They really need to re-ban direct-to-consumer advertising of prescription drugs. Not only is there no reason for it, and not only does it encourage drug companies to focus their research only on "marketable" drugs, it makes our drugs much more expensive. And most other countries do not allow it. Doctors should make the decisions about prescription drugs anyway.

Don't get me startd on these fuckwits.

Most of what they do spend on RD goes to finding ways to extend patents on profitable drugs. If your allergy pill patent is about to expire better find a way to modify the formulation and extend your patent another few years, then do a study that shows a 3% improvement over the last formulation. Then design an ad campaign that plays up the advantage, taking advantage of the fact that most american are scientifically and statistically illiterate, then put those ads everywhere and who cares if thats the best way to spend the health care dollars from a medical point of view.

Prescription Drug advertising should be forbidden. " I SAW IT ON THE TV AfTER THE AMERICAN GLADIATORS I WANT" is not a great way to do medicine.

In a system without advertising and bribes to doctors, the medicines that work best make the most profits. In systems with ads and bribing doctors (what we have now) whoever is best at advertising and bribing doctors makes the most profits.

i was seeing a pain management doctor for my migraines. he always pushing new drugs. after experiencing some very negative side effects from a few of those drugs, i decided to stop blindly taking whatever he prescribed.

i also started to question:

* why was he always traveling (Hawaii, NYC, San Francisco, etc + staying in five star hotels) to give 'lectures' about drugs?

*why were there always fully catered lunches at this office?

*why was there drug company 'swag' all over this office i.e. note pads, pens, posters?

*why was there a photo of my doctor, smiling, with a group of drug company reps framed + hanging in his office?

when i finally figured out he was a drug company 'shill', i fired him.

"Profit is good, but profit at the expense of the public health is dangerous." I think its a sever lapse in judgment to assume that companies have some sort of conscience. It's called capitalism. The whole point is to make money, not to help people. As long as there are enough people to buy their products, the pharmaceutical companies couldn't care less about public health. Capitalism has never been on the side of public wellbeing and never will be. Regulations do little to tame the beast that is capitalism, and the only real solution is to slay it.

Skatanic- I don't think the solution is to end capitalism, just to regulate certain components of it to balance the public interest.

I agree with other posters that we need to stop direct to consumer advertising of drugs. We also need to stop (or at least have full disclosure) of all the bribery going on at doctors' offices.

The problem is that behind the oil and pro-Isreal lobby, the drug lobby is the most powerful group in Washington.

@skatanic: That's patently silly. As previously stated, if you end direct-to-consumer marketing the best drugs will generally sell best.

Capitalism involves making things people want and selling them for a profit. Right now we 'want' the crap they advertise on TV, rather than new cures, new drugs, etc. Legislation can end that vicious cycle and make drug companies innovate once again.

That would be capitalism, and it'd work just fine.

I should clarify lest I be viewed as anti-semetic. I'm not suggesting that the pro-Isreal lobby is a good thing or bad thing (unlike the oil and drug lobby- they are bad), only that they are well organized and very powerful.

I agree the whole pharmaceutical industry is pretty much f**ked here in the U.S.

However, I was recently very sick for an extended period of time, and in seeing no less than 5 different doctors at more than one clinic NOT ONE of them prescribed me a brand name drug. In fact, every one of them were generic. So I might have felt a little out of place grilling them on accepting drug company money...

So i suppose you would be the one lobbying in congress to get legislation passed? The fact that they have billions of dollars is going to outweigh your concerns.

why spend money on a valtrex commercial? are there really that many people with herpes who call in when it comes on?

why advertise a drug that i need a Rx just to get? if i was getting a Rx from a doctor, wouldn't he tell me about my choices? i would think i could at least ask.

As much as I dislike that big pharm are money hungry and are in it for the profit, I can't help but think "so is just about every other business"

Everyone needs to make a living, and the fact is, the vast majority of people won't work for free, and if you are really good at what you do, you demand a high pay for it. If there was no money to be made in medical research, some of the industries top groups wouldn't do it.

Now, there is a huge difference in making a living and swimming in pools of money like some of the top execs, but good leadership costs money, and if it takes billions of advertising dollars to make the money for the companies who do the research to sell the drugs that cure and treat disease, then I'm ok with that. Anyone who doesn't like it is more than welcome to get into the field, and start their own non-profit drug company.

slow COMMENTS day? lol.

@snoop-blog: the advertisements are there for 2 reasons. 1) so you think you have the symptoms they treat (typically they only list the most general symptoms) A good example of this is for the commercials for people with restless leg syndrom. The symptoms are so common that millions of people will think they have it, but in reality the condition is no where near that common. These people then see a doctor, and out of that group and handful will refuse to believe the doctor when he says they are nuts.

2) so when you have a condition, you request their drug becasue it sounds familiar. If a doctor tells you 3 names you never heard of you will have no opinion of them, especially if he says they are all equal. If he lists 3 and you have heard of 1 from TV commercials, you will pick it (even if you don't realize that is why you are picking it).

@LAGirl: "he always pushing new drugs."

This should be a red flag generally. I teach medical ethics, and ethically, the best practice is to start with drugs with long track records that are generally known to be safe and have a wide body of research behind them (and the side-effects are well-understood).

Only if the older drugs don't work to you move forward to newer ones. Because even once they're approved, it takes years, even decades, to build up the kind of real-world side effects and long-term effects and efficacy data that helps make for good decisions for specific patients in specific circumstances.

If a doctor wants to START you on a new drug (say Vioxx instead of naproxen for osteoarthritis pain), the doctor should be telling you WHY he or she feels the drug is so superior to naproxen for your specific situation to warrant the new drug. Because sometimes the new drugs truly are vastly superior, but often they're just better-marketed.

I didn't really think anything of it until I started teaching medical ethics, but I've always had doctors that did this: "I want to try you on a newer antibiotic. Amoxicillan would clear your sinus infection, but we find we get better compliance from college students with the Z-Pak since there are 5 dosses instead of 30. However, it might be harder on your stomach. It also costs more."

Do you realize that very few drugs actually CURE anything. They mostly maintain a certain acceptable level. Of course the drug companies don't want you to get better. Then you would have no need to buy their product. When their exclusive rights to produce a drug runs out and the generic equivalent becomes available they IMPROVE the original drug. Case in point is GSK's Coreg CR. Cogeg CR is taken once a day with a cost of $148 for 30 capsules. Take the generic Carvedilol twice a day and 60 tablets will set you back only $4.

@aphex242: This is the point i am trying to make: In capitalism, money is always going to be the bottom line, and everything, like public interest, is going to take a back seat to money. Millions and millions of people may be concerned about an issue, but if they don't have money, they will be at a huge disadvantage to any opposition that has money. As much as we may dislike direct-to-consumer advertising of prescriptions, we are going to have a hard to being heard. It would take us thousands on man hours to inform the public, raise money to be heard, and still the majority of the public isn't going to care. All the pharmaceutical companies have to do is lobby a bit to congress and create a clever ad campaign explaining the "benifits" of direct-to-consumer marketing and the "risks" of not having them.

In line with TomK's comments, even Big Pharma's "research" is misleading. The vast majority of their funds - as high as 80% - go into reformulating existing drugs to extend their patent, or on "lifestyle" drugs that treat hair loss or limp dicks. NOT saving lives.

For example, Malaria drugs aren't researched, even though they'd save literally millions of (brown-skinned) lives, because they can't charge Third World people enough to get Wall Street excited. Same with flu vaccines.

So not only do they spend WAY more on amoral marketing than research, but even their research is skewed away from helping those that need the most help.

@snoop-blog:
Excellent point. As always "word of mouth" is always the best advertising. Take Oxycontin for example. I would ask my doctor for that.

@snoop-blog:

Not necessarily, there are a lot of new drugs coming out and doctors do not always take the time to keep up with the advances.

You don't need to spend mad amounts on research, you can just steal it from academia!

About a year ago I saw an article that told a story of a drug company. Apparentally they hire college cheerleaders straight out of school and pay them 6 figures(pun intended), then they relocate them to new, to them, areas to do what they do. The problem was these girls didn't know they were candy for the doctors...and sues their employer.

In the same article it said the research cost was about 17%, naturally I howled!

So the depiction of the drug industry in "Brain Candy" is spot-on, then.

@VicMatson: Every rep Ive ever met has a Biology or Chem degree. Yes, a lot of them are buxom blondes, but they know the drugs. I dont see a problem with reps coming to my doc and providing him with lunch in order to get time to present him the facts about their companies products. I did the same when I did business to business sales, you need to make it worth the time it takes to hear you out.

@JustRunTheDamnBallBillick.: The point is that it's medicine, not a vacuum cleaner being sold door to door. The product should be used because it does the job, not because you took Dr. No out golfing.

I used to work for a family medicine residency program which had 36 residents in it. The amount of advertising, doodads, and seminiars that are shoved at these doctors is obscene! Also they were REQUIRED to attend daily (Monday - Friday) lunches at which pharm reps would come in and push their latest product. After working with docs I only go to see one if I'm in severe pain or running a high temp.

Direct advertising should be banned again. There was no health reason to allow it. If they want a educational commercial that spotlights a disease and says "treatments are available" or "medication may help" that is all that should be allowed.

If a drug is developed at a public institution, with NIH funds or other gov't funds there should be a cap on % markup (profits) able to be gained by selling the drug. (Really on all drugs but it would be a start)

"Me too" drugs in the same class (mechanism of action) should have to prove superiority in efficacy or side effects before a patent is granted.

(LAGIRL: Try seeing a chiropractor for your migraines. Mine has worked miracles for me. I used to get BLINDING migraines but now get maybe 1 or 2 mild ones a year now and I see him at the first sign of one and he fixes me right up.)

Does anyone know if physicians get an actual "kickback" on the medicines they prescribe?

@ARP: If you're going to cast aspersions, at least learn how to spell what you're casting them at: it's Israel and semitic.

@doctormd: I would prefer it not be banned since I am a big fan of freedom of speech.

"In reality, drug companies pour $57.5 billion into marketing,"

When someone translates this for the poppy farmers of Afghanistan, U.S. troops better watch their backs.

----

"We think there is something severely wrong..."

And the award for understatement of the year goes to...

@ARP: "You're a rabid anti-dentite"

@EYEBROWS MCGEE
Three cheers for the medical ethicist! May I ask where you teach? I'm always looking for some book-learnin'.

With regard to being prescribed the Z-pak for a sinus infection - I was shocked. Most physicians I know will always prescribe the older (and cheaper) antibiotics before throwing the Z-pak or even Cipro at an infection, unless a culture specifically shows an antibiotic resistant infection.

Besides keeping costs down, the practice reigns in antibiotic-resistant infections. Why risk creating azithromycin resistant bacteria if amoxicillan would kill the critters in your boogers? I've only ever heard of the Z-Pak prescribed for the most severe infections and painful venerial diseases, so prescribing it for a sinus infection sounds like overkill.

@SkyeBlue: It's all non cash with exception to inviting MD's to become research board members or medical directors of studies. Beyond that, it's a conference here, a golf outing there, a cruise etc. It's like a time share pitch that starts in the Doctors office. Results are tracked by how many prescriptions are written and to which Patients. (Yes, the drug manufacturers know that Dr. X wrote an Rx for your RLS and that you've had it refilled three times at CVS. They know the dates and even what your copay was.

Those MD's that produce results (as referenced above) get the "educational" invites. You fly in on day one and all attend the mandatory conference. Sign in for your CEU credit (Another Scam), and your free to do what you wish for the remainder of the trip.

All expenses paid.

THIS IS WHY IMPORTING CANADIAN DRUGS CAN BE SO LIFE THREATENING!

@JustRunTheDamnBallBillick.:
My experience is just the reverse. I know 4 drug reps that have no background in chemistry or biology. My friends wife who is a rep barely made it out of high school and can only spell drug if you spot her the D & the G. She does however have a great ass and an ample rack.

@SkyeBlue: "Does anyone know if physicians get an actual "kickback" on the medicines they prescribe?"

It's supposed to be illegal and in most states ethical canons specifically provide for loss of license if doctors take kickbacks.

The problems come in with "what constitutes a kickback?" Schwag? Food? Trips? Free samples? Or only clear and direct monetary pay-outs to doctors who provide X prescriptions a month?

The other problem is that technically a doctor-owned pharmacy is a "kickback" machine, as the doctors get the profits from the pharmacy and therefore have an incentive to unethically overprescribe. However, in many rural areas, the doctor's in-house mini-pharmacy may be the only place to get drugs for 50 miles, and it's absurd to prevent doctors from stocking common prescription antibiotics and painkillers in that situation. (It also raises questions about hospital pharmacies that are open to the public.)

So the trick is defining "kickback" in such a way that it prevents drug companies from unduly influencing doctors' clinical judgment (which DOES happen, there are dozens of studies on it), but doesn't a) prevent education (drug companies can provide valuable educational material to doctors) or b) create scenarios like the one above where patients have to drive 50 miles because their doctors can't take "drug kickbacks" by making a small and regionally-standard profit on pharmaceuticals.

@thing_vs_thing: "Three cheers for the medical ethicist! May I ask where you teach? I'm always looking for some book-learnin'."

I teach at a local college, Illinois Central College, which I'm sure you've never heard of. It's a community college; we have a lot of medical technician programs and a full RN degree.

"With regard to being prescribed the Z-pak for a sinus infection - I was shocked. ... Besides keeping costs down, the practice reigns in antibiotic-resistant infections."

You're absolutely right. They were actually engaged in a clinical practice experiment that I understand was being carried out across several college campuses. They were having problems with drug-resistant common infections like strep and sinus infections on campuses because students don't keep normal schedules and were wildly unreliable about taking all 30 doses of a "3x day for 10 days" regime. So they were researching to find out if a) compliance was higher with 5-dose antibiotics and b) if compliance on the 5-dose regime fixed more drug resistance problems than it created.

This was also a few years before "superbug" was getting national press as an issue (about 1998, I think); I've read that antibiotic compliance has gone up generally as people have become more aware of the "superbug" issue.

Here is one question I have about those numbers. How much of that ad budget is free samples? I know most doctors keep closets FILLED with samples. When I was going through a rough financial patch I got almost all my meds free that way, and a friend of mine got the expensive baby formula she needed the same way.

I say we just reduce the patent protection period for a drug by one month each time the company does any direct-to-consumer advertising. That'll take care of it.

If you haven't yet, watch Sicko.

In the meantime, I'm moving to France, Canada, England or Cuba, or really any of the other 37 countries with better health care than us.

@Asvetic:

See ya. Don't let the door hit you in the ass.

I never bought the political/corporate propaganda that drugs cost so much due to research costs/slow-ass FDA/etc, and not advertising.

I think the consumerist really missed the mark on this one. Developing a single drug that is successfully brought to market costs...ready?.... Billions!!! If they don't sell a lot of drugs that are VERY VERY VERY profitable they would have NO MONEY to develop any drugs. Think about it. AIDS patients would suffer horribly. No new cancer drugs would be developed. Kids couldn't get vaccines. Drugs are very expensive to make and the companies need to spend that kind of $ on marketing to make enough profit to fund the R&D. Don't forget you also have bullshit lawsuits. You know, like the kind that put Dow Corning out of business over leaking breast implants. Forget that there was NO SCIENCE OR FACT AT ALL to back up the prosecutions claims. Every drug company has to be prepared for these kind of lawsuits as well. That means they NEED a stockpile of $$$. If the drug companies spent