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Should DayQuil Be Legal?

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131–140 of 322 posts

Re: Should DayQuil Be Legal?

#131
post #39

I just can't get super upset about this. Sure, OTC companies are duping customers with marketing, but what's new about that? As the person holding the money, it's my job to look at what is effective and what the active ingredients are in any given product. Or ask my doctor/nurse/pharmacist what to do, if I can't be bothered to make the effort myself. When I want to get irrationally angry about something in a departme…

> When I want to get irrationally angry about something in a department store, I'll walk over to the shampoos, which for some reason always have a whole entire aisle dedicated to a single product, when they all do literally the same exact thing, just with different scents and advertising budgets baked into the sticker price. Somewhere on a shampoo forum people are complaining that all computers do the same damn thing…

> all computers do the same damn thing

They're all Turing machines

Re: Should DayQuil Be Legal?

#132
post #81
post #39

I just can't get super upset about this. Sure, OTC companies are duping customers with marketing, but what's new about that? As the person holding the money, it's my job to look at what is effective and what the active ingredients are in any given product. Or ask my doctor/nurse/pharmacist what to do, if I can't be bothered to make the effort myself. When I want to get irrationally angry about something in a departme…

> As the person holding the money, it's my job to look at what is effective and what the act ingredients are in any given product. I wish the industry, our health organizations, and most people in general acted as though this were true. The environment we live in in general is increasingly hostile to people who ask those questions, do their own research, and take responsibility for their health in this way. I have fi…

"hostile" how?

Re: Should DayQuil Be Legal?

#133

I get that the discussion here focuses on doubtful decongestants, but just the mention of acetaminophen makes me think of pharmaceuticals and people's relationship with them in the US. It's a strange world to me, especially how deeply ingrained the brand names are in people's minds - years of evidently successful marketing. What, to me, should be illegal, is building expensive branding around a group of very basic an…

Same situation in the US. I can buy NyQuil/DayQuil, or I can buy the pharmacy-branded version for a lower price. Here it's usually not such a dramatic difference; probably the pharmacy brand is a a 30-40% discount off the big-name brand.

> How is THAT legal

Why shouldn't it be? Companies are free to set prices to whatever the market will bear. In this case it's based on customer ignorance, which makes it feel icky, but I don't think that's a reason to legislate this sort of thing.

> and how are people so unaware as to actually buy it?

Yeah, I don't know. I do remember that, many many years ago, I didn't know about this, and would always go for the big-name-brand version. At some point I learned to look at the active ingredients and just buy the cheapest one that had the same ingredients in the same dose, but I don't recall when or why I learned that, or why I didn't know that before.

I think there's also an implicit quality judgement sometimes, even if it's unfair. When it comes to groceries, say, canned tomatoes, and I see some fancy-looking Italian brand that I've heard of, my brain will automatically rate it much higher than the grocery store's own branded version of it. Maybe that's an effect of marketing/advertising, maybe it's something else, I don't know. And sometimes it's actually true: tomatoes are not all created equal. I think something similar happens with drugs, even if it's an entirely different kind of product.

People also often assume that something that costs more is automatically higher quality. For some types of things, that can be true (because yes, there is such a thing as a better tomato, and sometimes it costs more to cultivate said better tomato), but for drugs in a regulated environment, that doesn't really make sense. But people pattern match on what they know and what they feel.

Re: Should DayQuil Be Legal?

#134
The author has a point about dextromethorphan and phenylephrine. However, he does guaifenisin dirty:

>You’ll also find lots of cough medication with guaifenesin, which has similarly thin scientific backing.

He links ( https://pubmed.ncbi.nlm.nih.gov/24003241/ ) which shows that guaifenisin had no measurable effect on sputum volume or consistency (p = 0.12 for volume). But there are other studies with broader outcome measures which show positive effects:

https://link.springer.com/article/10.1186/1465-9921-13-118

>The pilot study was a randomized, double-blind study where patients were dosed with either 1200 mg extended-release guaifenesin (n = 188) or placebo (n = 190), every 12 hours for 7 days [...]

>Subjective measures of efficacy at Day 4 showed the most prominent difference between treatment groups, in favor of guaifenesin.

>The DCPD assessment of symptoms also indicated advantages for ER guaifenesin over placebo for the between-day changes from baseline in response to the questions “Over the last 24 hours how often did your phlegm prevent you from going to public places?” (Day 2; p = 0.0016) and “Over the last 24 hours, how difficult was it for you to bring up phlegm?” (Day 5; p = 0.0070).

G tends to do well in subjective (symptomatic) assessments, even when subjects are blinded, but poorly in objective assessments. However, this isn't enough to condemn it.

Re: Should DayQuil Be Legal?

#135

The article kinda glossed over it, but one fact under-appreciated by the general public is just how dangerous acetaminophen overdoses can be . Scientists often talk about the "therapeutic index" or "safety ratio" of a drug. It's the LD50 (dose at which 50% of recipients die) divided by the effective dose. Common hard drugs like heroin or methamphetamine have a safety ratio of about 6-10 [1]. "Soft" drugs like marijua…

Acetaminophen should be treated with more caution in general. So many people have reacted with shock and upset when I told them that taking Tylenol (or anything with acetaminophen in it like Dayquil/Nyquil) while drinking can cause immediate liver damage.

Re: Should DayQuil Be Legal?

#136

I get that the discussion here focuses on doubtful decongestants, but just the mention of acetaminophen makes me think of pharmaceuticals and people's relationship with them in the US. It's a strange world to me, especially how deeply ingrained the brand names are in people's minds - years of evidently successful marketing. What, to me, should be illegal, is building expensive branding around a group of very basic an…

We see this all over. Generic brands can be on-par with (or even 100% identical) to name-brands, and the name brands still make money. For example at my local grocery store, you can buy distilled white vinegar from Heinz or the generic brand. The generic brand costs half-price (or less if you get the bigger container), but the product should be chemically identical.

There can be some arguments made (maybe you think the generic cuts corners and it is only 4.5% vinegar instead of 5%), and the same arguments can be made for the drugs. But IMHO they come nowhere near to justifying the price gap.

The thing that is particularly frustrating in the case of the drugs is how the brand-name is (for many people) the vernacular name. I grew up in a family that called many drugs by their actual name (eg ibuprofen & acetaminophen), but when I go to the doctor, many of them insist on calling them Advil & Tylenol. Sometimes it seems to take them a second to recognize the generic name.

Re: Should DayQuil Be Legal?

#137
post #95

> Take your standard 12-ounce bottle of DayQuil, which costs around $15 at CVS. ... > So the only ingredient that’s doing anything in that bottle of DayQuil makes up just 2% of the bottle: the roughly 8 grams of acetaminophen, which separately would run you about 16 cents at Costco. Why are they comparing the price of CVS DayQuil to Costco acetaminophen? Either compare CVS DayQuil to CVS acetaminophen or compare Cost…

Yeah that seems odd. It's also a very different delivery mechanism. Might be easier to get a sick and snotty kid to drink some (maybe?) tasty liquid vs cheap pills.

that's why you have children's tylenol (or generic) that is $$$ but exactly that.

Re: Should DayQuil Be Legal?

#138

They wouldn't be selling the placebos if the real stuff were accessible. That's the real answer. The article mentions this but just accepts the inaccessiblity of the real thing as a given. You used to be able to get Nyquil with real sudafed in it. That was the gold standard. It's not even available behind the counter anymore, presumably because they can make more money from morons buying the placebos. As an aside: >…

> It's not even available behind the counter anymore, presumably because they can make more money from morons buying the placebos. What do you mean "morons"? Say I'm a normal person who doesn't habitually read magazine articles about drug effectiveness. How am I supposed to know that phenylephrine doesn't work? It's in the drug store and they're selling it as a decongestant; I have good reason to believe it will deco…

They also sell homeopathic drugs at that same store. So that at least should tip you off that not everything for sale can be trusted to be effective.

Re: Should DayQuil Be Legal?

#139
post #39

I just can't get super upset about this. Sure, OTC companies are duping customers with marketing, but what's new about that? As the person holding the money, it's my job to look at what is effective and what the active ingredients are in any given product. Or ask my doctor/nurse/pharmacist what to do, if I can't be bothered to make the effort myself. When I want to get irrationally angry about something in a departme…

I think I have two opinions on this, from different angles.

I think the phenylephrine stuff is absolutely messed up. I personally had no idea it was ineffective, and I've bought medicine with that included, believing it would do what it says it does in the active ingredients list. To me, this is criminal, and these companies should be taken to court for outright lying about their products. (And the FDA should be slapped, hard, for not having done something about this by now.)

But when it comes to the CVS brand of acetaminophen costing $5 and the NyQuil brand costing $10, that's just... the result of normal market forces. I'm not a big "free markets" guy (because we don't, and can't, have truly free markets, and if we could and did, it would be a disaster), but it's pretty normal and common for people to pay more for something just because some company did a better job advertising it than their competitor did. That's just life.

It's funny, because when I go to a pharmacy, the store brand is usually shelved right next to the big-name brand, and there's even often a little card next to the store brand (or even printing directly on its packaging) that says "Compare ingredients to $BIG_NAME_BRAND!" And yet, people still buy the big name brand. ::shrug::, that's life.

Re: Should DayQuil Be Legal?

#140

The real reason that all these drugs are mixed together seemingly willy-nilly is actually to prevent people from overdosing and going wild with a singular drug, or cooking up more potent mixtures from it. Guaifenesin in particular has been mixed with decongestants, for the primary purpose of preventing use as a precursor. If they sold these chemicals as singular treatments then the abuse would go through the roof. Th…

> The "accidental OD" scenario where an innocent patient quadruple-doses is realistic, and anticipated, and the shrewd consumer will avoid this.

I think we need to do more around accidental overdoses than suggest that everyone should be a "shrewd consumer".

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