Are you tired of being bombarded by the drug ads on TV urging you to “ask your doctor about prescribing a particular drug” for your problem? More accurately stated, they actually mean “pressure your doctor into prescribing our very expensive drug in order to fatten our income, and possibly even help your condition.”
But are such disingenuous tactics working? Unfortunately, aggressive marketing is persuading many people to overpay for medication. According to IMS Health, a pharmaceutical intelligence company which tracks drug sales and marketing, drug makers spent $4.3 billion to reach consumers and $6.6 billion on promotions aimed at both patients and physicians. These tactics seem to be succeeding. Consumer Reports states that, in a recent poll, 20% of respondents said they asked for a drug they’d learned about from advertising, and 59% of those said their doctor agreed to write a prescription for that product. So I must admit that even many members of my own profession share some of the blame for such questionable practices.
Let’s cite some of the more blatant examples of pharmaceutical misrepresentation:
Example 1: AndroGel (testosterone). A middle aged man proclaims his relief when a doctor says that his moodiness and low energy were caused by “Low T”, and therefore, he required treatment with testosterone. Unfortunately, although testosterone levels in the blood fall normally with age, the symptoms noted above are far more likely to be caused by depression, anxiety, obesity and other problems. Thus before embarking on testosterone treatment, careful—usually repeated—testing of the blood is required, and this is better supplemented by the advice of a specialist in glandular disorders (endocrinologist). Although, as I noted in a previous post, the dangers of such treatment have been previously suspected, we now have more confirmation that testosterone therapy taken for “low T” raises the risk of mortality, heart attacks and strokes, according to recent study appearing Nov. 5, 2013, in the Journal of the American Medical Association.
Example 2: Humira (adalimumab). A woman is embarrassed by her psoriasis (skin condition) when visiting a new hair salon. After asking her physician about Humira, she is then shown enjoying less stress and better skin when visiting that same beauty salon.
The down side: this very expensive mediation that must be given by injection and can cause severe (even life-threatening) side effects because it interferes with one’s immune system. One must undertake such a treatment under much caution, and not generally for gaining a more acceptable skin appearance.
Example 3: Crestor (rosuvastatin). A doctor describes the dangers of LDL (bad cholesterol) in contributing to plaque buildup in arteries. He says that in a clinical trial, Crestor helped more high-risk patients get their LDL below 100 in comparison with other similar (“statin”) drugs. The real story: While Crestor is a very strong drug, it doesn’t really matter which of the several statin drugs are used to lower the blood levels as long as the goal levels are reached. Thus a cheaper alternative to Crestor may suffice quite well to get to the desired goal and, therefore, confer just as much protection against bad cardiovascular outcomes. Crestor is better reserved for those instances in which the other drugs (such as generic lovastatin) cannot attain the targeted goal.
Example 4: Cymbalta (duloxetine). Men and women with arthritis or low-back pain are told the Cymbalta, a non-narcotic pain reliever, can help. Cymbalta is also recommended for several other conditions such as depression, anxiety and other causes of pain.
The real truth: Cymbalta flunks in all categories. Regarding relief of back pain and various forms of arthritis, it is less effective than the commonly used non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil), which are far cheaper. Moreover, Cymbalta is no more effective for depression than other, less expensive drugs for this purpose. Bottom line: There is hardly any justification for the use of this drug against anything.
Example 5: Celebrex (celecoxib): A man is playing in the snow with his family. Having taken Celebrex for his arthritis, he is now quite active. This drug is a member of the group of “non-steroidal anti-inflammatory drugs” (NSAID). Celebrex differs from the older varieties such as ibuprofen (Advil) by possessing a lower propensity to cause gastrointestinal upset or ulceration. But what’s the catch? Celebrex’s pain relief is no greater than that of the older generics. If one is able to tolerate these latter drugs without gastrointestinal problems, that’s the best choice. Stomach irritation from the cheap generics can be avoided by simply taking them with food or antacids. Moreover, Celebrex can increase the chances for cardiovascular problems such as heart attacks. Although some studies have implicated the older generics in cardiovascular problems, their incidence appears to be lower, if present at all. So, in general, opt for the generics if they agree with your gastrointestinal system and you haven’t had past problems with ulcers or intestinal bleeding.
My conclusion from the information provided above: Whenever encountering any pharmaceutical add, you might be better served by ignoring it altogether. If you actually do ask your doctor about the advertised product, inquire first if there is a cheaper generic alternative that is likely to be just as effective.