Prescription Drug Advertising

[A Nonny Moose 8,261]

Tonight, I happen to be watching a series of shows on the CBS affiliate in Detroit and I noticed several prescription drug advertisements for medications to treat conditions I happen to have.  Each was accompanied by lists of contra-indications that made by blood run cold.

If the drug company who sponsors these shows is having trouble getting physicians to prescribe their drugs, why should they think that media advertising is going to improve matters?

I have several fully controlled chronic conditions that I have had for more than twenty years.  All of these are controlled completely by a set of prescription drugs that have no apparent side effects for me.  Why should I go running off to my physicians and specialists to ask about drugs whose contra-indications cause me serious trepidations? 

This whole business needs discussion.

[DCMetro34 576]

I suppose some people would run off to their doctors because the condition affects them and they don't have a prescription for it yet (they aren't being treated). Some people will believe everything they see on TV........

-DC

[Zelgadis 638]

Far too many of these commercials are specifically crafted to make people think they have diseases or conditions they don't have.

Last time I went to Kentucky for a visit, I heard an ad for a drug for RLS (Restless Leg Syndrome).  Now, I'm sure that there are a few people out there who really have RLS, but they made it sound like everyone who gets a shaky leg once in awhile had a syndrome that needs drugs.

Couple that with the fact that some doctors are paid by drug companies to push their pills, and you have an overmedicated society.

ISF

 

[Duke87 1,070]

Originally posted by: N_O_Body

If the drug company who sponsors these shows is having trouble getting physicians to prescribe their drugs, why should they think that media advertising is going to improve matters?quote>

Because it does. People see commercial, people want drug.

Meanwhile, the list of side effects taking up half the ad just gets tuned out as noise by most of us since we're used to hearing it all the time. And besides, we've been desensitized to them. "Rare but serious side effects" and stuff like that doesn't scare us, it's become just a boiler plate.

Originally posted by: Zelgadis

Far too many of these commercials are specifically crafted to make people think they have diseases or conditions they don't have.

Last time I went to Kentucky for a visit, I heard an ad for a drug for RLS (Restless Leg Syndrome).  Now, I'm sure that there are a few people out there who really have RLS, but they made it sound like everyone who gets a shaky leg once in awhile had a syndrome that needs drugs.quote>

Not only that, but Restasis is a very dangerous drug. You're probably better off with the restless legs.

A good doctor will be frank with you about that if you come in and ask for it. But a lot of doctors will just sign a prescription and send you off because they don't feel like arguing with people, or because they consider it bad business to deny customers things they ask for.

Another case: "low-T". Sold a lot of steroid cream after that ad campaign, much of it to people who have zero need for it.

Do note that this is different from doing the Barry Bonds thing, though, in that the dosages involved are much lower.

Couple that with the fact that some doctors are paid by drug companies to push their pills,quote>

Er... are we talking about the "doctors" that appear in commercials to endorse various drugs? Or is there some other scandal here I'm unaware of?

and you have an overmedicated society.quote>

Well, there's overmedicated and then there's overmedicated. Sometimes consumption of drugs is completely uncalled for (see above examples). Other times there is consumption of drugs which is helpful but by no means necessary... *peers at bottle of zolpidem in drawer*

The former is unquestionably a problem. The latter, well... one could argue there is waste involved, but that depends on the value you place on the benefits.

(zolpidem = generic Ambien)

[Barbarossa 51]

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  Edited September 8, 2012 by Barbarossa  

[pckiller 1]

Most of those warnings are mandatory from their legal department. You know, C Y A!

[A Nonny Moose 8,261]

I think the most reprehensible ads are those for anti-depressants and other mind alterning potions.  These drugs are some of the most dangerous and may also be addictive.  It has been determined in some cases that users of such drugs have comitted suicide.

Science doesn't know enough about the biochemistry of the human organism to go around advertising their alchemy.  Medicine is an art, supported by science, but not at all an exact science.

[morriswalters 16]

Originally posted by: Duke87

Originally posted by: N_O_Body

If the drug company who sponsors these shows is having trouble getting physicians to prescribe their drugs, why should they think that media advertising is going to improve matters?quote>

Because it does. People see commercial, people want drug.

Meanwhile, the list of side effects taking up half the ad just gets tuned out as noise by most of us since we're used to hearing it all the time. And besides, we've been desensitized to them. "Rare but serious side effects" and stuff like that doesn't scare us, it's become just a boiler plate.

Originally posted by: Zelgadis

Far too many of these commercials are specifically crafted to make people think they have diseases or conditions they don't have.

Last time I went to Kentucky for a visit, I heard an ad for a drug for RLS (Restless Leg Syndrome).  Now, I'm sure that there are a few people out there who really have RLS, but they made it sound like everyone who gets a shaky leg once in awhile had a syndrome that needs drugs.quote>

Not only that, but Restasis is a very dangerous drug. You're probably better off with the restless legs.

A good doctor will be frank with you about that if you come in and ask for it. But a lot of doctors will just sign a prescription and send you off because they don't feel like arguing with people, or because they consider it bad business to deny customers things they ask for.

Another case: "low-T". Sold a lot of steroid cream after that ad campaign, much of it to people who have zero need for it.

Do note that this is different from doing the Barry Bonds thing, though, in that the dosages involved are much lower.

Couple that with the fact that some doctors are paid by drug companies to push their pills,quote>

Er... are we talking about the "doctors" that appear in commercials to endorse various drugs? Or is there some other scandal here I'm unaware of?

I've been posting too much so I'll just point to this article at that Liberal rag The New York Times.  www.nytimes.com/2010/04/01/business/01payments.html

[Barbarossa 51]

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  Edited September 8, 2012 by Barbarossa  

[saltandsauce 0]

haemorroid creams, asprins, painkillers, creams, lotions, stool softeners and ointments.... if it's not painful enough to visit the doctor for then deal with it. people get prescribed asprin for thinning the blood (something like diabetes) that's fine. but having a little headache? no. if you don't feel you need to see a doctor for it then don't take anything. and eat some brown bread/prunes/bran/fibrous food.

got a headache from work? get glasses or your eyes checked don't pop asprins because you can end up with high blood pressure from chronic thinning of the blood (once you stop taking asprins)

spots? - wash your face and use vodka on a cotton ball or something (apply alcohol topically not by ingestion) or just leave them alone. picking at spots makes them worse.

since most of you will interpret this the wrong way i'll sum it up with "try just leaving it alone, you don't need to douse everything with medicine"

[Duke87 1,070]

Originally posted by: Barbarossa

I don't think prescription medications should be advertised. Doctors need to know about them, and can consult with their patient on a solution to whatever ailment.quote>

Well, advertising prescription drugs to the general public is out of control and needs to stop.

On the other hand, I see no problem with advertisements for such drugs being put in media intended for consumption by those in the medical profession. JAMA, for instance.

Originally posted by: morriswalters

I've been posting too much so I'll just point to this article at that Liberal rag The New York Times. quote>

Screw that, how about looking directly at Pfizer's report?

Firsthand sources are always better.

Originally posted by: saltandsauce

if it's not painful enough to visit the doctor for then deal with it.quote>

The problem with this idea is that whether or not to visit the doctor is not a matter of how painful something is but rather or whether it requires medical expertise. You don't need to see the doctor if you're having allergy problems but taking Claritin or something like that isn't necessarily a bad idea.

got a headache from work? get glasses or your eyes checked don't pop asprins because you can end up with high blood pressure from chronic thinning of the blood (once you stop taking asprins)quote>

There are painkillers other than aspirin, you know. As for "dealing with it", I daresay a lot of people see no logic in doing so when they don't have to.

spots? - wash your face and use vodka on a cotton ball or something (apply alcohol topically not by ingestion)quote>

Rubbing alocohol would be the more normal thing to use in such cases, althogh I suppose vodka would work too.

Though, yes, pimples do not require treatment, nor are they painful or uncomfortable. What they are is unsightly, and so people go to some pretty exetensive ends to cure them, cover them up, and/or prevent them - it's vanity, really. America has a problem with that...

try just leaving it alone, you don't need to douse everything with medicinequote>

"It'll go away on its own" is the cheapest treatment available for anything.

On the other hand, sometimes it's denial. So use with caution.

[Barbarossa 51]

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  Edited September 8, 2012 by Barbarossa  

[fukuda 351]

I think the most reprehensible ads are those for anti-depressants and other mind alterning potions. These drugs are some of the most dangerous and may also be addictive. It has been determined in some cases that users of such drugs have comitted suicide.

Science doesn't know enough about the biochemistry of the human organism to go around advertising their alchemy. Medicine is an art, supported by science, but not at all an exact science.quote>

We do know a lot about human biochemistry, beta-blockers blocking beta-adrenergic receptors of epinephrine in the heart and slowing down heart rate is science, aspirin inhibiting cyclooxigenase and the prostagandin pathway and preventing the onset of fever (aswell as inhibiting the production of thromboxane and prostacyclin required for blood clotting, oops) is science, using the Cytochrome P450 Enzyme in our livers to oxidize and activate medicaments is science and so on....

But indeed there is a problem, not everything in our body is chemistry (even if pharma and friends would like you to believe so). Our brain does use chemistry to work, but it's a secondary use.. Structure and physics are what matter in your brain, a depression is not a "chemical imbalance", it's a series of complicated structural changes. Sure you can limit the effects of it by bombing down all the neurotransmitter effects in an specific area, but it's a ridiculous and barbaric way to act that only betrays our almost complete ignorance of what's going on.

You're absolutely right, anti-depressants and mind-altering drugs are pretty much "alchemy", and it's a shame that we're mass-producing them with lots of wishful thinking about how they "work" (and lots of side-effects, too).

[A Nonny Moose 8,261]

Thanks.

Really, do we know all that much about human biochemistry?  The electrical component of many of the reactions appears to be poorly understood.  Reactions occur in the body, catalyzed by often mysterious enzymes at body temperatures that require heroic physical efforts in the laboratory.  These are, at best, poorly understood.  The human organism, and for that matter, almost any living and reproducing organism is so complex that we barely understand the whichness of the why in most cases.

I admit that I take advantage of quite a lot of biochemistry.  I am on three heart drugs, and verious other things that keep me in "good" health.  I have more than the average share of autoimmune diseases, and keeping this all balanced is quite an adventure.  So far, I haven't had any real change since my heart arterial bypass surgery 10 years ago.  Without pharmaceuticals, I'd be dead in about a week or less.

[pckiller 1]

You ever heard the saying? Better life through chemistry. LOL

[Aontan 0]

Commercials for prescription drugs are illegal in most countries (except the US and New Zealand, apparently), and rightly so. It should be a health professional that prescribes a person medicine, not marketers.

Here's an interesting take on it, albeit from a few years ago.

[A Nonny Moose 8,261]

Originally posted by: pckiller

You ever heard the saying? Better life through chemistry. LOLquote>

Actually it was "Better living through chemistry" and was (is?) the company motto of E.I.Dupont of Wilmington Deleware.  Somehow, since I don't see their logo any more, I have a feeling they have been absorbed into some huge chemical cartel.

[Easy Bakes 253]

DuPont is still around and hasn't been snapped up quite yet. according to Wiki its the 4th largest chemical company in the world. their list of creations is impressive though, Nylon,Teflon,Kevlar, Freon,Neoprene,Lycra ( spandex).

but back to over medication.

Lets break down those that i belive a lot people take and i see advertisements for.Im not going to include pollen allergy medications as you can have  pollen allergies and be in very good health.

Cholesterol, High blood pressure, acid reflux,and sleep aids.

Do doctors not point out any more that most of  the   effects of these conditions can be controlled

by losing weight and exercise? or is it easier to just med them up an not hound them about their weight?

Part of the new health care will require restaurants to print nutritional information  right their on the menus.

not that that will stop people from eating it, but it will stop them from eating that  McDonalds grilled chicken salad that has the same calories as 3 Big Macs.

[morriswalters 16]

And if your wondering why I hate drug companies here's a link.

www.cnn.com/2010/HEALTH/04/02/pfizer.bextra/index.html

[Meg 368]

Originally posted by: Easy Bakes

Do doctors not point out any more that most of  the   effects of these conditions can be controlled

by losing weight and exercise? or is it easier to just med them up an not hound them about their weight?quote>

My doctor recently threatened me with cholesterol medicine.   Basically I've been given three months to reduce my cholesterol via diet and exercise or the doc will start prescribing drugs.

My sister's doctor is using "step therapy".   Apparently that means they try drug A (the cheapest) and see if it will lower her cholesterol.  If that doesn't work, they go to drug B (more expensive) and see if that works.  and so on.

Meanwhile, there are stories like this which bring up the question of whether either of us should be taken such medicine at all.

[pckiller 1]

Originally posted by: N_O_Body

Originally posted by: pckiller

You ever heard the saying? Better life through chemistry. LOLquote>

Actually it was "Better living through chemistry" and was (is?) the company motto of E.I.Dupont of Wilmington Deleware.  Somehow, since I don't see their logo any more, I have a feeling they have been absorbed into some huge chemical cartel.

quote>

Well, I am not going to write you any letters. You will send them back with all the spelling corrections. LOL

[A Nonny Moose 8,261]

Originally posted by: pckiller

Originally posted by: N_O_Body

Originally posted by: pckiller

You ever heard the saying? Better life through chemistry. LOLquote>

Actually it was "Better living through chemistry" and was (is?) the company motto of E.I.Dupont of Wilmington Deleware.  Somehow, since I don't see their logo any more, I have a feeling they have been absorbed into some huge chemical cartel.

quote>

Well, I am not going to write you any letters. You will sent them back with all the spelling corrections. LOLquote>

Maybe you need a grammar checker too? 

Never deny dialogue, it keeps us all going.

[pckiller 1]

I knew it! Cannot get anything past you.

[Duke87 1,070]

Originally posted by: morriswalters

And if your wondering why I hate drug companies here's a link.

www.cnn.com/2010/HEALTH/04/02/pfizer.bextra/index.htmlquote>

Well, there are multiple problems here. Not the least of which is the fact that many drugs people rely on are patented, and thus if a major pharmaceutical company were to get knocked out of business, it would be highly disruptive to healthcare as a whole and perhaps even cost a few lives. As such, the continued existence of companies like Pfizer is in the best interest of the general public. They are "too big to nail".

Any entity that people are too dependant on will inherently get immunity and be able to do whatever it wants without proper consequence. This is why monopolies are illegal.

Consider, though, the dependance of Pfizer on Medicare and Medicaid. I bet they're "too big to fail", too!

Reality is that everything has gotten too big and too centralized, both public and private. It breeds interdependance of everything on each other and that gives you a house of cards situation. One thing going down creates a huge tidal wave and knocks everything else down. On the other hand, with a lot of smaller entities, there are so many more alternatives and one going down creates only a tiny ripple in comparison. It's a less efficient system, certainly, but a much safer one.

...so, yeah. This has nothing to do with drug companies. It's but one manifestation of a much broader problem.

[morriswalters 16]

Although it took me a long time to learn, here is something I found out about raising kids.  Never threaten punishment that you aren't willing to apply. It teaches them that you don't mean what you say. And they will take advantage of that, without fail.  And it's the same thing here.   The money they were fined seems like a lot but compared to earnings it's nothing.  They will increase prices and move on to their next money making venture.

Given freedom from any serious penalties for poor behavior tied in to the ability to use large sums of money to influence the political process, we end up with a super citizen, one who is effectively above the law.  Welcome to my world.  You just have to love corporations.

[A Nonny Moose 8,261]

1. My rheumatologist says that Cox-2 inhibitors are no better than other NSAIDs and refuses to prescribe them.
2. There is no such thing as a company that is "too big" to fail.  If this is the perceived case, then the company needs to be broken up into smaller units because it has either become a monopoly or a "trust".  This applied to banks, drug companies, and arms manufacturers.  If the courts won't do it, the stockholders should, for their own protection as investors.  One of the best ways to get at a company is to buy a few shares and start attending shareholder meetings along with all your similary disaffected share-holding friends.  You can at least cause a panic among the more weak-kneed members of the board by putting appropriate motions on the agenda.  There is also the time-honored proxy battle.

[fukuda 351]

Really, do we know all that much about human biochemistry? quote>

We know a lot about (human(!)) basic biochemistry (metabolism, hormone action...). There's however still a lot to discover about signaling pathways and regulation, aswell as in development biochemistry.

The electrical component of many of the reactions appears to be poorly understood.quote>

Electrical component? Electricity in the cell comes from 2 places.

1) Exchanging electrons (Redox reactions) is how most biochemical reactions work, electricity, as electrons, is used to break bonds and form new ones by taking electrons from a donor and giving them to a receiver. These electrons come in the first place from what we eat, respiration is basically a process that breaks down what we ingest and gives all the electrons stored in the bonds to organic electron carriers, basically to the one known as NAD:

As you can see above this molecule accepts 2 electrons and breaks a double bond in order to store them (Reduction). It goes the reverse way to give them (Oxidation).

What for? Here's an example, these electrons can be used to transform nitrate (NO3) into nitrite (NO2) by giving electrons to the nitrogen and oxygen atoms respectively. With new electrons there's no longer need to share anything and they separate into NO2 and oxygen that is rapidly converted into water by spontaneous addition of protons.

That's all there is to the electrical component of reactions, it sure is a very important part of it but it's pretty well understood.

2) Now, there's a second place where electricity in the cell comes from, it's just that almost no chemical reactions are involved into it. The electric impulses in nerves and almost all cells don't come from chemical reactions, they're just based in the fast opening and closure of voltage-gated ion channels.

In order to be able to import and export things through the cell emembrane and to fire, receive or interpret electric impulses cells need to spend a lot of energy (>25% of their energy production) to create a difference of potential between the outer and inner part of their membranes. This is mostly done by pumping out charged ions out of the cell while pumping in other charged ions into the cell always against their concentration gradient.

Why? Because things always go from the highest concentration to the lowest one, see:

This is the cell in steady state, there's clearly way more sodium out of the cell than inside of it. When we open the gates this sodium will storm in and pass through tiny channels. And what's called a lot of charged particles going in the same direction? An electrical current! This current will open more voltage-gated channels and so on.. and an electric impulse will be fired.

This is pure physics. It's more complex but it's entirely out of the scope of this thread.

Reactions occur in the body, catalyzed by often mysterious enzymes at body temperatures that require heroic physical efforts in the laboratory.  These are, at best, poorly understood. quote>

Back in the day we had to put enzymes and substrates into a glass tube and see what happened(with a spectrophotometer), 90% of the times it never worked, we had to add more coenzymes and other proteins to see if the thing worked or not. If your reactions do not occur at around body temperatures it means that you're missing a coenzyme or a step as your enzyme is not catalyzing anything at all.

Nowadays we can know beforehand which cofactors and coenzymes bind to the enzymes by searching for the specific binding sites in the DNA sequence, something we couldn't do before the sequencing of the human genome. if this fails we can look for what works in all the phylogenetically related enzymes, something wwe couldn't do back then either.

The human organism, and for that matter, almost any living and reproducing organism is so complex that we barely understand the whichness of the why in most cases.quote>

I agree, however, meds don't use obscure or even a lot of molecular targets. There are only around 1200 different approved chemicals as meds, and all of them only use 270 human molecules as targets, 25% of which are isoforms of the same G-Protein! [1]

Crazy thing.. There may be a lot of different names, but in fact we have a shortage of meds...

I admit that I take advantage of quite a lot of biochemistry.  I am on three heart drugs, and verious other things that keep me in "good" health.  I have more than the average share of autoimmune diseases, and keeping this all balanced is quite an adventure.  So far, I haven't had any real change since my heart arterial bypass surgery 10 years ago.  Without pharmaceuticals, I'd be dead in about a week or less.quote>

Ouch, good luck with your health problems, you sound like a strong-willed man

Do doctors not point out any more that most of  the   effects of these conditions can be controlled

by losing weight and exercise? or is it easier to just med them up an not hound them about their weight?quote>

Well, it depends on the person. It may be caused by bad health habits or real disease in some people. The responsibility of deciding what to prescribe is always on the doctor though.

The problem is not only our understanding of biochemistry, it's also how some companies are reluctant to pull out of the market meds when they've been proven dangerous or when new safer(and even cheaper!) chemicals have been researched and found. Another thing is that most people have been tricked to buy patented meds by their doctors or even pharma companies when there are cheaper and generic meds that would work aswell.

[1] Pharmacology (course + corrected exercises), Yves Landry & Jean-Pierre Gies

[A Nonny Moose 8,261]

With respect to your last point:  In Ontario's medical programme, generic drugs are required when available.  The pharmacist is free to use generics except when the doctor ticks the "no substitution" box.  I am mostly on generics at the moment with the exception of Advair for my asthma.  Apparently no generic manufacturer cares to get into that market.

[pckiller 1]

Originally posted by: N_O_Body
With respect to your last point:  In Ontario's medical programme, generic drugs are required when available.  The pharmacist is free to use generics except when the doctor ticks the "no substitution" box.  I am mostly on generics at the moment with the exception of Advair for my asthma.  Apparently no generic manufacturer cares to get into that market.
quote>

 

Here in the USA, I think that the inventor of the medicine, gets a 4 year patent before others can make a genetic of it. I could be wrong thou.
 

[Duke87 1,070]

Originally posted by: pckillerHere in the USA, I think that the inventor of the medicine, gets a 4 year patent before others can make a genetic of it. I could be wrong though.  quote>

A patent in the US for anything is good for 20 years from date of application. And it's not automatic, you have to apply for it and get it approved by the USPTO.

Thing is, with drugs, it is several years between when the patent is filed and when the medication is actually ready to start being sold and used (needs to go through clinical trials, FDA approval, etc.), so the period in which the brand name and only the brand name is available is in practice considerably less than 20 years.