PDUFA and the highly suspect practice of renaming current drugs to treat previously off-label conditions (to say nothing about newly "discovered" ones ala PMDD), just to name a few.
Sampling is a great thing as it allows a doctor to provide a patient with a drug that may very well not be covered under their insurance plan (if they even have one). No problem there for me.
I won't go too far into the advertising thing as I am not very well-versed on the subject. One thing that does standout was the Lipitor/Jarvik controversy. You have to admit that it was pretty disingenuous to parade out a doctor in name-only to pitch a drug he can't even prescribe.
So, to sum-up, Pharma is a bit behind when it comes to ethical promotion and business practices. It's not an anti-corporate attitude, it's the unethical for-profit promotion of healthcare products.
I agree that most doctors will make the informed decision, but c'mon, there's a reason why they send Kens and Barbies; because it has been shown to be effective.
Last edited by Jetworks; 04-22-2011 at 09:04 PM.
That's it, exactly!
DTC ads were not available before Clinton's era, 1997
Prescription drug spending has risen steadily over the past decade.
Spending on prescription drugs now represents 10 percent of health care
expenditures in the United States, and adults aged 65 and older spend
nearly 3 percent of their total household expenditures on medications.
Increases in overall drug spending are the result of three types of changesshifts to higher-cost drugs for a 4.1 percent increase.
in drug prices and drug use: increases in utilization, that is, the number of
prescriptions dispensed; price increases; and a shift from older drugs to
new, more expensive drugs (newly marketed drugs are generally more
expensive than older drugs in the same class). The National Institute for
Health Care Management Foundation (NIHCM) reported that overall
spending on prescription drugs in the United States increased 17.1 percent
from 2000 to 2001: an increase in the number of prescriptions accounted
for a 6.7 percent increase, price increases for a 6.3 percent increase, and
Among the factors besides DTC advertising and promotion to physicians that may contribute to this increased utilization are an aging population that is more dependent on multiple medications for treatment; new medications for conditions that had less effective previous treatments, such as high cholesterol; and increased insurance coverage for medications. In addition, the number of patients diagnosed with chronic conditions for which pharmaceutical treatments are available has increased dramatically. For example, the number of people with arthritis, one of the most frequent causes of disability in the United States, increased from an estimated 38 million in 1990 to 43 million in 1997.
Furthermore, for some conditions, such as high cholesterol, increased drug utilization has resulted from biomedical research that has led to a broadening of the guidelines for treatment with drugs.
Countries that do not allow DTC advertising and have publicly fundedCanada, 10 percent in Germany, and 12 percent in the United Kingdom.
health systems have also experienced increased drug utilization, and
therefore increased spending, because of these same factors. According to a drug marketing research firm, retail pharmacy sales from April 2001
through April 2002 rose 16 percent in the United States, 16 percent in
The purpose of Advertising is to sell product.
Prescription Medication is not a consumer product, in my mind, although consumers are sold it, ad it is obviously a product.
The difference, for me, is that you have no right to go to a doctor and demand Medication X. It requires the MD to view X as appropriate for your specific condition, not the other way round.
Advertising therefore serves no purpose. It does not educate, nor does it promote sales of a product we shoud be promoting sales of in that manner, unless we're somehow promoting having those conditions first.
It's hard to explain, perhaps thats part because my view is flawed in some way (or entirely). But I prefer my MD telling me what Meds I need, not me going to my MD and telling him what Med I saw on TV and telling him I should have it.
Sampling is regulated and is an effective tool for marketing, limited trial and filling Rx gaps. That being said, K&B SR beauty alone can not force a drug to be distributed or to be placed in a hospital or Insurance co. formulary. Samples don't magically fly out of a drs sample closet into your medicine chest because Novartis, A-Z, Merck gave them to the dr.
Drs have very limited time for Sales Reps. It is before or after office hrs or lunch. 15 mins is a lot of time!The average SR has a route that is managed by their employer and they cant spend "chunks" of time at one either Dont care either way, but there are fewer SRS than before with lots of turnover. A bagel/donut tray or cold cut platter lunch for a group practice with 5-10 atttendees while a SR shows a video or gives a short briefing no way approaches $15 per person.
Due to state and PPACA rules pharma spend is more limited than ever. Drs and Orgs accept less promotional items of lesser value than ever as public disclosure is upon us. There have been cases where spend has been incorrectly attributed to Drs by the media with malicious intent so that makes spend even more limited
Off-label uses are not diabolical-Wellbutrin was found to be an effective smoking cessation drug (as Zyban) and Zoloft and Paxil, anti-depressants are useful in treating periomenopausal symptoms.
The former was renamed for marketing purposes---someone who is not depressed may feel very uncomfortable taking a drug known primarily for treating depression-yes there is a risk of overmedication/overdose if you use different drs/pharmacies and happen to take the original AND same renamed drug-that is why you always tell/review w drs what medicines you are taking on a regular basis
I've never known a drug to talk/say "Hi!" to me, perhaps you have, but Thalidomide, a genuine tragedy, was never approved for use in the US and only affected a handful of US children. Its failure was attributed to the erroneous yet widely held belief that side effects were not passed on to fetuses-clinical trials were improved as a direct result. Thalidomide is still used as a cancer drug today.
Vioxx was a very effective drug for millions who couldnt take Celebrex, Advil, Aspirin due to allergies or GI issues. I took it for a month with ZERO side effects for kidney stone pain/treatment. When it became obvious that the risks of a drug outweigh its benefits, the manufacturer withdraws the drug voluntarily to avoid being told it has to do so by the FDA and Merck did that. Penalties were handed out than limited because long-term effects were the issue, not every person who took it for a month and died from a heart attack.
I have no issues with Pharma, private sector firms making profits. I have no problems with them being sued to the point of bankruptcy when they do wrong either. Even media cos have greater copyright protection-pharma bear the cost of discovery and trials then generic cos can copy without that investment
Too bad B. Hussein Carter wants to make pharma a bogeyman while he lets his (D) crony-crooks on Wall St currently driving oil prices sky-high skate-the result is fewer drugs coming to market, more slowly. Whether that's a good thing or not, you decide.
Last edited by Jungle Shift Jet; 04-23-2011 at 11:18 AM.
The point is that the ads make you reflect on yourself and any health problems you have. In ways both serious and humorous they make you aware of a treatment (or a alternative treatment to what you currently take) for a problem. If you didn't see the ad and relate to the depiction perhaps you wouldnt make the dr appointment and get the Rx. That's commerce and commerce that results in an improved quality of life/better health is not an insidious thing...is it? Also. the product may be new to market, that is when drug companies have a monopoly and can recoup their costs, they are keenly interested in making you aware of a new item that may either address a health issue or be better for you than what you currently take from a competitor...that's where competition is healthy (Pun intended?)
For (L)s to decry ultra-lib nanny-statism from commie (D) JI mouth-foamers then turn around and say we should or shouldn't be promoting drugs because it promotes conditions is absurd and ignores the fact that people have real afflictions they wish to address..and even worse that others in a free society have "no right" to ask for relief. Yet the Dr. is the final arbiter there-hypochondriacs are not entitled to be dispensed drugs on demand whether an ad makes them feel sicker or not; if a dr thinks a medicine is not good for you he won't sample or prescribe it no matter how many times you request it-your insurance may or may not cover it either
It's true that advertising does not result in or equate to a level of health literacy-In Canada, where there is no DTC ads people are found to be more aware of efficacies than in the US . But maybe due to their demographics or schools they are smarter...although the Canuckistanian posters here disprove that regularly early and often
Last edited by Jungle Shift Jet; 04-23-2011 at 11:13 AM.
How can the general public make the determination that a drug is better for them or addresses a health need they may or may not need by asking their doctor about it?
When I go for my physical, I get tested and I get an exam and I talk to my doctor. I'm not a chemist or a doctor and can't possible know if a drug is better worse or totally inappropriate for me that's if I have a problem that will be diagnosed during my physical or in between if a problem occurs and I seek diagnoses and treatment.
I have no issue at all with doctors getting vital information on new drugs and prescribing appropriately, according to the condition being treated. Asking my doctor about a specific drug based on an ad that may or may not address some malady I think I might or might not have seems absurd to me.
Clinically doctors diagnose and treat. The drug companies through ads are attempting to get the patient to ask for drugs to treat problems they may or may not have. Personal reflection in humorous or vial ways is no way to deliver health care. If something is wrong you make an appointment with your physician and get it checked out. They test, they diagnose and they treat, rinse repeat.
Nothing wrong with commerce but prescription drugs are dangerous and not for the general public. Advertising dangerous substances to the general public is intuitively dangerous.
It doesnt have to be the drug they just saw on TV last night, but the ad they saw coupled with the fact that the issue is affecting them similarly one way or another is driving demand. If the Dr. thinks it will be effective you may get a sample and/or Rx. If he does not due to your circumstances (hypertension, health, cholesterol, allergies, asthma, history) you will not get it. The dr makes the determination. Often it is new to market and can have efficacy that didnt /doesnt exist with a competing or older drug.
Thinking a drug is bad just because it is advertised, how it is advertised or because someone sees the ad and is motivated to request it is dumb elitist snobbery. Ads rarely if ever depict healthcare, they depict before/after quality of life. If you see an ad for prostate health showing a guy running to the bathroom to p 10x a day instead of enjoying his golf game, balll game, family outing (which is not normal) and you say ZOMG thats me and that gets you to the dr. and you get effective treatment whether its the very drug you saw in that very ad everyone wins-pharma, the dr. & you. No Plumber that is not me.
Viagra vs Cialis is competition for similar drugs plain and simple yet one may be better for someone than the other. If a drug does not seem to work or affects you adversely you tell the dr just like any other drug advertised or non-advertised.
Another assumption you make is that people are happy as you to visit the dr, when people are dr. averse. They either fear a problem being identified due to poor habits or the treatment which will at least involve revising those habits. Yet they still want and seek relief. If an ad drives anyone to see a dr., I don't view it as a problem. No guarantee they will get the drug(s) they see sampled or prescribed
I didn't put any vaccine-autism link into the conversation. I simply stated the facts, which are that pharmaceutical companies are 100% NOT LIABLE for any adverse effects of their very profitable vaccine product. The government pays for any injuries/deaths through a special court that has table injuries, all of which is funded by a vaccine tax. My beliefs vis-vis autisms & vaccines were previously spelled out very clearly in a thread you chose to abandon, so let's agree to leave them out of this particularly thread, mmmkay?
Again, a cold breakfast/lunch is naturally cheaper, but since reps are typically afforded a per-person budget, they will tend to go with a more expensive option, therefore a breakfast or lunch. Naturally, the more people the more elaborate it can be since it is budgeted per person. Of course, if your territory is solely small private practices in a professional medical building, your meals will be smaller and therefore cheaper. But if you have hospitals in your territory, you are servicing departments that average ~20.
I can't believe you are trying to justify Vioxx since it helped many but killed thousands. What about the efficacy data that was faked, the purposely left out reports filed by Merck in their defending the drug against the Lancet determinations or even their own investigative paper that determined Vioxx was aggressively marketed by the sales team at the cost of honestly reporting safety data?
Generic companies can only copy that after the patent runs out or is shown to be invalid. I'm surprised that you are not stating that the PPACA authorized the FDA to grant manufacturers 12 years of exclusivity before a generic can be developed. Whether that applies to data or marketing exclusivity is open to debate, but there it is nonetheless. Any reason for the omission?
Last edited by Jetworks; 04-23-2011 at 01:33 PM. Reason: sp.gr., toned down
Besides my child I have a dozen nieces and nephews who were vaccinated just like the majority of other kids and suffered no ill effects. You can believe what you want to believe. As much as I am interested in cause and treatment of autism I'm not interested in discussing a hypothetical discredited cause of autism based on phony research that has led to death and illness from not being vaccinated. I personally believe parents' age and genetics are far more likely a cause but I have no hard proof of that either.
Now I work in pharma industry but not directly for a pharma co. Since you are so cocksure aboiut what you know and others don't, I am equally certain I know plenty more "stuff" about pharma than you - I'm confident I also have personal contacts that work in the medical field such as group practices and hospitals and at pharma cos that you don't.
Again, HCPs HCO MCOs etc do NOT block hours and days to SRs, time is too precious. The average call is 3 minutes!
Most pharmaceutical companies expect their sales representatives to make 8 to 10 sales calls per day, depending on doctor density and territory size (doctor density is the number of doctors in a given territory. Doctor density will be greater in a metro area with a large medical center than in a rural area.)
A day can start as early as 7:45 AM with a breakfast meeting at a physician's office and end at 10:00 PM with a dinner at a nice restaurant with a physician or two. Daily sales calls are made in the morning and late afternoon.
The PhRMA code is industry self-governance - not a guarantee malfeasance wiil not occur. Lib states and PPACA regulations towards spend are driving pharma co's behavior far more than PhRMA
True off-label use of drugs, even if it helps people may be unethical if not backed up by a study or FDA-approved- IMO there's nothing unethical about versions of Welbutrin/Zyban that are FDA-approved for several uses
And yes Thalidomide was distributed to US drs for sampling but only as many as 6-17 cases of deformed children were reported as opposed to 1000s worldwide- some of the mothers got their pills from Europe-10 cases out of 20,000 recipients made claims on and rightfully so
My kid did regress following multiple "catch-up" vaccines. Unfortunately I was unaware of any recourse until it was past the statute of limitations. Oh well, that's my lot in life and I have come to terms with it. I'll assume that your friend received compensation from VICP since he couldn't sue the manufacturer. THAT was my point. This isn't about autism, it's about vaccine injury/death and how the pharmaceutical industry is exempt from facing any liability regarding their product. I find that stupefying. Go read about it if you're so inclined:
As for the rest of it, feel free to go back to the thread I started on the subject and refute/debate/agree with what I wrote. Or just drop it. Either way is fine by me.
I am not "cocksure", I simply know what I know. I know plenty of reps, a few service providers, doctors and an attorney. This is where I draw my information. You think I'm just diddling around on Wikipedia pulling this stuff? Now, maybe you know more. Maybe I am wrong on some of my points. Maybe not. But I don't think the people I know would lie to me and I am reasonably sure they know what they are talking about. Still, who knows? Guess we're at an impasse.
Interesting that you feel government approval means something is tacitly ethical. Just to be clear, you think it's perfectly okay to rename a drug for another purpose solely in the interest of marketing it?
Those are some amazing stats that you pulled out there regarding Thalidomide. I say that because I personally know 3 people who were victims of Thalidomide. Maybe I should play the lottery.
It is absolutely amazing to me some people's opinions on the pharmaceutical industry. There may be no subject in this country in which people take more liberty to form such strong opinions based on so little knowledge.
Do you have any concept on how much time and money it takes to get a drug to market? Any concept on how much development and testing time eats into patent exclusivity? How many drugs that would potentially help patients never make it to market because they are not feasible business?
Thank your buddies the FDA for this. Probably a necessary evil, but the worst of the worst inefficient government entities. Absolutely clueless people. Lawyers regualting a scientific businesses That they can barely comprehend.
Drugs drugs drugs. Drugs drugs drugs. Americans want their f*cking drugs. Feel sad? Take a pill. Feel lonely? Take a pill. Legs got the jimmies? Take a pill. Feel out of place in large groups of people? Take a pill. Can't muscle up the courage to f*ck that botox addled sea hag of a wife of yours? Take a pill. Want a time delay to muscle up the courage to f*ck that botox addled sea hag of a wife of yours? Take a pill. Want to be able to muscle up the courage to f*ck that botox addled sea hag of a wife of yours at the drop of a hat? Take a pill.
Pills, pills. Take some pills. Pill popping Christian America with more drugs in their collective veins than a Volkswagon Bus full of hippies that ran out of gas outside Woodstock. 8 million New Yorkers. 1.5 million Oxy prescriptions written. 1 out of 8 people you see are f*cked up. High as a motherf*cking kite. Seeing stars.
God bless America. Home of the high.