patrick.net

Restraint on direct advertising of potentially dangerous drugs to force physicians to prescribe them by dint of patient demand is overdue.

Ironman says

Do the patients hold him at gunpoint until he writes it?

American general practitioners' number 1 complaint is patients lying to them in order to get permission to buy drugs they saw advertised on TV but that are bad for them. If you want to be cynical about the AMA (which comprises fewer than 20% of doctors, mainly specialists), you can suggest that their real complaint is they'd rather prescribe the drugs and treatments that they have a financial stake in, which might also be bad for the patients. Ultimately, as long as federal and state governments prohibit patients from making their own decisions (e.g. Rx requirements and the drug war), the overpricing system (including emergency hospitalizations and eye-popping revenues from complications) can continue.

If only Doctors are allowed to diagnose, treat and cure diseases...where is a doctor in the ads diagnosing you?
There isn't one.

curious2 says

American general practitioners' number 1 complaint is patients lying to them in order to get permission to buy drugs they saw advertised on TV but that are bad for them.

There is no logical reason why patients, who are basically completely ignorant of the difficult field of medicine, should be asking or demanding specific drugs from doctors who are far more knowledgeable about medicine. Thus there is no legitimate reason to advertise drugs to the general population. It can only cause bad things.

Dan8267 says

patients, who are basically completely ignorant of the difficult field of medicine....

Patients who get their information about drugs from TV ads are worse than ignorant, because the drugs "as seen on TV" tend to be among the worst. But, if they get the doctor to sign the mandatory Rx slip, they can shift the absurd costs via mandatory subsidized insurance, so they feel like they are getting a "benefit" endorsed by an expert. Meanwhile, the evening "news" on commercial networks is brought to you primarily by drug companies, and half their ads are for drugs the audience can't even buy without an Rx from a licensed prescriber.

Other patients can include PhDs in pharmacology, foreign or retired doctors, and so on, and they are all subject to the same Rx mandate even if they know precisely what they need and pay for it on their own. There is no logical reason (other than a revenue reason) to require them to buy permission slips, but the Rx system enables massive markups at every stage, including hidden payments to doctors, among other carrots and sticks that distort doctors' prescribing patterns. Studies have found that giving doctors "freebies" as cheap as pens can distort prescribing patterns. It's why I likened Obamneycare to Taxicare: nobody is allowed to walk or bicycle or drive on their own, everybody is required to ride in the Taxicare, the most expensive and cumbersome way of getting anywhere, and with no assurance of getting where you want to go.

It's every drug profiteer's dream to be a pusher, whether there is a need or precaution or not. Direct advertising of these brand name drugs to a public ill equipped to evaluate what they are taking is the closest the pharmaceutical industry can get to being a pure pusher.

I would never suggest that the middle men (doctors) are incorruptible, but often they just do what is convenient and will please the patient. Also, a lot of doctors don't necessarily know a lot about the drugs they prescribe to begin with, and rely on the pharmaceutical propaganda around brand names as much as the patients.

It's called trying to generate a false need/demand purely through slick salesmanship which is devoid of indication, appropriate diagnosis, context or individuation, or trying to get advertisement-dazzled but poorly informed patients to pressure their providers.

Well then maybe you need to update your logical reason list...

Dan8267 says

There is no logical reason why patients, who are basically completely ignorant of the difficult field of medicine, should be asking or demanding specific drugs from doctors who are far more knowledgeable about medicine.

Why Doctors Uselessly Prescribe Antibiotics for a Common Cold
Let’s get real. The list is mostly stuff that most doctors already know isn’t going to help the patient, such as antibiotics for a cold or a mild sinus infection. Most upper respiratory infections are caused by viruses, and will clear up on their own in a few days. Yet about half of the 100 million prescriptions written for antibiotics each year are for respiratory ailments that aren’t going to be helped by a drug.
http://ideas.time.com/2012/04/16/why-doctors-uselessly-prescribe-antibiotics-for-a-common-cold /

I loathe pharmaceuticals and don't touch them personally, but to ban their advertising is anti-freedom and also counterproductive (in the same way the 'war on drugs' is counterproductive). The solution to the pharma problem is education and personal accountability.

One cannot legislate good behavior. One can however encourage legislative policies that promote sustainable culture and individual opportunity for good behavior. I think our policies should support organic food and natural remedies. Good enough for our ancestors. In harmony with nature.

Greg Glaser says

The solution to the pharma problem is education and personal accountability.

Yeah, what about the major segments of the population that are ineducable dumb fucks with no personal accountability to speak of.

Yeah, what about the major segments of the population that are ineducable dumb fucks with no personal accountability to speak of.

-----------

Hell, I don't think intelligent folk are immune from the hypochondria mentality, and the brainwashing that there's a Rx drug to remedy it. This perverse nonsense has affected everyone

Personal accountability is a recipe for success in the big picture. Institutional accountability is a safety net and a bonus, but people can't live day-to-day on safety nets and bonuses.

Nations need to produce high-quality sustainable products and intelligence day-to-day. Pharmaceuticals are not sustainable, and are questionably intelligent. Even Coke is a joke, its quite terrible for the body, even though its advertising is stellar. When bodies choose not to act in their own best interests - to answer Ceffer's question - they fail.

Failure is good because it produces useful or educational results. Things are supposed to fail. Plants grow, then die, and that produces organic soil. The problem is when things are sustained unnaturally. When failure is presented as success, that's a problem. And that's what this thread is about - marketing problems as success.

Ironman says

doctors are just trying to pass the buck for THEIR mistakes in treating their patients

They certainly share some blame in writing prescriptions for opioid drugs in Ocean County. After patients there get cut off, they start seeking out heroin.

Ironman says

Yeah, what about the major segments of the population that are ineducable dumb fucks with no personal accountability to speak of.

Be nice to the Obama voters...

There are a lot of people like that in Ocean county unfortunately and more than half of them didn't vote for Obama.

Ironman says

Do the patients hold him at gunpoint until he writes it

No they just doctor shop until they get what they want; very common in Ocean County....not surprisingly the opioid abuse there is just behind Newark, Camden, Trenton, Atlantic City, Elizabeth and Paterson. Specifically Toms River, Brick, and Jackson and probably further south in places like Waretown.

SoftShell says

Yet about half of the 100 million prescriptions written for antibiotics each year are for respiratory ailments that aren’t going to be helped by a drug.

And yet,that might be a fraction of the antibiotics the general public is exposed to. Most of the antibiotics used in the US are used in livestock, particularly those coming from CAFO operations.

Also, some antibacterial hand cleaners contain antibiotics....triclosan was one that came to mind.

Dan8267 says

Thus there is no legitimate reason to advertise drugs to the general population

Most of the budget comes for marketing of drugs and not R and D. I believe someone of your intelligence could grasp that info quite easily if you decide to.

Ironman says

There's a reason why over 200,000 people die a year due to physician errors

It could be a lot of reasons, but the reason why so many might be dying off of drugs used as prescribed is because the interactions between 10 different drugs at the same time isn't studied or well understood. I can't for the life of me realize why so many patients are on that many drugs at one time on a daily basis for years, in some cases. No emphasis on prevention whatsoever.

Ceffer says

Also, a lot of doctors don't necessarily know a lot about the drugs they prescribe to begin with, and rely on the pharmaceutical propaganda around brand names as much as the patients.

A lot don't even know how to precisely prescribe the drugs. In many cases ,the pharmacists are more knowledgeable.

curious2 says

Patients who get their information about drugs from TV ads are worse than ignorant

medical equivalent of a low information voter.

Numbers vary by year, so I have updated this comment a few times as I find more.

As of 2014, BBC reported that each of the world's 10 largest drug companies spent more on sales&marketing than R&D.

As of 2012:

"Prescription drug companies aren't putting a lot of resources toward new, groundbreaking medication, according to a recent report in BMJ, a medical journal based in London. Instead, it's more profitable for them to simply to create a bunch of products that are only slightly different from drugs already on the market, the reports authors said.

The authors go on to say that for every dollar pharmaceutical companies spend on "basic research," $19 goes toward promotion and marketing."

As of 2008:

"The U.S. pharmaceutical industry spent 24.4% of the sales dollar in 2004 on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion."

Also note that many states require doctors to endure "continuing medical education" (CME), i.e. PhRMA infomercials, where profitable prescribers can get complimentary tickets to Hawaii while unprofitable prescribers can be required to pay to sit in a basement and learn the error of their unprofitable ways:

"In 2011, the pharmaceutical and medical device industries provided 32 percent of all funding for continuing medical education courses in the United States—$752 million out of $2.35 billion. To prevent these courses from functioning as veiled marketing, they are regulated by the Accreditation Council for Continuing Medical Education. However, a 2007 Senate Finance Committee report found that “drug companies have used educational grants as a way to increase the market for their products in recent years.”

It's the lemon socialist version of Maoist re-education.

Ironman says

So, as we see, marketing Directly To the Consumers (like the chart above showed) is only a SMALL piece of the puzzle, and the actual sales/marketing spending (backing out all the salaries and other expenses lumped in to the SG&A) is HALF in comparison to the R&D costs.

http://www.fiercepharma.com/story/does-pharma-spend-more-marketing-rd-numbers-check/2013-05-21

Funny, a year later fiercepharma changed their mind about that. http://www.fiercepharma.com/story/new-numbers-back-meme-pharma-does-spend-more-marketing-rd/2014-11-06

Ironman says

So, as we see, marketing Directly To the Consumers (like the chart above showed) is only a SMALL piece of the puzzle, and the actual sales/marketing spending (backing out all the salaries and other expenses lumped in to the SG&A) is HALF in comparison to the R&D costs.

http://www.fiercepharma.com/story/does-pharma-spend-more-marketing-rd-numbers-check/2013-05-21

Funny, a year later fiercepharma changed their mind about that. http://www.fiercepharma.com/story/new-numbers-back-meme-pharma-does-spend-more-marketing-rd/2014-11-06

Ironman says

My point, (like I mentioned above), is that many doctors aren't great at what they do and don't take the time to learn about new drugs. It's sad that the patients (by way of direct advertising) have to PUSH the doctors in considering new, advanced therapies for treatment. As the chart shows, even with all the money spent directly focused on helping the doctors learn, that effort falls short, as the doctors don't get it.

That's why the two most advertised drugs by far are viagra and cialis? For that advanced therapies for treatment? At least viagra went off patent in 2012. Oh wait a minute, Pfizer used their vast R&D spending to tweak viagra to extend the patent so the new and improved viagra has another 7 years of heavy advertising and high profits.

After that the third most advertised drug is humira a biologic for arthritis. Any doctor treating serious arthritis, the kind that would need biologics, knows all about the 9 biologics currently on the market and when to use them.

Fourth is lyrica for nerve pain. Abapentin and tricyclic antidepressants are just considered just as good and are far cheaper.

Fifth is Eliquis, which like Pradaxa and Xarelto is new generation of blood thinner. Blood thinners aren't rocket science, Warfarine has been used for 60 years. The new generation doesn't require blood testing like warfarine, but that's hardly advanced therapies for treatment that doctors don't get. Interesting that Eliquis was released without an antidote for serious bleeding events.

So these 5 are half the spending on DTC advertising for 2014. https://www.washingtonpost.com/news/wonk/wp/2015/03/23/yes-drug-companies-are-bombarding-your-tv-with-more-ads-than-ever/ Where is the advanced therapy that doctor's don't get?

I just love those commercials...

"Ask your Doctor if Perplexia is right for you!"

I mean can you imagine.
"Hey Doc you know I saw and advertisement about Perplexia, I have no idea what it is or what it does. But the guy on the TV said to ask you about it. Are sure I don't need Perplexia?"

"Hmm! Well I'll be damned... You know come to think of it you might be right. I'll Google it in my office while you wait in the pay up room, for another hour then I'll write you a script. "

"Well the feller in the advert sure did sound like he knew what he was talking about."

Curious2,

at some point you should start a thread to discuss the current state of healthcare and the future of ObamaCare. It would be good to get homeboy back in here and see how most of his arguments were BS. Our small business "effective" premiums jumped over 20% this year (8% premium increase and 30% out of pocket max increase from 10K to 13K per family). However, i talked to some larger companies and they are not seeing the same premium increases. On exchanges most plans have seen effective increases of 10-15% (higher premiums and higher out of pocket). It appears that subsidies only jumped 6-8%

Thanks tr6, but I don't see much hope as long as the industry runs both major parties and is the largest sponsor of the evening "news" pipers, calling the tune. The GOP clown show looks worse than the Democrats, so I've been trying not to think too much about it.

curious2 says

Thanks tr6, but I don't see much hope as long as the industry runs both major parties and is the largest sponsor of the evening "news" pipers, calling the tune

Agree. The biggest reason to keep insurance is get "negotiated rates" which are often 80% less than the list price. Without insurance, it's nearly impossible to negotiate with certain providers such as Quest or big hospitals