Want a New Drug? Plenty to Choose From on TV

Want a New Drug? Plenty to Choose From on TV
Posted by FoM on January 23, 2000 at 10:32:47 PT
By Sheryl Gay Stolberg
Source: New York Times
By day, Dr. Penelope Friedman, an internist at the Washington Clinic here, has been busy prescribing Relenza, a new and heavily promoted medication for the flu. At night, when commercials for Relenza pop up on her television screen, she finds herself angrily lecturing the set. 
"It irritates me," Dr. Friedman said. "I think it gives partial knowledge to the consumer that is not always helpful." Drug manufacturers have a conflict of interest, she said, adding, "They present themselves as educating the public, but they stand to make money if the patients ask for these things."  Experts complain that the media blitz will misinform consumers and put pressure on doctors to write unnecessary prescriptions.  In the two and a half years since the Food and Drug Administration relaxed its rules, enabling drug companies to pitch products directly to consumers on television, the public has gotten a cram course on drugs, Madison Avenue style. Herpes, allergies, depression, baldness, obesity and, in this season of runny noses, the flu all make the heartbreak of psoriasis look insignificant by comparison. As the billion-dollar "direct-to-consumer" media blitz has escalated, so has the criticism from drug safety experts and physicians like Dr. Friedman, who complain that the flood of ads will misinform consumers and put pressure on doctors to write unnecessary, or inappropriate, prescriptions. Their concerns recently won an ally in the agency that opened the floodgates in the first place: in a public health advisory, F.D.A. officials warned that doctors appeared to be relying too heavily on Relenza, and that some patients might have died for lack of more aggressive treatment. The agency, which had already forced the drug's manufacturer, Glaxo Wellcome, to pull an ad for Relenza off television, said the caution was prompted in part by its concern over the intense marketing campaign. Surveys have found that more than 80 percent of patients and doctors have seen such drug ads, and the commercials have clearly affected the dynamics of the doctor-patient relationship. A recent F.D.A. survey found that among 960 people who had visited a doctor in the previous three months, 27 percent were prodded by an advertisement to talk to a doctor about a medical condition they had not mentioned before. Roughly 7 percent of respondents had seen an ad and subsequently asked their doctor for the drug. Half the requests were granted. Still another study, a survey of 329 randomly selected residents of Sacramento County, Calif., asked patients how they would react if their doctor refused such a request. One-quarter said they would seek the prescription elsewhere; 15 percent said they would consider leaving their doctors. "Doctors are being pressured," said Dr. Raymond Woosley, chairman of the pharmacology department at Georgetown University. "People are saying, 'I will go to another doctor if I don't get it from you.' " Whether doctors succumb to that pressure depends, in part, on their specialty and the severity of the illness, said John Fezzuoglio, a market research analyst for the Scott-Levin consulting firm in Pennsylvania, which tracks prescription drug ads. Infectious-disease specialists seldom prescribe AIDS drugs based on a patient's request, he said. But podiatrists often accede to requests for therapies for toenail fungus, which many people did not know existed until ads for Laprisil, an antifungal medicine, started appearing on television. Women who ask for Ortho-Tri-Cyclen, a contraceptive promoted as the only birth-control pill that can relieve acne, almost always get the drug. In an era when patients show up at appointments armed with printouts from the Internet -- sometimes reliable, sometimes not -- some doctors complain that direct-to-consumer advertising is just another source of confusion. But supporters say the change results in more informed consumers, if only by prompting more discussion between patients and their doctors. "It's consistent with the whole trend toward consumer empowerment," said Dr. Nancy Ostrove of the F.D.A.'s Division of Drug Marketing, Advertising and Communications. "We believe there is a certain public health benefit associated with letting people know what's available. People are telling us that they are going to talk to doctors about conditions that they have never discussed before." But there are unseen risks, said Dr. David A. Kessler, the former commissioner of food and drugs. Under the old system, he said, the F.D.A. would approve a drug, and its sales would increase gradually, giving the agency time to track side effects that did not turn up in testing but emerged only with use in the general population. "What happens now is that the F.D.A. approves a drug," he said, "and with the direct-to-consumer advertising, the drug becomes a blockbuster overnight and all of a sudden it's in wide use. That's what makes me nervous." As to how much a particular commercial changes prescribing patterns, that is almost impossible to tell. The drug industry conducts studies, but does not discuss the results -- in part, some in the advertising world suspect, because certain commercials are not as successful as is generally believed. Such campaigns have brief runs, promoting flu drugs in the winter and allergy drugs in the spring, and outsiders cannot easily track their effectiveness, said Richard Campbell, a partner in the Campbell Regan Ward agency, which specializes in promotion to medical professionals. "When somebody spends $40 million and then stops," Mr. Campbell said, "it begs the question: Did it stop because they found out it didn't work, or because it was effective? Nobody's telling." Merck, for instance, dropped its campaign for Fosamax, an osteoporosis medicine, and replaced it with generic ads encouraging women to talk to their doctors about the disease. Such "unbranded" ads are not subject to the F.D.A.'s stringent rules about advertising information on side effects, and can therefore be shorter and less expensive. "We just wanted to do something else," said Jan Weiner, a company spokeswoman. Sometimes the ads backfire. Dr. Friedman says the litany of side effect information required by the F.D.A. scares off some patients, keeping them from taking drugs they really need. "They'll start listing off the side effects," she said, "and say, 'I am not about to try these things.' " WASHINGTON Published: January 23, 2000Copyright 2000 The New York Times Company 
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Comment #1 posted by kaptinemo on January 23, 2000 at 10:59:18 PT
Yeah, and wait till Marinol is C3 everywhere!
So, Dr. Friedman is worried and angry? That will be nothing when her patients start asking for Marinol!Several months ago, the DEA, in the only decision reversal in its history, stated that Marinol (synthetic THC) will now be schedule 3. Meaning doctors can prescibe it for almost anything remotely affected by it. Depending on whether it has been re-classified as C3 in your state, you'll soon be able to go to your pharmacy and pick up a bottle.And the average Joe who asks for it, or is prescribed it, is going to be very pissed off.Why? Because when he or she makes the connection that it is nothing more than a souped up version of pot he had when he was 'engaged in youthful experimenting' (as our lying, two-faced pols like to say to excuse their early adventures) they are going to make the final connections that pols=liars. And the WoSD just might start to come apart at the seams. Because the real motive behind the continued prohibition will become so crystal clear that even Mr. Magoo will see it.Money. Nothing but money. Because the pill will almost certainly cost a lot more than a joint would, were the natural drug legally available.(Chuckling while rubbing hands together)I can hardly wait to see the commercials the ad agencies will come up with for *this* one.Are you ready, Dr, Friedman?
Marinol Web Site
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