Sunday, July 10, 2005

Which Drugs Are Right For You?

Most doctors will tell you about the power that continual pharmaceutical advertising has on television to persuade the public to demand the latest drug, often without a clear understanding of whether they need the prescription.

In clinical trials, new drugs usually are tested on a sample of usually less than a few thousand people. The trial sample does not cover all the possible side effects that may occur. However, direct-to-consumer advertising helps greatly enhance sales of these largely unknown products.

By the time hidden side effects surface, millions of people may have used it. That happened with new-generation painkillers such as Vioxx, linked to thousands of heart attacks and deaths.

The governing body of the American Medical Association, which represents some 250,000 physicians, will not support legislation in Congress to ban direct-to-consumer ads on TV and in print for a period of time following approval of pharmaceuticals by the federal Food and Drug Administration.

Instead, the AMA's house of delegates, at the group's annual meeting in Chicago, adopted a resolution calling for "further study" of the problem. In the process, the group shuffled aside no fewer than six resolutions from various state delegations that argued strongly in favor of a ban.

AMA officials insisted the action doesn't mean the association won't eventually support a ban, but published reports indicate that the pharmaceutical industry launched a full-court lobbying campaign at the Chicago convention to thwart action by the physicians.

Big Pharma's line with the AMA was the same one to Congress: Don't ban drug ads; the industry is going to limit them voluntarily.

In view of the explosion of such advertising since the lifting of a previous federal ban in 1997, voluntary limits are not enough. The drug industry spent $1 billion a year on advertising before the ban was lifted. Now it's $4 billion and climbing, and only Americans living overseas are immune to the explosion.

The advertising message is very simple: "Ask your doctor if [Cialis, or Nexium, or Lipitor] is right for you."

This tends to assume that every patient needs prescription for expensive name-brand drugs for erectile dysfunction or acid reflux or high cholesterol. Less expensive generic substances work just as well, but the catchy brand ads prompt them to ask just the same.

Physicians realize the problem because they spend a significant portion of their office hours dealing with such queries. Sometimes, the doctors even enable the industry tactic by prescribing certain drugs against their own better judgment.

A recent study published in the AMA's own journal showed that primary-care physicians were five times as likely to write a prescription for an anti-depressant if the patient mentioned a specific name brand.

The AMA to want to have all the data it can get on direct-to-consumer ads, but some of the objections are weak, eg it is suggested a ban would violate the free-speech rights of the drug companies. If the federal government can ban tobacco advertising, it can ban harmful drug ads.

It is also interesting that the main reason Big Pharma want to block the availability of generic drugs online, is because generics spoil the returns required to make research viable. When the money spent on advertising is compared to the funds spent on research - the arguements of Big Pharma sound hollow.

The fact is as a percentage of pharmaceutical lines revenue other nations spend about the same as USA on research. Yet in other countries like Canada and Australia, pharmacy lines are up to 80% cheaper. So where is the big price difference you ask? Well we have just gone full circle, take a look at the advertising.

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