For example, there's some very promising work being done on arthritis "vaccines"....most drug companies have shown little or no interest in the work.... On the other hand, drug companies are delighted to fund arthritis TREATMENTS.

I think there's a fair amount of financial incentive involved with producing a cure rather than a treatment, especially if you are the first out of the gate. See Merck's Gardasil (the HPV vaccine).

The biggest issue is that it has to work, and it has to be worth the side effects. The problem with all the -mab drugs being explored as an option for arthritis is that they haven't been shown to really "cure" arthritis on a long-term level... yet. So right now, they are basically just another treatment option. A treatment option that not many people will look at because 1.) They are expensive as hell and most insurances require you to jump through many hoops to pay for it, if they even pay for it at all. 2.) It's an injection, which most people are inherently resistant to, and 3.) The -mabs are basically systemic immunosuppressants, which can lead to a lot of serious side effects considering that most people with arthritis are elderly and therefore already have a compromised immune system.

I believe that once they perfect those medicines, there will be a LOT more research dollars being thrown at them. But at the current stage in the game, there's just too much wrong with them and not enough right for it to be worth it...

...And therein lies the Catch 22. A drug won't be researched if it isn't promising, but most of the time it can't be shown to be promising without a fair amount of research.

Hambriq

I teach medical ethics. This article is outdated, but shows the scope of the problem:
[medicine.plosjournals.org]

The CSPI's been continuously reporting on it; here's an instance from two years after that article:
[www.cspinet.org]

The issue has become far more prominent since the WSJ's story, but the problem does continue. And it is a very real question about whether there IS a truly reliable source of drug data for medical professionals; many GPs prescribe with this in mind. (Specialists have fewer problems with this, for a variety of reasons -- they're more likely to be involved in drug research/trials, they read specialized journals that aren't targeted as heavily by drug companies, they prescribe (say) gastrointestinal drugs to 1,000 patients a year instead of 10 so have a good idea of the side effects simply from their own practice -- but it is still a problem.) In some classes of drugs (luckily, mostly lifestyle drugs) that are heavily dominated by advertising, there simply isn't much if any clearly valid data available.

It's a terrible thing, because there ARE fair players in the industry, but it paints them all with the same brush. If I'm a drug rep who genuinely is interested in getting good, valid information to doctors about a new drug, in the hopes they'll prescribe it when appropriate, and the other drug rep visiting today has falsified studies in hand and is just interested in selling as much as possible ... well, we both get tarred with the same brush, and my decent data is thrown out with his crap data.

Eyebrows McGee

"The practice is better-known these days, and some of the journals actively guard against it, but it still happens, and it still happens a LOT."

A lot? I really hope you're wrong, because that is beyond scandulous. If mainstream medical journals are being duped, then what truly reliable source do doctors have for efficacy data and side effects for drugs?

Are you in the healthcare industry?

ClayS

The problem there is that studies have been forged, fudged, and manipulated, since typically the drug company pays for them. There was a series of scandals a few years ago when it was revealed they commonly did their own research, fudged the bad numbers, then paid MDs huge chunks of cash to put the MD's name on it when submitting it to an academic journal, to make it look like a 3rd-party study.

The practice is better-known these days, and some of the journals actively guard against it, but it still happens, and it still happens a LOT.

It's not that drug companies "bribe" doctors; it's that there are a lot of subtle ways they use to influence doctors, who are just as prone to being influenced by advertising as the rest of us (I myself am Pavlovianly trained to order pizza whenever a pizza commercial comes on), and a lot of ways to present them with falsified data that leads them to making less-than-optimal treatment decisions.

Eyebrows McGee

For example, there's some very promising work being done on arthritis "vaccines" (for the auto-immune varieties like rheumatoid arthritis, not for the osteo kind that's a result of running out of cartilage when you're old). However, it's extremely difficult to get funding for this research, and most drug companies have shown little or no interest in the work.

On the other hand, drug companies are delighted to fund arthritis TREATMENTS. Which isn't a bad thing -- advances in arthritis treatments in the last 10 years have been pretty spectacular and allow sufferers to live far more normal, less-painful lives -- but every auto-immune arthritis sufferer I know would much rather have the CURE than the treatments.

Some of the treatments run $1600/month, every month, for the rest of your life. The cure would be a one-shot deal. There is definitely a financial incentive to developing the treatments that doesn't exist for the cure, which is part of why most of the research on the vaccines is being done in academic laboratories, not by drug companies.

Still, that doesn't necessary mean this is a BAD way of doing things, except for two things: First, it can be very difficult to get "orphan" drugs (needed by only a few people) or high-liability, low-profit drugs (e.g., vaccines) MADE by drug companies even once they're perfected. Second, substantially more research dollars flow to drug companies than academic research, and "cure" research tends to occur in academia. (For a few reasons, not least of which is that "cure" research is often more experimental and has far less of a chance of panning out than research which tweaks existing drugs to come up with better maintenance/lifestyle drugs, and that is a fair reason for a public company to avoid "cure" research; hardly anybody since AT&T was a monopoly has allowed research with no apparent commercial applications.)

So perhaps the solution would be to redirect government grant money away from drug companies (it bugs the heck out of me that they get to patent drugs discovered using US gov't grants anyway and then charge so much for them, while other countries pay less!), or, in exchange for allowing direct-to-consumer advertising, require them to put X% of their ad budget towards producing orphan drugs or low-profit vaccines, which the federal government could parcel out among the companies to ensure adequate production. (They're already willing to hand out liability waivers in the desperation to keep vaccines coming!)

Eyebrows McGee

Lawk Salih

I would also not know that a certain restless leg drug will turn you into Britney Spears. (sexual and gambling impulses)

I also would not know that a 4 hour erection was a problem called priapism and it needs medical treatment and not another BJ.

trollkiller

If you watch TV or read any magazine anymore you would think we Americans are totally unable to eat, sleep, have sex, pee, not pee, function in public, not stop eating.........................without the help of the pharmacutical companies. At $150.00 for a 30 day supply of said medicine, of course.

SkyeBlue

catnapped

Rusted

I doubt the bribery is what is working. Would you compromise your values and your efforts to do your job well for a free lunch? Even more so for health care professionals where patients' lives and their quality of life is at stake.

The value of the drug reps is more likely their ability to get literature and up to date information on drugs to physicians. Also the free samples give the office the ability to get drugs in the hands of patients that may have financial or insurance issues.

Physicians sometimes have several drugs that are designed to treat a given condition. If all are known to be effective, which is the doctor likely to prescribe? Probably the ones that he is most familiar with and for which he has seen the latest studies.

The free lunches may help the rep establish a good relationship with the office staff which may be a prerequisite to getting their literature and samples to the physician.

ClayS

The surgeons I worked for didn't seem to give a crap who was pushing their goods. Patient satisfaction was what made their decisions, at least where I worked. I doubt many physicians prescribe any differently because of food and swag, but I just can't imagine why these drug companies continue to spend huge amounts of money on this "bribery" if it isn't working. The practice should be banned, or at least curtailed. Consumers shouldn't have to pay for this kind of crap.

MellowCat

More likely, they would release the cure, benefit greatly from customer good will, see a massive influx of research grants, then move on to other problems. If someone cured cancer tomorrow, there are still millions of other deseases that can be cured/treated. Plus if people live longer there are going to be more chances to sell Crestor/Cialis/other drugs like that.

The only time that I see a true effort to treat rather then cure desease are in the mental health field. GSK would obviously lose a big chunk of income if suddently Welbutrin (which they reformulated to extend patent) wasnt needed. Psych drugs are lifetime-use, and a big chunk of the money pharmas make.

Tracy Ham and Eggs

Tracy Ham and Eggs

Which company, needing to exceed shareholder expectations, could, in good conscience, roll it out to the market at a price of $10?

None. WAY too much money to be paid treating AIDS versus curing it. It would be "irresponsible" for them to do so.

Trai_Dep

Sounds like you've identified a significant market niche. Start a pharmaceutical company that will develop drugs that will actually cure disease. Clearly there is a conspiracy among the existing drug companies to keep patients on drug maintenance regimens without curative intent. Instead of pens and notepads, your drug reps can provide doctors with tinfoil hats with your company logo.

ClayS

catnapped

Mr.Purple

I had to watch it in my high-school Economics class ("the Economics of Health Care" was the unit being covered) and the teacher was an American immigrant to Canada, so he probably knew both sides of the issue when he showed it...

jamar0303

Drug companies research lifestyle drugs. Life saving drugs are much more often researched because of government grant dollars. Saving lives simply doesn't bring in the bucks that extending erections does.

I'm not sure I agree with that. The average patient at our pharmacy who regularly uses Viagra or Cialis goes through about 4 to 5 in a month. They both cost about $13 a pill, so the companies are making about 60 to 75 dollars a month off of these regulars. Now, compare:

Viagra/Cialis: ~$60-75 a month.
Crestor/Lipitor: ~$110-150 a month.
Nexium: ~$190 a month.
Diovan/Cozaar/Benicar: ~$120-130 a month.

Granted, these figures are just off the top of my head, and when I go into work today I can figure out exactly how much more money pharmaceutical companies are making off of maintenance medicines over lifestyle medicines.

The main reason behind it is, maintenance medicines have to be taken every day for the rest of your life. Get a customer stuck on a statin, and you have a customer for life. Lifestyle medicine, on the other hand, is taken on an as-needed basis. And when people start to cut costs, the first things that go are the lifestyle medicines, not the maintenance ones.

Hambriq

"I will agree with that (and you're sweet for liking me!), with one caveat: New drugs are almost invariably better than old drugs FOR A SPECIFIC SUBSET OF PATIENTS. Vioxx is CLEARLY better than naproxen for patients who don't respond to naproxen."

Here's where I disagree. As I mentioned in an earlier post, if a patient has high cholesterol, I cannot think of a single reason to prescribe an older statin over Crestor/Lipitor besides cost. I wouldn't say Crestor/Lipitor is better only for patients who don't respond adequately to Simvastatin. It's better, period.

Now, regarding Vioxx specifically, I think it's a huge stretch to say that Vioxx is unnecessary. Taking an NSAID (especially Naproxen) every day is going to wreck severe havoc on your GI system, especially in the age group of patients who tend to have arthritis. COX-2 inhibitors, on the other hand, have a significantly lower incidence of disturbances. By taking an NSAID daily, you are basically forced to tack on a PPI like Nexium every day in order to prevent a GI event, and the costs of that are going to end up being about equal to what it would cost to just pay for the Vioxx or whichever COX-2 you're using.

Now, the increased risk of MI is truly unfortunate, and obviously it represents a risk disproportionate to the reward. But to say that COX-2 inhibitors are unnecessary, considering the huge GI issues that stem from long-term NSAID use? I really have to take issue with that.

One hopes this is true, but countless studies show that doctors also respond to drug advertising.

Also very true. I think this stems more from the fact that doctors are constantly searching for better medications and better options to treat their patients. Despite this, they still have to remain prudently skeptical, to a point. So when a rep comes in touting the latest, greatest treatment option, the doctor is obliged to play the role of devil's advocate. Of course, this is a losing proposition. Even the most well-informed doctor will not have the kind of off-hand knowledge to go toe-to-toe with a good sales representative. A doctor's job is to know about everything out there. A sales representative's job is to know absolutely everything about the one or two medications they are selling.

Unless the doctor researched everything before hand and developed the same level of familiarity with the drug that the rep has, there's no way he's going to "beat" them. Therein lies the other problem. The doctor isn't looking to prove the rep wrong. He's looking for the best medicine out there. So if a rep can address all of the doctor's potential misgivings in a satisfactory manner, then why not prescribe the medicine? Again, the doctor isn't looking to show the rep why Simvastatin is better than Lipitor, or even why Crestor is better than Lipitor. He's looking for the best possible medication to prescribe his patients.

Hambriq

Then you need to read the research.

"Also, when a patent is about to run out on a drug the company will come up with a "new drug" to extend the paten life and to get new customers, the best example of this is Prozac. which is now used to treat women who suffer from PMS."

This is just patently false. Yes, Prozac (and all other SSRIs) is being used now as a line of treatment for women with severe PMDD. But Prozac has been generic for quite some time. Tacking on another indication to a medicine does not extend the life of the patent. You can still get generic Fluoxetine for 4 dollars and the only people who profit from that are the generic drug manufacturers and Wal-Mart, not Big Pharma.

Hambriq

I will agree with that (and you're sweet for liking me!), with one caveat: New drugs are almost invariably better than old drugs FOR A SPECIFIC SUBSET OF PATIENTS. Vioxx is CLEARLY better than naproxen ... for patients who don't respond to naproxen. For the majority of osteoarthritis patients who respond perfectly fine to naproxen (or ibuprofin, for that matter), Vioxx simply wasn't necessary ... and as it turned out, had dangerous side effects that weren't anticipated, and the drug should have been confined to the patients who didn't respond to the older, safer drug. But it wasn't, largely because of advertising.

"Why? Because any doctor worth his salt is going to prescribe the best possible medication within reason."

One hopes this is true, but countless studies show that doctors also respond to drug advertising. It's honestly only natural, because if they're already working a 60-hour week, they're probably not reading and closely comparing every single drug study in every English-language journal; they're going to respond to drug reps who provide them with timely, topical information, and they're likely not going to have seen any (very limited) studies that may suggest side effects outweigh benefits. Add that to drug companies buying studies, buying doctors' names to put on studies, and suppressing data on negative effects ... it's seriously problematic.

Even if they're only seeing excellent, third-party studies of a Brand New Drug (BND), it takes years for adequate side-effect and long-term use data to become available on BND. If older treatments are effective for a patient, there's no good reason to expose them to the risk of the BND until there's a substantial body of real-world data on the BND. It's when existing treatments are NOT effective that BNDs become an excellent idea.

Eyebrows McGee

Except that most AIDS and cancer drugs are developed using US government grants paid for by our tax dollars, not discretionary research dollars from drug company profits. And then patented by drug companies who make ridiculous profits off drugs that were funded by taxpayer dollars in the first place.

Drug companies research lifestyle drugs. Life saving drugs are much more often researched because of government grant dollars. Saving lives simply doesn't bring in the bucks that extending erections does.

Eyebrows McGee

Are there pharmaceutical representatives out there that couldn't spell their name of their drug if you asked them? Maybe a few

Are there doctors that would write a drug based solely on their relationship with a pharmaceutical company? Very possibly

Are there drugs out there that probably should not be on the market because they have relatively little value? Yes

Do pharmaceutical companies spend a lot on advertising (direct-to-consumer, pharmaceutical reps, lunches, etc...? Probably

BUT...

We forget that healthcare is a business, just like anything else. You take away the ability to make money and no one would do it. Sure it would be nice to say that everyone from your local doctor all the way to the CEO of Pfizer is doing their job out of the goodness of their heart... but let's be realistic here. If I told you that you can work your rear off to make a boatload of money (that you earned) or work for free, which would you choose? Yes, you will say that I am speaking in extremes... but am I really? If it wasn't healthcare but some other industry, would we still be burning everyone at the stake?

Some of you guys will argue that doctor trying to "upgrade" you to a "better" medication is a bad thing. If I told you that you could have two drugs, one cheap but works 30% and has a 25% incidence of side effects or one that is more expensive but works 35% and has only 5% incidence of side effects which would you choose?

Remember, your doctor is giving you options, if you say "no, I want a generic" they will prescribe you a generic. Like I said, I know a lot of doctors personally and while some of them may be kind to pharmaceutical reps, they are definitely shills or puppets of them and their company.

One last thing, a new drug may only marginal differences in efficacy but do not forget about tolerability. drug profile, etc... Regardless of what is may be, NO DOCTOR I KNOW OF would EVER prescribe a drug that is LESS EFFECTIVE and WORSE for the patients just because it's more expensive and because they go on trips or because they got free pens and pads, etc. For god's sakes, you all make doctors seem like they're homeless and destitute. Willing to jeopardize their license, get sued for malpractice just for a free lunch or pens with the drug's name on them.

l0pher

I live under the "socialized" medicine given to the military (no copays except for family dental). It's currently underfunded/understaffed (something about a war), but other than that it's pretty good.

But just a little off topic.

taka2k7

courtneywoah

Don't get me wrong. There are a lot of bullshit pharmaceutical companies. But it just seems intellectually dishonest to talk about "drugs we don't need to treat ailments cultured by public relations firms" from one side of our mouth and then decry the growing obesity, diabetes, and various other dietary problems ailing our country from the other.

Most of these drugs are beneficial. There are plenty of bad apples. Believe me. I know. But for the most part, most of the drugs that get advertised in medical publications and pharmacy journals and to directly to doctors and pharmacists are the kind that genuinely help people. High blood pressure and high cholesterol are the two leading contributors to the majority of the non-cancer deaths in America. And in my mind, anything that can help with that, I'm in support of.

Hambriq

All that marketing money isn't being spent convincing doctors to upgrade from cheaper medicine to more expensive medicines. Why? Because any doctor worth his salt is going to prescribe the best possible medication within reason.

No, Pfizer is spending all their money to ensure that doctors prescribe Lipitor over Crestor. And Astra Zeneca is spending all their money to make sure doctors prescribe their patients Crestor over Lipitor. Why? Because Lipitor and Crestor are clearly superior to older statins like Simvastatin, Pravastatin, and god forbid, Lovastatin. The only real reason to be taking an older statin is because of financial issues. If all the medicines cost the same, there is no reason I can think of not to take a newer statin.

So, what it boils down to is, doctors aren't being convinced to prescribe a more expensive medicine over a less expensive one. They're being convinced to prescribe one expensive medication over ANOTHER expensive medication.

Hambriq

I like you. Everyone else in this post, not so much. And I may have had some wine with dinner, but I'm always good for wading into a raucous pharmaceutical debate.

Here's my stance: New drugs are almost invariably better than old drugs.

Now, I will be the first person to point out the million and one bullshit medicines out there that have no business being prescribed. Zegerid. Doryx. Solodyn. Tussionex. The countless "XR" formulations of existing medicines: Effexor XR, Toprol XL (prior to it going generic), Coreg XR, Ambien CR. And that's just off the top of my head.

But when it comes down to it, if I had high cholesterol, I would want to be on Crestor or Lipitor, and not on an older statin. If I had high blood pressure, I would rather be on an ARB (Diovan, Cozaar, Benicar, etc.) than an ACE Inihbitor (lisinopril). If I were manic, I would rather be on an atypical antipsychotic (Abilify) than a typical one (Haldol).

Why? Because these newer, more expensive medicines are better.

Hambriq

NickRB

NickRB

psyop63b

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

ClayS

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

ChristopherDavis

Tracy Ham and Eggs

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.

Eyebrows McGee

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.

Eyebrows McGee

topgun

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!

Boberto

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.

thing_vs_thing

Boberto

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...

Elviswasntmyhero

woertink

arby

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

SkyeBlue

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.

DoctorMD

deb35802

floydianslip6

Tracy Ham and Eggs

TechnoDestructo

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

VicMatson

floydianslip6

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.

woertink

topgun

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.

Trai_Dep

skatanic

topgun

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."

Eyebrows McGee

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).

xtc46

snoop-blog

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.

xtc46

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.

snoop-blog

skatanic

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...

ceriphim

ARP

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.

aphex242

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.

ARP

skatanic

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.

LAGirl

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.

TomK

johnva