Wealth versus Health: an example of why things are broken

[nick1985]

Then no more viagra, cialis, etc ads?

If you get a 4 hour boner, call your doctor.

 

[Genx87]

Yes, if only ads were banned we would squash our appetite for prescription drugs in this country lmao.

 

[palehorse]

What does work? 'Good government', with neutral experts who serve the public interest regulating the industries in ways that work for everyone, and cut out the corruption of policy by profit motives.

HA HA HA.... no.

Your ideology and theories completely break down the moment each of your precious government agencies becomes just as corrupt as those they are meant to regulate.

 

[palehorse]

Direct to consumer advertising of prescription drugs should be banned, IMO.

The drug commercials are f'n hilarious. What's wrong with sending someone to ask their doctor about any particular drug? If your doctor has any skills and integrity, at all, then they'll recommend a generic alternative. If not, and you later discover that one exists, then find a new f'n doctor.

Hi, my name is palehorse, and I'm addicted to my first amendment rights.

 

[Pens1566]

Direct to consumer advertising of prescription drugs should be banned, IMO.

Winner ^

 

[WHAMPOM]

The FDA is the problem, not Republicans. Has been for decades. Although I see how you (wrongfully) link the two.

And here I thought it was the lobyists spending $millions a day in Washington both writing and conniving to get favorable laws passed by Congress. Oh silly me!

 

[WHAMPOM]

HA HA HA.... no.

Your ideology and theories completely break down the moment each of your precious government agencies becomes just as corrupt as those they are meant to regulate.

Or have a free press to guard the guards? Sorry past tense, did have. :$

 

[Fern]

-snip-
A drug company might have a patent on drug 1, and drug 2 might be in the public domain. Each might cost $1 - but drug 1 can be sold for $100, $20, $5 - some big markup in big profit since there is no competition, the sky the limit as far as marketig to create demand for the drug can take the price, because no one else can sell it, compete, and lower the price. Meanwhile, drug 2 might get the manufacturer $1.25, and retail for $2.50 on the market, makin gvery little profit.

And so in this system, there can be enormous pressure - based on profit - for the drug companies to get drug 1 used - and that may well mean instead of drug 2 even if drug 2 is better.

In a perfect world, drug 2 would get full use for the good of the patient - but when, when there are such huge economic distortions to incent the wrong choice, has the perfect world not had corruption?

"Ask your doctor about" is one way. With huge marketing budgets, drug companies can build demand directly among the public to 'ask their doctor', who typically have competitive pressure not to say no to their patients too much where they're allowed to say yes, and the use of the drug increases. Everyone's happy - the patient has his manufactured desire met, the doctor has his patient, and the drug company gets more sales.

I think the problem is mis-stated.

1) With insurance/Medicaid/Medicare covering the cost, the individual just doesn't care about costs.

2) Doctors letting patients influence their decisions? FFS why? That won't fly in other professions like accounting. Does this indicate another area where tort reform is necessary? Are doctors afraid to prescribe the "tried & true" out of fear they'll be sued?

3) Agree that marketing presecirtion drugs to the general public s/b mostly forbiden or majorly scaled back. I do think it OK to empower people with knowledge about (new) drugs that may help them, but the current state of drug marketing borders on brainwashing.

Somewhere in here is a very contradictory view held by progrssives/liberals. On the one hand, we need UHC so everybody can afford their expensive drugs - the best HC. OTOH, doing so may not be in their best (medical) interest and is a capitalist rip-off. Predictably, Craig234 tries to 'square' this by advocating increased government intrusion and regulations. It really does sound like Craig234 and the 'progressives' want the government to make the decisions for you and your doctor, something they constantly deny yet at other times clearly advocate.

Fern

 

[ebaycj]

I think the problem is mis-stated.

1) With insurance/Medicaid/Medicare covering the cost, the individual just doesn't care about costs.

2) Doctors letting patients influence their decisions? FFS why? That won't fly in other professions like accounting. Does this indicate another area where tort reform is necessary? Are doctors afraid to prescribe the "tried & true" out of fear they'll be sued?

3) Agree that marketing presecirtion drugs to the general public s/b mostly forbiden or majorly scaled back. I do think it OK to empower people with knowledge about (new) drugs that may help them, but the current state of drug marketing borders on brainwashing.

Somewhere in here is a very contradictory view held by progrssives/liberals. On the one hand, we need UHC so everybody can afford their expensive drugs - the best HC. OTOH, doing so may not be in their best (medical) interest and is a capitalist rip-off. Predictably, Craig234 tries to 'square' this by advocating increased government intrusion and regulations. It really does sound like Craig234 and the 'progressives' want the government to make the decisions for you and your doctor, something they constantly deny yet at other times clearly advocate.

Fern

Doctors are afraid to prescribe "tried and true" because their customers have their minds pre-set by TV commercials on (treatment a) which is not "tried and true". They fear that if they don't prescribe (treatment a), their patient will go somewhere else to get (treatment a), and will not return. End result is that they usually just prescribe (treatment a) as long as it won't kill/harm the patient.

 

[ebaycj]

Yes, if only ads were banned we would squash our appetite for prescription drugs in this country lmao.

So what you're saying by this is that marketing doesn't work ?

 

[Genx87]

So what you're saying by this is that marketing doesn't work ?

What I am clearly saying is we will continue to demand prescription drugs regardless of whether or not a few of them are advertised on TV. How many prescription drugs are you on? I am on 3 depending what time of year. Not a single one is advertised on TV.

The vast majority of drugs arent advertised on TV. Removing the ability to advertise for a few boutique or designer drugs is laughable in the context of curtailing our appetite for these drugs.

 

[Skitzer]

Denial is a long river.

You should take that to heart.

 

[daishi5]

Doctors are afraid to prescribe "tried and true" because their customers have their minds pre-set by TV commercials on (treatment a) which is not "tried and true". They fear that if they don't prescribe (treatment a), their patient will go somewhere else to get (treatment a), and will not return. End result is that they usually just prescribe (treatment a) as long as it won't kill/harm the patient.

That is garbage, doctors are afraid to prescribe "tried and true" because so many of them don't know what "tried and true" are. Did you read the article linked in the OP. Some of the most trusted medicines today would not have a chance in hell of being approved because they are so dangerous. Physicians are not like accountants, when you add two numbers, the answer is always the same. When you give two patients the same drug, the outcome is not the same, because every patient is different. Read the article, the problem is not doctors and advertising, the problem is an actual lack of knowledge. Studies are not being done that compare drugs, so since there is no study which identifies which drug works best, doctors cannot know which drug works best. In other words, there is no "tried and true" in modern medicine and it turns out our old "tried and true" like aspirin and tylenol can be very harmful to patients. You give doctors too much credit for knowledge, when that knowledge you presume they know is not actually known to anyone.

 

[Fern]

That is garbage, doctors are afraid to prescribe "tried and true" because so many of them don't know what "tried and true" are. Did you read the article linked in the OP. Some of the most trusted medicines today would not have a chance in hell of being approved because they are so dangerous. Physicians are not like accountants, when you add two numbers, the answer is always the same. When you give two patients the same drug, the outcome is not the same, because every patient is different. Read the article, the problem is not doctors and advertising, the problem is an actual lack of knowledge. Studies are not being done that compare drugs, so since there is no study which identifies which drug works best, doctors cannot know which drug works best. In other words, there is no "tried and true" in modern medicine and it turns out our old "tried and true" like aspirin and tylenol can be very harmful to patients. You give doctors too much credit for knowledge, when that knowledge you presume they know is not actually known to anyone.

Please read this portion of the article:

The drug industry’s intense marketing to physicians has been well covered. But it’s worth noting here that some marketing is designed to push out perfectly worthwhile older treatments (whose patent protection has often expired and can therefore be sold as cheap generics) in order to advance newer treatments (which are under patent protection, and therefore are more expensive).

"Tried and True" was my paraphrasing. Clearly the article is saying that established (a better description?) drugs that are effective are being pushed aside for more expensive drugs, often with no benefit (other than profit for Pharma).

So the question remain "Why" are doctors prescribing the newer more expensive drugs. The fact that there is no comparable studies, while unacceptible, is almost irrelevent. If there are no comparable studies, neither doctors nor Pharma can make the claim that newer more expensive are superior. Similarly, doctors could bring this point to the attention of their patients. The average consumer won't spend for the more expensive product unless their is a perceived superiority or benefit. If this were any other product where the consumer had to spend their own money I suggests it's unlikely the 'unproven' newer product would get as many sales. But the HI companies are picking up the tab, so why should they care?

I suppose the lack of comparable studies should mean that tort risks is not a factor. If there is no comparable study how can one be faulted for whatever appropriate drug they prescribe? No one cn demonstrate the more expensive is superior. But that assume a certain of legal sophistication among physicians, IMO that's unlikey.

Otherwise, the whole "they don't know" thing as an excuse for recomending the more expensive drug sounds both unlikely and concerning. I think it equally as likely that doctors get benies/kickbacks from pushing new expensive drugs (and patients don't care because they don't pay).

Fern

 

[daishi5]

Please read this portion of the article:



"Tried and True" was my paraphrasing. Clearly the article is saying that established (a better description?) drugs that are effective are being pushed aside for more expensive drugs, often with no benefit (other than profit for Pharma).

So the question remain "Why" are doctors prescribing the newer more expensive drugs. The fact that there is no comparable studies, while unacceptible, is almost irrelevent. If there are no comparable studies, neither doctors nor Pharma can make the claim that newer more expensive are superior. Similarly, doctors could bring this point to the attention of their patients. The average consumer won't spend for the more expensive product unless their is a perceived superiority or benefit. If this were any other product where the consumer had to spend their own money I suggests it's unlikely the 'unproven' newer product would get as many sales. But the HI companies are picking up the tab, so why should they care?

I suppose the lack of comparable studies should mean that tort risks is not a factor. If there is no comparable study how can one be faulted for whatever appropriate drug they prescribe? No one cn demonstrate the more expensive is superior. But that assume a certain of legal sophistication among physicians, IMO that's unlikey.

Otherwise, the whole "they don't know" thing as an excuse for recomending the more expensive drug sounds both unlikely and concerning. I think it equally as likely that doctors get benies/kickbacks from pushing new expensive drugs (and patients don't care because they don't pay).

Fern

First, I was responding directly to the idea that doctors are making the decision to use worse drugs because of advertising that is aimed at patients. In that context it is very important to realize that the doctors do not have any actual information about which is better. Therefore claiming they knowingly use the worse one cannot be true.

But, more directly to your point, I think you assume the doctors know more then they do. The rules an accountant learns do not change, the math still works 30 years after they graduate. Medicine is different, new things are learned all the time. Even worse, treatments don't work the same for every patient. Finally, the doctor does not have very good information, because most of his knowledge comes from the patients own feedback, which is not objective. For example, it could be very possible that doctors prescribe new treatments because of a placebo effect. It may be that patients that are prescribed a drug they hear about on TV have better results than patients on non advertised drugs because the patients expect good results. This would in turn lead the doctor to prescribe the new drugs more often because the results have been good. The patients own expectations matter because the placebo effect is very real.

I work in a hospital, and I know several physicians. I have seen nothing that would indicate to me that they receive kickbacks, and I believe that sort of arrangement would actually be illegal. However, I think it is probably more of a cognitive bias. The drug reps job, is to inform the doctors of the companies drugs. Because the generic drug makers do not have reps, or at least not as many, the doctors have had much more recent information about the new drugs then the old generics. The more recent information is recalled more easily, and the doctors prescribe the drug they know the best.

I honestly think that we should increase the length of time that drugs are covered by patents to be much longer, if we could ensure they spread the costs over the longer period as well. Right now, our patent system actually creates a system where a company loses money if they promote an old drug that performs better than a new drug.