Is this the system we really want?

I've got Humira on my mind.

The AbbVie drug intended to treat rheumatoid arthritis, Crohn's disease and other afflictions is one of those touted endlessly on television and streaming services. "Humira helps people achieve remission that can last," an actress intones excitedly in one of the many spots. "You can experience few or no symptoms."

This month, The Lund Report, the health care information nonprofit, reported that Oregonians spent more on Humira than any other drug for the third year in a row. The 10 insurance carriers that report to Oregon's Prescription Drug Price Transparency Program said that $93.5 million was paid for 19,225 Oregon prescriptions over the last year, according to the report.

Clearly, AbbVie made a business decision to plunge heavily into consumer advertising - a practice that is conducted in only four countries in the world. And only two countries, the United States and New Zealand, allow pharmaceuticals to advertise claims about product benefits directly to the consumer.

The Oregon prescription numbers explain why pharmaceutical makers are so keen to place their products in the minds of consumers. It explains why they spend so much money lobbying your representatives in Washington, D.C., to be allowed to do so.

How much do they spend?

A study published by JAMA Internal Medicine in 2020 found that pharmaceutical companies and health product companies spent $4.7 billion, an average of $233 million a year over a 20-year period, to lobby the federal government; $414 million to contribute to presidential and congressional candidates, national party committees and others; and $877 million to state candidates and committees.

AbbVie, which is headquartered in corporate-friendly Delaware, is publicly held, which means it must detail its financial condition in detailed reports to the U.S. Securities and Exchange Commission. In the most recently reported quarter, ending Sept. 30, 2021, the company said Humira, one of multiple drugs AbbVie is selling, generated revenues of $4.6 billion in the United States, and a paltry $812 million in the rest of the world.

Clearly, advertising pays.

By the way, the cash price for a prescription for two Humira kits of 40 mg doses is about $6,200, according to Drugs.com and GoodRx.com.

If you're fearful of getting sick because of how much it will cost, and you wonder how it is that countries in Europe and elsewhere can treat patients for so much less than they charge in the United States, pharmaceutical sales and advertising offers one important clue.

Even if you accept that it's appropriate for a pharmaceutical company to pitch its products to consumers, rather than to health care providers - which it isn't - you have to wonder how many of those 19,225 Oregon prescriptions achieved the results patients hoped for.

Is this the system we want? Ask your elected representative if this drug delivery system is right for you.