Tuesday, March 15, 2011

Most Common Side Effects

In the last decade, there has been an exponential increase in the amount of advertising for prescription pharmaceutical medicines and a corresponding increase in prescription drug consumption. This is partly the result of a significant change in the way drug companies are marketing their products. Back in the day, pharmaceutical companies sent drug reps out to visit doctors and hospitals. They generally came bearing gifts—radios, clocks, sometimes even television sets. But, more importantly, they provided technical information about what their drug could do for the patients and what side affects might occur. They answered questions and gave medical professionals all the information they needed to make qualified medical decisions about what, if any, drug would best address the illness the patient presented.

The new model for marketing drugs has the pharmaceutical companies skipping right over the medical professionals and going to the consumer directly. Often times, even after seeing an ad several times, the consumer may not know what illness the medicine is intended to treat. But, it sure sounds good. Maybe I better ask my doctor if that drug is right for me.

I remember watching NFL football with my 12 year old son years ago. One of these drug ads kept appearing that depicted a middle-aged man throwing a football through a tire swing. The audio message was intentionally vague, and being na├»ve, I missed all the phallic symbolism that was meant to convey the message that this was the newest of what a friend of mine called “giddy-up drugs.” Stupid me! I turned to my son and asked him what he thought that drug is supposed to do. His response was priceless, “I think it makes him throw the ball better.”

The point is these messages about sophisticated drugs are dumbed down and intended to make us all think we can’t live without these medicines. We are not sure what they do, but that person sure looks happier. And who doesn’t want more control over their health care decisions? I believe we should all assume more responsibility for our physical and emotional well being, but that does not make us trained and qualified medical diagnosticians.

Of course, to ensure that as an informed consumer we all make the right medical choices, we are told about all the possible side affects of the particular drug we are being sold at the moment. Have you listened closely to some of the contraindications of these wonder-working medicines? Here are a few snippets of the choicest “Most Common Side Effects”:
• “chest pain; confusion; fainting; fast or irregular heartbeat”
• “new or worsening mental or mood problems”
• “sudden, severe dizziness or vomiting; slurred speech; uncontrolled muscle movement; unusual weakness or tiredness”
• “suicidal thoughts or actions”
• “abnormal thinking; behavior changes”
• “hallucinations; memory loss; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being”
• “decreased sexual desire or ability” (Don’t worry; there are plenty of other drugs that counteract this symptom)
• “red, swollen, blistered, or peeling skin; ringing in the ears; seizures”
• “sudden decrease or loss of hearing; sudden decrease or loss of vision in one or both eyes”
• and, my all time favorite, “sudden urges to gamble”

The pharmaceutical industry is big business, and to be fair, they have developed some really valuable medicines that treat previously untreatable conditions. Medical care has improved thanks in part due to research and development by drug companies. Research and development is expensive and the testing and application process to get Food and Drug Administration approvals cost a lot of money as well. As a result, some of the newest and best drugs are also very expensive as the industry prices their product to recover their investment before the patent runs out and cheaper generic versions of the drug come on the market.

Prescription drug use in America is up—way up. We cannot discount the impact this has had on the cost of delivering health care services in this country. Over the past ten years, the percentage of Americans who have taken at least one prescription drug in the past month has increased from 44% to 48%. The use of two or more drugs increased from 25% to 31%. The percentage of Americans using five or more drugs per month increased from 6% to 11%. In 2007-2008, 20% of children and 90% of older Americans reported using at least one prescription drug in the past month.

Prime time television ads rates vary widely from $40,000 to $400,000 per ad. Full-page color ads in a popular men’s magazine can cost more than $70,000, and by the time the drug company buys the extra page and a half to print all the disclaimers in fine print, a $175,000 per month per magazine budget is not out of the question. It doesn’t take rocket science to see that drug companies are spending a lot of money to get you to “ask your doctor” about their latest wonder pill.

If you have followed my columns over the last few years, you know that I am a free-enterprise advocate. I favor market solutions over government regulation. Although the government has historically banned alcohol and tobacco ads, I am not suggesting that prescription drug ads be banned. Besides, the government has no nexus that would empower it to ban advertising in the print media or on cable and satellite television.

However, I do wonder about the ethics of marketing prescription drugs directly to the consumer. I do believe it significantly contributes to the escalating use of prescription drugs and the spiraling cost of providing health care. And, perhaps I am old fashioned, but shouldn’t we all leave the decision to prescribe or not prescribe drugs to the medical professionals and not the consumers. There are certainly a number of circumstances that warrant prescription drug use and I am neither anti-medicine nor anti-drug industry. But, I wonder if it is really necessary or in our best interest to take “Mother’s little helper” for every perceived problem we have in life. Maybe we would all be better off if we took charge of our own physical and emotional well being. As consumers we can exert market changing power through our consumption patterns. We can all reconsider our prescription drug use, and through the free market, we can have a positive impact on our physical, emotional, and financial well being and help bring down the cost of health care in America. As Nancy Reagan said about illegal drug use, “Just say ‘No.’”

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