50 and Moving Forward

Making a Killing: The Untold Story of Psychotropic Drugging – Full Movie (Documentary)

17 Feb 2012 Leave a Comment

by ladydee50 in Political

To Ban or Not to Ban: The Direct-to-Consumer Dilemma

30 Jan 2012 Leave a Comment

by ladydee50 in Political

We have all seen commercials showing someone frolicking in a meadow after taking anti-allergy medicine, or the down trodden man who suddenly is happy after taking an antidepressant, and last but not least, we are bombarded with commercials that resemble soft porn for erectile dysfunction. Is direct-to-consumer advertising in the public’s best interest? Because of the potential risks and the rising cost of prescription drugs, the Food and Drug Administration (FDA) and lawmakers must make stricter laws and revisit the process for approving DTC ads.

Direct-to-consumer (DTC) ads are published in magazines and newspapers that are distributed to a general audience rather than to healthcare clinicians. DTC ads can also be broadcast through television or radio (FDA). DTC advertising is permitted in only two countries New Zealand and the United States. Proponents argue DTC advertisements educate consumers leading to better communication between patients and their doctors (FDA). They also contend DTC ads are needed to support research and development of new drugs. While opponents argue the advertisements are dangerous causing patients to want and request medication that might be unnecessary or even harmful.

Pharmaceutical companies claim DTC advertisements inform the public about potential medical conditions and drugs that can treat these maladies. Industry spokesman Paul Antony told a Senate hearing in 2005, “DTC advertising can be a powerful tool in educating millions of people and improving health “(Ann Med). Drug companies insist DTC ads encourage patients to discuss these conditions or related drugs with their doctors. Pharmaceutical companies maintain these ads provide a public health service (GAO). Doctors David Kessler and Douglass Levy found DTC ads do not include the right balance of information to provide pertinent facts to consumers (Kessler, and Levy). The ads are oversimplified and unclear making it easy to attract new customers. The average viewer is unlikely to remember things like side effects and risks associated with these drugs. Pharmaceutical companies cannot educate consumers by cramming a decade’s worth of research into a 60 second commercial. These ads are not educating the public. The result of research by Dr. Frosch and his colleagues showed; eighty two percent of the ads made some factual claim; eighty six percent for product use; only twenty six percent discussed condition causes or risk factors; while twenty five percent showed commonness. Almost every ad, ninety five percent, used emotional appeals. None of the ads researched talked about lifestyle change as an option to the medications, although some ads depicted the medications as an on add on to other medication. Eighteen percent of the ads researched implied lifestyle changes were not enough. Some ads showed lifestyle changes as unable to control a condition. The DTC ads frequently portrayed medication use as losing and regaining control of one’s life; resulting in social approval. Medications were routinely depicted as a medical breakthrough (Frosch et al.).

DTC ads have a single goal, and that is to sell their medication. The drug companies have spent their advertising dollars wisely using cute animations to push the products. According to Forbes magazine, in 2005, the makers of Lamisil spent $110 million on advertising, generating $538 million in sales; even though the FDA said these ads overstated the drug’s effectiveness. Lunesta spent $215 million on advertising bringing in $538 million; $329 million in the first nine months on the market, even though long-term studies were only compared to placebo, not their competition (Langreth, and Herper). Doctors Kessler and Levy point out, DTC ads are ineffective and they do not contain vital information about the risks and benefits (Kessler, and Levy). In 2002, the FDA surveyed a group of primary care and specialty physicians. The study showed forty one percent of all physicians thought their patients were confused about the effectiveness of medicine in the DTC advertisement. The study also indicated that twenty two percent of primary care and thirteen percent of the specialist said they felt “somewhat” or “very” pressured to prescribe a drug at the request of a patient, straining the doctor patient relationships (FDA). Websites provide more detailed information, but finding it can be a task, while the medication’s benefit is featured prominently throughout the site. Patient and physician surveys have found that the messages consumers come away with after viewing DTC ads are often incorrect. During their research, Frosch and his colleagues found that DTC ads led to clinicians prescribing more medication (Frosch et al.).

Doctors Kessler and Levy explained that physicians are aware that the most effective drug is not always the most suitable for every patient. There are many things to consider when writing prescriptions, such as the patient’s risk factors, medical history, lifestyle and insurance status. Nevertheless, patients come in under the spell of DTC ads showing miracle pills expecting instant results no matter what their problem may be. DTC ads create fear about conditions they never thought about until they see these commercials prompting to ask their doctors for medicine by its brand name. Kessler and Levy go on to say that patients are relying “on Madison Avenue as a provider of health information” (Kessler, and Levy). Patients are always searching for instant fixes to complex problems. The trouble is not with drug companies communicating with consumers; guidelines must be created as they pertain to medicine and not for some product that has minimum risks like soap or toothpaste. Opponents would be more likely to support DTC if the ads led to the diagnosis and treatment for diabetes or heart disease, rather than diagnosis for conditions that are not life threatening (Kessler, and Levy).

The drug industry reports that R & D spending exceeded promotional spending every year. According to their website, GlaxcoSmithKline USA spends about $800 million dollars developing a single medicine. They also inform readers that “out of a million potential medicines screened at such high cost (GSK)” only a few will ever be approved for use. The U.S. General Accounting Office reported, “Prescription drug spending increased at an annual rate of eighteen percent from 1997 through 2001” (GAO), it is healthcare’s fastest growing component in the United States. For every $1.00 spent on advertising, pharmaceutical sales increased by $4.20 (Kaiser). From 1999 to 2000, it is estimated that DTC advertising increased retail sales of its most popular drugs by twelve percent. In 2008, IMS reported the top fifteen prescribed medicines topped $58 billion in sales. In a 2010, IMS reported that prescription drug companies spent 4.7 billion dollars on DTC advertising (IMS). The money pharmaceutical companies spend on advertising is passed on to consumers by skyrocketing prescription prices.

It is time to rein in DTC advertising. Richard Kravitz proposes one way to achieve success is for pharmaceutical companies to educate more and sell less. The spot light has to be put on conditions and not prescription drugs. Instead of writing prescriptions, patients should be educated about home-based triage and self-care, and given treatment options that do not include prescription drugs. Kravitz goes on to say, drug companies should form partnerships with physicians alerting doctors before DTC ad campaigns are released to consumers, helping physicians to prepare for questions they will receive from patients (Kravitz). Per the FDA website, the agency “encourages” companies that use DTC advertising to include accurate information in their ads. “Through their comprehensive surveillance and enforcement program, the FDA ensures that consumers are not manipulated or deceived by ads that violate the law” (FDA). As cited by an American College of Physicians (ACP) position paper, The FDA must “impose serious limits on the pharmaceutical industry to ensure that consumers receive complete and non-confusing information” (ACP). The FDA has made attempts to regulate DTC ads, insuring that they are “truthful, balanced and accurately communicated” (FDA). In 2005, an independent Drug Oversight Board was created to supervise the management of drug safety issues (ACP). However, these efforts still fall short. Drug companies must not be allowed to use DTC ads before the information has been approved by the FDA. A mandatory “pre-release screening” is favored by the ACP to “ensure clarity and truthfulness” (ACP). There are many opponents to DTC advertising in Congress, but they are not calling for a complete ban of DTC ads. In a Time Magazine article, Democratic Representative Bart Stupak of Michigan wants a moratorium on DTC ads during the drugs first two years on the market. “Two years will give the FDA and doctors time to see what safety issues arise once a drug is approved,” Stupak says. “It will also allow adequate time to educate doctors on how to use the new drug.” In the same article, Energy and Commerce Committee Chairman Henry Waxman of California, supports a two year ban with caveats, “Americans must face an inconvenient truth about drug safety,” he says. “The truth is that we inevitably allow drugs on the market whose risks are not fully known.” The difference between the two lawmakers is Waxman wants to give the FDA the power to make exceptions to the moratorium. In 2006, The Institute of medicine made the same recommendation entitled “The Future of Drug Safety” (Gregory).

In conclusion, direct-to-consumer ads are not going away. They may never be banned, but they have to be regulated. We will continue to see florescent butterflies, little black clouds and gold robots with overactive bladders. By themselves, DTC ads cannot educate consumers. DTC can be educational if used in conjunction with other resources like pamphlets, websites, mailings and print ads. It is critical that doctors are update to date on all information concerning new drugs, so they can effectively answer patient questions. Although, it is not a priority for lawmakers, they have taken notice. They have proposed new regulations and a new approval process that will lower the risks for consumers. In the meantime, consumers must educate themselves and make sure they have all information necessary before choosing the latest DTC product that dances across the screen.

Works Cited
ACP. Consumer-Directed Promotion of Regulated Medical Product. Jan 2005. Web. 25 Jan. 2012.
<http://www.acponline.org/advocacy/where_we_stand/other_issues/dtc_fda.pdf>.

Ann Fam. Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to- Consumer Advertising.

Annals of Family Medicine, 2005. Web. 21 Jan. 2012. .FDA . United States. Dept of Health and Human Services, Web. 22 Jan. 2012.

GAO. United States. FDA Oversight of Direct-to-Consumer Advertising Has Limitations, U.S. General Accounting Office, 2002. Web.

Gregory , Sean. Are Direct-to-Consumer Drug Ads Doomed?. Time Inc, 04 Feb 2009. Web. 26 Jan .2012.
GSK . Common questions. GlaxoSmithKline, 2007. Web. 22 Jan. 2012.

IMS . Promotional Spend by Type, 2010. IMS Healthcare, 2011. Web. 21 Jan. 2012.

Kaiser. Impact of Direct-to-Consumer Advertising on Prescription Drug Spending. ProCon. Kaiser Family Foundation, 2003. Web. 25 Jan. 2012.

Kessler, MD, David A., and Douglas A. Levy, JD. Direct-to-Consumer Advertising: Is It Too Late to Manage the Risks?. Annals of Family Medicine. National Center for Biotechnology Information, Jan 2007. Web. 19 Jan. 2012.

Kravitz, Richard. Direct-to-consumer advertising of prescription drugs. Western Journal of Medicine. Oct 2000. Web. 25 Jan. 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071087/>.

Langreth, Robert, and Matthew Herper. Pill Pushers. Forbes, 08 May 2006. Web. 25 Jan. 2012.

US Military Dodges Budget Cuts .. again

30 Dec 2011 Leave a Comment

by ladydee50 in Political

An article receiving little attention 2011 involved Defense Secretary Robert Gates. Secretary Gates proposed a $78 billion dollar cut in the military budget over the next five years. Gates’ proposal would eliminate the positions of 102 general and admirals, roughly 10% of the top brass. Let’s just say those wearing stars were not pleased. Mark Thomas of Time noted earlier this year, efforts to cut $1 trillion in defense spending over the next decade was not receiving a warm reception. The Navy has started constructing a $15 billion dollar aircraft carrier to follow the equally – costly USS Gerald R. Ford, which is only 20% completed. Will new Defense Secretary Leon Panetta push for budget cuts? The congressional “super committee” disagrees on the cuts; Panetta warns that a half trillion in additional cuts will lead to a “hollow force”. All the while the ranks of the brass continue to grow: over the past seven years, the Air Force has cut over 42,000 personnel, while adding 44 generals. Last month Panetta issued a list of 39 colonels scheduled for promotion to Brigadier General.