[H-H-H-H]

3.Every $1.00 spent advertising prescription drugs is estimated to increase their retail sales by $4.20. Prescription Drug Ads ProCon.org[3]

I am not a fan of direct-to-consumer advertising. According to a study in PLOS Medicine:

The study shatters the accepted myth that pharmaceutical companies spend more on research than on marketing. In reality, drug companies pour $57.5 billion into marketing, dwarfing the comparably paltry $31.5 billion devoted to research.

Billions of marketing dollars go toward television ads that implore us to “ask our doctor” about drugs we don’t need to treat ailments cultured by public relations firms. Yet even more money is spent convincing doctors to prescribe costly medicine—an astounding $61,000 in “promotion per physician.”

For the last 50 years, say the authors, there has been an ongoing debate as to which image of the drug industry is most accurate. The industry promotes a vision of itself, say the authors, as “research-driven, innovative, and life-saving,” but the industry’s critics contend that the drug industry is based on “market-driven profiteering.”

The study confirms the more cynical view that drug companies are out to profit first, and save lives second. And there’s nothing wrong with that.Drug Companies Spend Almost $60 Billion On Marketing, $30 Billion On Research. What? ? Consumerist

"4.The United States and New Zealand are the only two countries where direct-to-consumer (DTC) advertising of prescription drugs is legal. [4]" The ProCon article explains why, and much more.

It seems people need to be harmed or even killed before Congress will act, not unlike other issues Americans face.

What do you think?

[Sneezyyy]

I think it's all crap just my opinion

[Altered Moment]

I think it should be illegal. It should be up to docs to educate themselves. Pharma can mail them literature.

Check out this deal-

Pfizer Warns UK Docs About Patent Infringement Over a Generic Lyrica - Pharmalot - WSJ

Pfizer has three patents on Lyrica. One for pain, one for anxiety, and one for epilepsy. I didn't know you could get three patents on the same drug for different use. The patents for anxiety and epilepsy ran out last July. Pfizer is warning docs not to use generic Lyrica for pain because they still have that patent. I don't know how they would enforce it unless the NHS really put the hammer down on docs over it.

[~Christina]

And right before the patents fall off .. they refile it under a new patent .. Advair did that.

Big Pharma is horrible !

[kiwi33]

Ben Goldacre's Bad Pharma is worth reading in this context.

[Altered Moment]

Originally Posted by ~Christina

And right before the patents fall off .. they refile it under a new patent .. Advair did that.

Big Pharma is horrible !

Glaxo Declines as FDA Clears Path for Advair Rivals - Bloomberg

Glaxo, and until now the FDA, have said that the same drug in a different inhaler is a different product because the device used to administer the medicine can cause dosing to vary. While the patent on Advair expired in 2010 in the U.S., a separate patent on the Diskus device remains in force through 2016.

That's just crazy. Looks like the FDA is going to allow generics out now though.

It's ugly. Big pharma has owned the FDA for a long time and always had by far the biggest lobby on capital hill. They don't always get their way though. They are allowing generic versions. And I think over the long haul they come out with lots of good drugs that do end up generic. They just rape us as much as they possibly can along the way. Probably if you have asthma and chronic obstructive pulmonary disorder you like your Advair.

[Altered Moment]

Then there is the "me too" trick. Market the active metabolite of a drug when the original runs out but you have the patent on the active metabolite. Pfizer did it with Effexor. Pristiq is the active metabolite of Effexor. It does turn out though that Pristiq is a cleaner version as it produces less other active metabolites that cause side effects. Effectiveness is probably no different.

Then they patent and add extended release coatings of different kinds to keep the original patent going. ER XR XL ED whatever....

[Altered Moment]

I'd say that over 95% of all psyche meds are available generic now though.

[H-H-H-H]

That a high percentage of generic psyche medications are available is wonderful. Then again, who writes the prescriptions?

Do doctors succumb to prescribing higher-priced brand name medications as the quid pro quo for promotional fees they receive from Big Pharma?

[Altered Moment]

Originally Posted by H-H-H-H

That a high percentage of generic psyche medications are available is wonderful. Then again, who writes the prescriptions?

Do doctors succumb to prescribing higher-priced brand name medications as the quid pro quo for promotional fees they receive from Big Pharma?

In my experience no. Docs prescribe the generic. You can ask they prescribe the generic. As far as I know doctors to not get promotional kick backs for prescribing. If they do it would be totally illegal and would have to be an under the table deal between a drug rep and a doc. I don't know how the drug rep would get the budget to do this. I am talking about 99% of prescribing doctors. There are some at universities who get trips for signing papers and studies and things like that.

If it is written name brand when you go to the pharmacy you can ask for generic and they will fill it. All of us should use generic (unless there is a valid reason to use name brand) even if insurance pays for it as it keeps health care costs down.

My brother in law was a drug rep for Pfizer for many years. It is now illegal to even give pens, food for staff, trinkets, or dinner for a doc. He was number one salesman and lost his job because they made huge cuts in sales staff. His biggest tactic was food for office staff. Half the docs in his area refused to see all sales reps. Drove him crazy. They are now only able to provide promotional and educational materials to docs. Giving samples is a tactic because the doc can provide someone for free for a long time but it gets the patient on that drug. In my experience my docs were always more concerned about my welfare and financial status.

I don't think you can even get samples if there is a generic. I used to get name brands totally paid for by the drug companies. They won't do it if there is a generic.

[H-H-H-H]

Thanks for your feedback, zinco14532323.

The question remains for me: Why the promotional fee if the doctor does not promote?

[Rose76]

I benefited from that "food for office staff" when I did some training in a lab connected with a set of medical offices. Every second morning, the place was catered. And what a spread. They sure know how to throw a party right down to the high quality paper plates and pretty napkins. Office staffs all over the country must be heart broken.

[AncientMelody]

Originally Posted by H-H-H-H

Thanks for your feedback, zinco14532323.

The question remains for me: Why the promotional fee if the doctor does not promote?

Which promotional fee are you referring to?

I think direct to consumer advertising is a terrible thing. There's a reason only two countries in the world allow it. I can't remember the last time I wrote a name brand prescription. Maybe Lyrica a year ago, which was actually a refill for a new patient I believe.

[Altered Moment]

Originally Posted by H-H-H-H

Thanks for your feedback, zinco14532323.

The question remains for me: Why the promotional fee if the doctor does not promote?

I do not know of any promotional fee that exists. You will have to enlighten me.

Ancient Melody is a prescriber and can't remember the last time she prescribed a name brand. That jives with my experience and the experience of people I know as far as common clinical practice.

[H-H-H-H]

Billions of marketing dollars go toward television ads that implore us to “ask our doctor” about drugs we don’t need to treat ailments cultured by public relations firms. Yet even more money is spent convincing doctors to prescribe costly medicine—an astounding $61,000 in “promotion per physician.” Drug Companies Spend Almost $60 Billion On Marketing, $30 Billion On Research. What? ? Consumerist

[AncientMelody]

Well, I see part of the problem. The article you reference is from 2008. The reforms were in 2009 or 2010. So, quite simply these figures are not accurate today.

[Altered Moment]

Originally Posted by H-H-H-H

Billions of marketing dollars go toward television ads that implore us to “ask our doctor” about drugs we don’t need to treat ailments cultured by public relations firms. Yet even more money is spent convincing doctors to prescribe costly medicine—an astounding $61,000 in “promotion per physician.” Drug Companies Spend Almost $60 Billion On Marketing, $30 Billion On Research. What? ? Consumerist

But the physician does not get any money or a fee. That would be highly illegal even in 2008.

The $61,000 figure would include the whole industry. It would have to include the sales staff ($100,000 salaries), the management team, the budget for food, pens,dinners for each rep. Samples, detailing, all the mailings, emailing, conferences, etc etc. Not money to docs.

All this changed. Reps have no budget for food, dinners, pens, and trinkets. I have sold all my brother in laws Viagra and Chantix pens, mugs, scrubs, etc on Ebay. 100's of them. People want that crap. 5 bucks for a good metal viagra pen. He's gone and that budget is gone. Big Pharma cut their sales staff to doctors big time. They put all that money in TV ads now.

I am not disagreeing with you. They spend tons more are marketing and sales than research. They want to make the maximum profit because they are answering to stock holders. I think direct advertising should be banned. I have never trusted pharma or the FDA. My dads a pharmacist, my brother is a pharmacist, my sister in law is a pharmacist, and my brother in law was a drug rep for pfizer for many years. We have been talking about these issues for 35 years.

I think my point is that doctors are not so corrupt as everyone thinks. Half the doctors in my brother in laws district refused to see him or any of them. They get influenced and try new drugs.... sure. I think docs want as many tools in the box as they can get. Patients are influenced and ask for drugs. Most docs prescribe generics. Lipitor was prescribed because it worked and then the patent ran out so now generic. Both my parents take generic Zocor. Medicare won't pay for name brand if there is generic.

I was in Michigan and taking abilify. The drug company was paying for all of it. I went back to CA to work and had Kaiser Insurance and went back to my old psychiatrist. I told him I am now taking abilify. He said not any more your not unless you want to pay 400 a month yourself. he said if everyone who walked into kaiser and asked for abilify Kaiser would go broke. They wouldn't prescribe it and there was no generic. For schizophrenia they would but not as an antidepressant augmenter.

It could be debated how much of a full window the companies they got their data from had into the private financials of companies in the study cited in the article.

PLOS Medicine: The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States

[AncientMelody]

I guess this thread ceased to be interesting to H-H-H once there was a fragment of defense towards the medical community.....

[metamorphosis12]

Your doctor and research from reputable on the web (Web MD., Medline, and respectable websites that have information and quality forums.) Anecdotal reports can be of value. If you accumulate a lot of peoples responses from good forums. Like this one and askapatient.com is another source of ancehdotal reports that comes to mind.
Basically accumulating as much information as you can and presenting/discussing it with your pdoc-doc-healthcare team and going from there.
I wouldn't use pharmaceutical companies as much. Remember, they pay their scientists and doctors salaries but it is a starting point at best. There's a whole world of research and information out there.

[Altered Moment]

In my Dad's 40 years as a pharmacist the best he ever got was plastic pens and coffee mugs. They did get lots of samples.

My dad started as a pharmacist in 1964 and worked 44 years. I worked in his pharmacy as a teen. He says the first twenty years there were hardly and generics. So all the name brand reps competed with each other in this area. The docs would see them all and spread it around. Normally the docs were working way to many hours to be going to dinner and hanging out with them. They were annoying. There were once a year outings maybe for golf or something.

There main job was detailing (education, in the early era reps were actually pharmacist or bio chem guys), handing out lots of samples, handing out pens, and giving the best pitch to influence them. Also trying to get pharmacies to buy direct in bulk.

Then generics and big insurance companies entered the scene. For a certain period after generics new docs would tend to stick to name brand. Probably more influence during this period. Patients didn't trust generics. It took awhile quite awhile for generics to become standard practice and it was driven by costs. Mainly insurance companies but patients too who had to pay for them.

Docs may write name brand but say GEQ (generic equivalent) and every knows today that your gonna get generic if available. If the doc writes DAW (dispense as written), the pharmacist has to give name brand even if the patients insurance company doesn't pay for it. So the patient calls the doc and says, hey I can't pay for this. The doc needs a very good medical reason to say stick with name brand. He has the patient, the pharmacist, and the insurance company telling him to write generic.

Oddly enough in my brothers pharmacy he had a lot of cash customers who would buy 4 or 6 months worth while they were in their vacation homes (very wealthy). They requested name brand because they want top of the line even though in reality there is no difference.

[Altered Moment]

Originally Posted by metamorphosis12

Your doctor and research from reputable on the web (Web MD., Medline, and respectable websites that have information and quality forums.) Anecdotal reports can be of value. If you accumulate a lot of peoples responses from good forums. Like this one and askapatient.com is another source of ancehdotal reports that comes to mind.
Basically accumulating as much information as you can and presenting/discussing it with your pdoc-doc-healthcare team and going from there.
I wouldn't use pharmaceutical companies as much. Remember, they pay their scientists and doctors salaries but it is a starting point at best. There's a whole world of research and information out there.

What he said.

Don't listen to big pharma or the FDA and get all your info from reliable independent sources. Even research all the reviews on your doctor.