Kerry Howley | February 1, 2007
Writing in The Annals of Family Medicine, five doctors report on their experiences watching a bunch of prescription drug ads. They don't seem to have much to say on the benefits of lower search costs for drug-seeking patients, but they've come to some startling conclusions. Apparently, televised drug ads "oversell" drugs. Worse, they've got "limited educational value."
This seems to be a problem throughout the entire advertising industry. The last Cingular pitch I saw added nothing to my limited knowledge of cell-phone network technologies, though it did suggest that signing up would improve relations between me and my mother. I don't think I've ever learned anything about actuarial science from Geico's talking lizard. The last Absolut ad I saw failed to address the current or future state of my liver. And those are all products I don't need anyone's permission to buy.
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Back when Atkins was all the rage and people thought nothing of
eating a tray of cold-cuts for breakfast, there was a study of
doctors which asked them which diets they reccomended to patients.
Most docs said that they cautioned patients not to try fad diets,
but to concentrate on lowering caloric intake. Then docs were asked
what diets they themselves were on. Most docs responded that if
they were on a diet, they were on Atkins.
Conclusion: the five docs in this report are all writing each other
scrips for Valtrex in hopes that it will improve their ability to
ride a bike.
While it would be irresponsible of me to presume that all physicians abhor drug adds for the selfish desire to remain in control of systemically infantilized patients, the fact remains that drug adds chip away the archetypical role (although not the regulatory role) of the physican as arbiter of health. The more people know, good or bad, the better chance we have of bringing the marketplace back to medicine for the patients.
Apparently, televised drug ads "oversell" drugs. Worse,
they've got "limited educational value."
When sixty second commercials adequately educate the populace about
drugs and provide accurate estimates of their usefullness, we won't
need physicians.
Poor docs...victims of a 60-second emotional plea from a
marketer...somehow, I would have thought all that training might
enable them to have a rational discussion with the patient instead
of just writing the scrip...
For the professors, please please tell us how you established
causation in your study? Those of us in the ad industry haven;t
figured it out...maybe you can help?
I call BS on the notion that ads don't help inform consumers.
Consumers can use the intarwebs to look up drugs they see
advertisements for.
I know of two people with persistent conditions who have educated
themselves that way and I have myself both for allergy medications
and sleep aids I might want to use on long flights. We don't need a
doctor cabal that doles out only information they feel like we
should be exposed to. Have the fortitude not to write a scrip just
because a patient saw an ad, then you won't have a problem. If you
can't explain why someone shouldn't have access to the drug, maybe
you should rethink your position on it.
The biggest problem with pharmaceutical marketing is not their
ads (which are no more useful than any other ads). No, the biggest
problem is the amount of money they spend showering gifts on
doctors.
Before anybody thinks I'm calling for regulation of
pharmaceutical sales reps, I should say that I see this as
a pathology of a system where you are required to go through a
gatekeeper for a prescription, where you are required to buy from a
licensed pharmacist (restricting supply), and where there are
strong tax incentives to buy these things with insurance that a
third party provides. There are at least 3 entities (doctor,
pharmacist, insurance company) between the end user and the
manufacturer, and so the marketing strategy focuses on making the
gatekeepers happy.
The role of doctors as gatekeepers will not end any time soon.
Maybe the next best thing is to move some drugs from "prescription
only" to "behind the counter", where you can get it after
consultation with a pharmacist. I know, it isn't laissez-faire, but
it would remove one intermediary from the equation, thereby
enabling easier access than we currently have.
If you can't get rid of gatekeepers, at least give the consumer
more gatekeepers to choose from.
While it would be irresponsible of me to presume that all
physicians abhor drug adds for the selfish desire to remain in
control of systemically infantilized patient
So, my wife (who incidentally believes narcotics etc. should be
OTC) really, really hates most drug ads. The problem is that a lot
are ambiguous and vague resulting in hordes of valetudinarian
oldsters pestering her for scripts. So, maybe they are resentful
because they are forced to infantilise the patient.
No, the biggest problem is the amount of money they spend
showering gifts on doctors.
I have a collection of USB thumb drives given to my wife by drug
reps. I just got a 1G drive from Roche with a snappy flash
presentation about some drug for anemia. I have a lot of coffee
cups too. We have yet to get anything of any substantial value
though.
I gotta say, if doctors are incapable of deciding what medicines people need... then a large chunk of my reality is caving in.
What's really interesting and kind of sad are the disclaimers they put with them: "Menstruex helps menstrual cramps and prevents digital hyperpilosity. In rare cases, your hair will fall out and your eyeballs will explode. Not to be used with Midol because this may result in twenty-hour erections in women. Ask your doctor if Menstruex is for you!"
There is something I have never understood about this whole
nonsense over drug ads. Of all the companies out there who make
money wouldn't you want the drug companies to make the most?
When Starbucks runs ads they make more money, which allows them to
expand and then make more coffee and find new varieties. No one has
a problem with this.
When a drug company runs ads they make more money which allows them
to expand and make more drugs and find new varieties. Somehow
everyone finds this unethical. It's not like their putting the
profits under the CEOs mattress. All that profit goes to R and D.
Which results in the next new wonder drug.
Drug companies aren't perfect, but they've done a lot of good for me. Their ads are often ridiculously over the top, but they do get the message out that they have a product that may help you. I agree that the web is a great resource for researching medical information. I can't see how it hurts "public health" for patients to be knowledgeable about their personal medical conditions. I research everything I have or get, and my knowledge helps me communicate my symptoms to my doctors, which seems to help them help me more efficiently than otherwise. If you treat your physician with respect, I doubt they'll resent you trying to make their difficult job easier.
The role of doctors as gatekeepers will not end any time
soon. Maybe the next best thing is to move some drugs from
"prescription only" to "behind the counter", where you can get it
after consultation with a pharmacist. I know, it isn't
laissez-faire, but it would remove one intermediary from the
equation, thereby enabling easier access than we currently
have.
Most of the drugs that the reps pitch are patented. Opportunity for
competition is therefore additionally limited by things other than
the prescription-only laws.
My guess is that even if Congress passed a law tomorrow that said
that all behind-the-couter drugs could henceforth be sold over the
counter, I doubt that the drug companies allow over the counter
sales of many of their patented drugs. there are a couple reasons I
think that. One is that the presence of a doctor and a pharmacist
make the pills seem valuable, which prevents people from thinking
too hard about profit margins on patented drugs.
Another reason is that there would be a lot more lawsuits against
pharmaceutical companies (frivolous and non-frivolous varieties
both) against pharma co's. Right now, when someone gets a side
effect, the pharma company can argue in settlement discussions that
the patient suffering the side effect was warned good and counseled
personally by a smart men or women (that is, the doctior and the
pharmacist). You put that same drug on the other side of the
counter and the only counselling is that tv ad. Fair or not, that
would not look good to a potential jury and the lawyers know that
even in settlement discussions. they settle in the shadow of those
facts.
Finally, if the drugs are sold over the counter, then health
insurance companies are less likely to pay for them. Does your
policy pay for over the counter drugs? That may not be a big deal
on a small margin, small price item like aspirin, but when it is
hundreds of dollars per jar of pills, then many people will only
get the pills if they can use their insurance to do so.
Anyway, it would be cool if Bailey or one of the other
reasonwriters can track down a pharma rep and ask her whether
patented drugs would be sold over the counter if the law allowed
it. It would be real interesting to see the reps answers and see if
she saw things my way or T.'s (or was non-committal).
Drug companies aren't perfect, but they've done a lot of
good for me.
where they hurt me is when they charge my insurance company for
drugs for somebody who is not me (lets say a fat old man with high
cholestorol). then my insurance rates go up. When I was employed,
that was sort of okay. When I was unemployed it was really worrying
and painful wondering how I could scratch together the monthly
premium and keep the old COBRA going.
I don't blame advertising for this, but I do blame the fact that
the drugs probably sell for a lot more than they would in a more
transparent market. It really makes you wonder whether patent law
does more harm or good.
What's really interesting and kind of sad are the
disclaimers they put with them: "Menstruex helps menstrual cramps
and prevents digital hyperpilosity. In rare cases, your hair will
fall out and your eyeballs will explode. Not to be used with Midol
because this may result in twenty-hour erections in women. Ask your
doctor if Menstruex is for you!"
The one I just love says, "Tell your doctor if you've had a kidney
transplant."
Ya think?
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