{"id":62118,"date":"2015-12-11T19:55:00","date_gmt":"2015-12-12T00:55:00","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=62118"},"modified":"2015-12-11T19:59:34","modified_gmt":"2015-12-12T00:59:34","slug":"damn-the-torpedoes-full-speed-ahead","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/12\/11\/damn-the-torpedoes-full-speed-ahead\/","title":{"rendered":"damn the torpedoes! full speed ahead…"},"content":{"rendered":"\n
I so rarely disagree with anything Ed Silverman of Pharmalot has to say, I relish the opportunity to disagree with him for a change. When I read that the AMA had voted to call for a ban on Direct-to-Consumer<\/font><\/em> [DTC] ads on TV [doctor power…<\/a>], I felt almost giddy about my fellow physicians finally making that particular stand. Ed thinks it won’t work, thinks that it’s a dead end. I see it as the Phoenix now rising from the ashes!<\/div>\n
\n
Why doctors’ call to ban drug advertising is a dead end<\/a><\/div>\n
Pharmalot<\/font><\/strong><\/div>\n
By\tEd Silverman<\/div>\n
December 8, 2015<\/div>\n

Open any magazine or flick on the television, and chances are you’ll see an advertisement for an arthritis treatment, an erectile dysfunction drug, an anticlotting agent, or some other medicine you don’t need. For years, doctors have complained these kinds of ads targeted directly to consumers can sway patients to ask for unnecessary, and potentially harmful, prescription drugs. The American Medical Association, the nation’s most influential physicians group, was long mum on the subject. But last month, the 168-year-old organization — which represents around 235,000 doctors — finally took a stand, calling for an outright ban<\/a> on consumer ads for prescription drugs and medical devices. “Now is the time,” Dr. Patrice Harris, chair-elect of the AMA Board of Trustees and a psychiatrist in Atlanta, told STAT. “We hope to make this a reality.”<\/p>\n

Whether this notion is realistic is debatable.<\/p>\n

For a ban to go into effect, Congress would have to pass a new law. And given the slim chances for political change, the AMA might be better off reaching a compromise than setting up an antagonistic relationship with drug makers. The United States is the only country other than New Zealand that permits drug advertising directed at consumers. Last year, the pharmaceutical industry spent $4.8 billion pitching its products and messages to Americans, a 17 percent increase from 2013, according to the market research firm Kantar Media. That much money buys a lot of airtime — so it’s no wonder that physicians gripe that drug ads can create inappropriate expectations in consumers or make doctors feel pressured to write prescriptions out of concern their patients will go elsewhere.<\/p>\n

But the AMA is now seizing on another reason for a ban. The organization argues that the ads largely feature the latest and priciest medicines that few can afford. “Most of the ads are often for newer drugs that are getting more expensive,” said John Mack, a marketing consultant to drug makers and publisher of Pharma Marketing News. “I think their concerns are valid.” By pointing to high prices, the AMA is making a smart move. The accelerating cost of medicines has galvanized Americans. About three-quarters of the public believes that prices for brand-name drugs are too high, according to a poll<\/a> conducted last month by STAT and the Harvard T.H. Chan School of Public Health.<\/p>\n

This tactic is more likely to resonate than the most commonly voiced arguments against drug ads — namely, that they misinform patients, overemphasize benefits, and encourage overuse. In another recent public opinion poll<\/a> from the Kaiser Family Foundation, about half of the respondents said that prescription drug advertising is mostly a good thing and that the ads do a good job of describing potential benefits and side effects.<\/p>\n

The fact is that a majority of Americans believe drug ads allow greater patient involvement in health care decisions — and the Pharmaceutical Research and Manufacturers of America agrees. “It’s not a bad thing for patients to bring questions to the doctor’s office,” said Dr. Michael Ybarra, an emergency physician and the trade group’s senior director of alliance development…<\/div>\n<\/blockquote>\n
I could unleash a rant for all seasons at this point, but I’ll try to exercise restraint of pen and tongue and stick to my own specialty, though this applies to all of medicine. In psychiatry, we’ve gone through a horrible era – an era in which medications have been over-valued and over-prescribed. The Direct-to-Consumer<\/font><\/em> ads have had a big part in that. People are told that drugs are the answer, specifically in-patent expensive drugs, and they’ve turned unhappy people into a pressure group to lobby physicians. There have been too many complicit KOLs who have pounded that drum, but those ads have fanned the flames. Patients literally plead for the newer in-patent drugs they see on tv, and are disappointed if they’re given a generic or no prescription at all. From the point of view of a practitioner, the time honored journals are flooded with industry jury-rigged articles, and the patients come primed from last night’s ads. Ask your doctor if XYZ is right for you. If ABC happens, call your doctor.<\/font><\/em> The damned ad writers get to spend a lot more time with our patients than we do!  [restraint 1boringoldman, use restraint]. And people get hurt in the process. My contention is that any drug that is advertised on television should be available Over-the-Counter<\/font><\/em> [OTC]. Get me out of the loop.<\/div>\n

Ed doesn’t think physicians as a group can make a stand like this. I do and I hope it happens. As a group, we could do what I do. I don’t prescribe drugs when they first come out, even things like Prozac®. The FDA isn’t charged with telling us what to use – just with assessing safety and minimal efficacy [no snake oil]. We learn about drugs through use, not from ads. So I wait until I hear from colleagues and patients and then I’m willing to give it a try. That’s the way it has been since the beginning of my career. But I’ve added something new. I don’t prescribe drugs advertised on television at all. I doubt all specialties could do that. But I can, and do. Aren’t I depriving people of the up-to-the-minute-world’s-greatest-breakthroughs-ever<\/font><\/em>? I can’t imagine what they would be. I can’t think of an example.<\/p>\n

So I think if physicians actually get behind this AMA resolution, we can make this happen. After all, we write the prescriptions and it’s our job to do it responsibly<\/font><\/em>. If I see a patient and put them on a drug that’s dangerous without an adequate warning, I’m liable for not being honest in obtaining informed consent. And if I mumble and thereby minimize the dire consequences like they do in television ads, I am and should be called to task. Those mumbles are hardly adequate, and, in my opinion, they are essentially false advertising. So unlike Ed, I don’t think we need to spin anything. I think we need to fight fire with fire. We hold these truth to be self evident! Damn the torpedoes! Full speed ahead!<\/font><\/em><\/strong>…<\/div>\n","protected":false},"excerpt":{"rendered":"

I so rarely disagree with anything Ed Silverman of Pharmalot has to say, I relish the opportunity to disagree with him for a change. When I read that the AMA had voted to call for a ban on Direct-to-Consumer [DTC] ads on TV [doctor power…], I felt almost giddy about my fellow physicians finally making […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-62118","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/62118","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=62118"}],"version-history":[{"count":20,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/62118\/revisions"}],"predecessor-version":[{"id":62134,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/62118\/revisions\/62134"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=62118"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=62118"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=62118"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}