in the remicade commercial. Likewise, the side effects that are read in an amazing speed at the end of the commercial also are to be taken literal.
Yet, the literal message gets lost, among the overpowering symbolic message (that pushes a painfully ableist ideology), and the linguistic message (let’s be chummy about serious conditions, right?).
Like the iphone commercial that evokes old-world imagery over the reality (Greece has been on the verge of an economic collapse), the biologics commercials choose mythical imagery over what’s really happening. Seriously, why would someone with IBD go to a fun fair and eat shitty food? And why don’t they show me in a doctor’s office every eight weeks getting my infusion?
The commercials paint a simplistic picture of very complex diseases. Many people on biologics need to take additional immunosuppressants to make sure they don’t develop antibodies (I for example take Methotextrate with Remicade). So, while Remicade is doing a lot of the work, it’s not everything. Also, not everyone is as lucky as I am- I am fairly healthy except for Crohn’s (which is a weird thing to say, but it’s true). Most people have more than one auto-immune disease, such as ankylosing spondylitis and RA, RA and Crohn’s, UC and Psoriasis (those are just examples). While biologics are powerful medications, they may help only to some degree. You only need to go to the restroom seven times, instead of twenty seven for example. They don’t make your pain go away, but make it bearable.
These commercials also conveniently downplay the fact that biologics are STRONG medications. They read the side effects super-fast with music in the background, so that you really have no clue what’s going on and tune out. Let me tell you about the side effects: After a Remicade infusion, I am out for about three days. And by “out” I mean I am incredibly tired, my whole body is aching and my digestion is going crazy (probably adjusting). That is just the normal side effect. You can have allergic reactions (up to anaphylactic shock), rashes, fevers- read the laundry list for Humira, Remicade, Cimzia, and Simponi on their website. The other effect of biologics is a compromised immune system. This is good- it works against your immune system attacking itself. But, this means also that getting a cold can be more than just a cold, and flu season is no fun. It means that whatever bacteria tries to attack your body, it will, and you may need antibiotics to fight it off. It means not being able to get live vaccinations, and thus you can’t just close your suitcase and hop on a plane like the lady in the Humira commercial does.
So while Remicade has helped me and I am in a great remission for the first time in many years, it’s not without a price, and many people are hesitant to go on them.
Don’t believe the hype. Don’t advertise for medications. Read more Barthes and listen to your doctor.