(November 24, 2002 // link)
It seems that people in this country don’t get cold anymore --we get hypothermic. We also don’t get heartburn, we get acid reflux disease. We have big names for lots of other illnesses that people actually used to ignore, but more importantly, we have drugs to help us over these illnesses. Before I offend any one, I should point out that there are people who actually suffer from these maladies, but it sure seems that direct marketing of drugs has exposed us to a whole new way of looking at illness.
Direct, mass media marketing of drugs presents a host of different problems, including the drastic effect on health care costs, the erosion of patient confidence in physicians who don’t happen to agree with the drug company’s diagnosis, and the establishment of an institutional drug culture. People are simply being bombarded with information from big businesses (if I had a research staff I could give you a statistic about just how big, but I don’t, so I won’t) who happen to be in the business of selling drugs.
Physicians and pharmacists are telling us that we need to be more judicious in the use and prescription of drugs. There is real fear that the effectiveness of our antibiotics will be undermined from overuse due to the evolution of more drug resistant bugs. Likewise, over prescription of certain anti-depressant and other medications can have serious negative consequences as patients become more resistant to the drug in low doses. There are hundreds of examples that illustrate this point, but suffice it to say, the drug companies are not pointing out these potential problems when they set out to sell the little purple pill.
There is a dangerous mixed message here. At the same time that we are allowing companies to market their drugs directly through the mass media, we are telling kids that it is not OK to do drugs. The social, economic, societal and personal consequences of illegal drug use are drilled into our children almost from birth. There are T.V. ads designed to enlighten even the youngest member of the household in the most graphic of terms just how bad drugs are for everybody. The problem is, these ads are run right next to ads which exhort viewers to diagnose themselves and then “go ask your doctor about …”. This makes doctors look a lot more like drug dealers than any of us should feel comfortable with.
In essence, we are now being told that there are good drugs and bad drugs, when in actuality all drugs are bad if you don’t need them. The diagnosis and treatment of illness should lie with the health care provider, not with the drug company with the most money. Not only is there a societal cost when we allow the producer of a drug to market its properties to consumers who are not trained to understand the true consequences of its use, both good and bad, there is an economic cost as well. Pharmaceutical development and manufacturing is a huge business. There is a fine line between being able to recover the costs of research and development and improperly influencing the freedom of the health care provider to properly and ethically provide for his or her patients.
These ad programs are also extremely expensive and the cost is reflected in the cost of the drugs. A major factor in the rising cost of health care in this country is prescription drug costs. These costs are driven by pharmaceutical companies that make obscene amounts of money selling patented drugs. True, they also spend a lot of money developing those drugs for sale, but the are constantly seeking government intervention in the form of less regulation and longer patent protection so that they can get their product to market sooner, advertise it directly to users and have an exclusive right to sell it longer. So far they have been very successful.
In fact, Bob Herbert reports in Monday’s New York Times that, buried deep in the recently passed Homeland Security Act is a provision that protects drug manufacturer Eli Lilly from lawsuits by parents who believe their children were harmed by the preservative Thimerisal, contained in children’s vaccines. It seems there may be a link between this mercury compound and an increasing incidence of autism in vaccinated children. Perhaps this type of legislation is the payoff for the huge cash contributions by drug companies to political campaigns, and it is certainly related to the fact that Mitch Daniels, Bush Budget Director, and Sydney Taurel, Homeland Security Advisory Council, are both former high level Eli Lilly executives.
Technology is a wonderful thing. Pharmaceutical technology is no exception; prescription drugs are not a panacea and business should not be permitted to tell us otherwise. Kids are not usually great with subtlety and our message to them needs to be clear and consistent. Direct marketing of drugs should not be permitted. By the way, if you have a headache after reading this article, it probably isn’t a migraine.