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Doctors want ban on prescription drug, device advertisements

arstechnica.com

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Re: Doctors want ban on prescription drug, device advertisements

#122
post #74

Earlier quoted context omitted.

> I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker. "Surveys conducted by FDA and private organizations consistently show that DTC advertisements have an impact on whether consumers request and receive a specific brand-name prescription from their physician. [...] In several of these surveys, consumers were asked whether they had seen an advertisemen…

I wonder how much data there is against the First Amendment. I'm not saying the ads aren't a problem, I'm saying censorship isn't the solution.

My comment was descriptive, not normative.

Re: Doctors want ban on prescription drug, device advertisements

#123
post #90
post #76

Earlier quoted context omitted.

"I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker." Plenty of logic is there. Part of the purpose is to make the Doctor pay attention to the advertising that they see in a journal. [1] How? Patient goes in and "asks their doctor" about a drug. Then another patient. And another. So now when the doctor sees an ad (or the detail man comes in) the doctor…

Patient goes in and "asks their doctor" about a drug. I wonder if this really ever happens. I mean, for many of the ads, it's hard to tell even what the drug does, so going to your doctor and asking for that med would amount to a random question.

Oh hell yes. The main one peaople ask me about right now is Marcumar/Warfarin, a drug many patients with atrial fibrillation have to take for the entire rest of their life, despite the fact that it has awful side effects and requires them to go to their doctor every two to four week to have a blood test done. Many patients are quite excited to hear that there's now new alternative drugs (NOAKs) that let you skip the biweekly blood draw. I get asked about Pradaxa, Eliquis and Xarelto so often, my standard Marcumar pitch now includes a whole paragraph about how those alternatives are just as bad. This is getting harder to sell as new studies are coming in and my arguments against the new drugs are steadily being reduced to "They're a lot more expensive." Patients really do NOT want to hear about how they have to get stuck with needles every two weeks so their doctor can save a few Euro a month in the prescription budget.

The whole NOAK advertising scheme seems like a huge win for the pharma companies to me. (Possibly also for the patients. Not so much for the affordability of our medical system.)

Re: Doctors want ban on prescription drug, device advertisements

#124
post #40

Earlier quoted context omitted.

> Someone, something, or some organization needs to be responsible for properly communicating and educating consumers on a drug Why shouldn't this just be their doctor?

The best reason, in my opinion, is that there are new drugs all the time. The FDA approves on the order of 20 or so drugs per year (that's new drugs, not including new generic versions of old drugs). So physicians have to learn 2 new drugs per month in enough depth to consider how it should change their current prescribing habits.

There are precious few professions that don't require constant skill-sharpening, and if anything, I would expect doctors to be amongst the best at keeping up to date. They spend more time than any of us being formally educated, so the informal self-education necessary to do the work seems like it should be natural.

But I don't know anything about this stuff, and I'd love for someone who does to teach me a thing or two.

Re: Doctors want ban on prescription drug, device advertisements

#125
post #40

Earlier quoted context omitted.

The best reason, in my opinion, is that there are new drugs all the time. The FDA approves on the order of 20 or so drugs per year (that's new drugs, not including new generic versions of old drugs). So physicians have to learn 2 new drugs per month in enough depth to consider how it should change their current prescribing habits.

And now, when advertising is allowed, doctors don't have to learn those new drugs?

When there's a brand new drug for your semi-rare condition, your family doctor might not yet know such a drug even exists were it not for you seeing the ad and asking about it.

Re: Doctors want ban on prescription drug, device advertisements

#126
post #87

Earlier quoted context omitted.

People with addictions don't have preferences in the sense you mean. The nature of addiction is that it subverts and overrides the (delicate) mechanisms of rational choice. If the principle we live by is maximizing total individual freedom, then I think freedom from addiction has to be part of that. For that matter, much of the point of advertising is also to subvert one's preferences. So as a believer in individual…

People with addictions don't have preferences in the sense you mean. The nature of addiction is that it subverts and overrides the (delicate) mechanisms of rational choice. It's an interesting point to discuss. Presumably they did (in most scenarios) have a choice when beginning the drug, but then once addicted, you have a good point. So should we argue that that initial choice was made freely, and that we have no ri…

I have yet to meet the person who, when asked for the reason for their decision, replies "it was irrational". The truth is that people take the action they feel is the most rational, and there are many factors influencing that conclusion.

It's also important to consider that addiction is far more complicated than a dependance on a biochemical reactions to a stimulus. There are strong psychological issues at play as well. If we were to outlaw every addictive substance or action, surely no form of entertainment would remain legal.

A person always has a decision to engage an addiction. Deciding to not be addicted is the foundation to recovery. This choice cannot be removed at any point in a person's life, be it before, during, or after an addiction.

To say that an addict is not making decisions is like saying that someone you disagree with is not thinking. Just because you don't like their opinions or their behaviors does not justify denying their freedoms.

Re: Doctors want ban on prescription drug, device advertisements

#127
post #93

These ads are one of the main reasons I became a cord cutter. I'm very happy they have not yet followed me onto any of the streaming services I use. They are the creepiest thing ever on television. The actors sit around dinner tables with family members speaking unnatural, FDA manipulated dialog ("Oh, I'm doing great, I've been taking Pradaxa for my afib, not caused by a heart valve problem!") Then you get the unendi…

That would meet the great entertainment criteria 'informative AND entertaining'.

[deleted]

Re: Doctors want ban on prescription drug, device advertisements

#128
Are family doctors able or willing to keep up on the flood of new medicines available, each of which may only apply to a handful of their patients?

Aren't drug ads, in a way, a good method for matching medicines to the people who need them? As far as I know, your family physician isn't going to call you when a new drug comes out that better treats your semi-rare, non-fatal condition - and patients aren't going to read medical journals to discover new drugs to ask their doctor about.

Re: Doctors want ban on prescription drug, device advertisements

#129

Great news, so pharma companies could focus more on drugs itself and less on marketing. It's huge money waste with mysterious intention - if your drug is the best, doctors should use it anyway, and if it's bad but you can increase its usage with huge marketing campaign, then mankind just gets screwed for own money.

if your drug is the best, doctors should use it anyway

Amazingly that is untrue. Doctors have to know that it's the best drug and they often don't. Doctors are often creatures of habit. If I gave my last patient Crestor and it lowered their cholesterol, why not try the same with the next patient?

Re: Doctors want ban on prescription drug, device advertisements

#130
post #123
post #90

Earlier quoted context omitted.

Patient goes in and "asks their doctor" about a drug. I wonder if this really ever happens. I mean, for many of the ads, it's hard to tell even what the drug does, so going to your doctor and asking for that med would amount to a random question.

Oh hell yes. The main one peaople ask me about right now is Marcumar/Warfarin, a drug many patients with atrial fibrillation have to take for the entire rest of their life, despite the fact that it has awful side effects and requires them to go to their doctor every two to four week to have a blood test done. Many patients are quite excited to hear that there's now new alternative drugs (NOAKs) that let you skip the…

Slight OT: How much more expensive does the stuff have to be that biweekly doctor visits for blood tests are cheaper?

(Not even getting into the topics of "how much is not having to do that every 2 weeks worth" and "can't the patient pay the difference if they want to?")

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