Monday, March 19, 2012

Talk to Your Doctor

I found the reading very interesting as it provided a solid background and answered some previous questions of mine. For example, I’ve always been interested in the fact that many drugs are able to be advertised to patients, or consumers, I’m torn between which is the proper term. So, it was useful to read about the increase in the ability for pharmaceutical companies to advertise directly to consumers as opposed to just physicians not only in magazines but also in television commercials. I was surprised to read that $4.5 billion was spent advertising medications in 2005 (Conrad, 17). I was even more surprised to read about how effective that advertising is on consumers with every $1 spent on advertising translating into $4.20 spent on pharmaceutical drugs ( )** That’s a pretty amazing return and explains why pharmaceutical companies do spend so much on advertising their drugs. But it raises the question of whether it’s ethical. Should they be able to leverage so much influence on patients? Do you think that patients should be able to ask their doctors to try particular medications or should doctors recommend the medications? I’m personally slightly ambivalent in regards to this question. I think patients should have the ability to do research and make a decision about which prescription is right for them without being entirely influenced by the doctor, but I’m also wary about the influence that advertising or social groups might have on the individual’s decision. I I question how much of a role they should have in advertising, if any. There are certainly some perverse incentives for them to market certain illnesses as if to convince consumers they are suffering from the symptoms described in the commercial or magazine ad and that they should do something to get treated. I’m certainly looking forward to our next reading assignment on drug companies.

**note: I’m pretty sure this same statistic was mentioned in the reading too, but I couldn’t find it.


  1. I find myself torn on the marketing of pharmaceuticals directly (and aggressively) to consumers. On one hand, it may be empowering for someone suffering from an ailment to have information available to them directly and may make them more active in pursuing health. On the other hand, I can how it's dangerous to bypass a doctor's medical expertise and pursue treatment on one's own (though I'm assuming most of these drugs still require a doctor's prescription). I can't come to a conclusion about whether drug advertisement is good or bad, though my paramount concern is that the advertisements are done responsibly--yes, it's the consumer's job to respond to advertisements in a healthy way, but my hope is that drug companies don't go too far with advertisements.

  2. I do believe drug companies should be able to engage in DTC advertising, so that patients who are not receiving any relief from other drugs that their doctors have previously prescribed them, may come to know about new treatments. From personal experience and from having a mom who is a psychiatrist, I know that many patients do come into doctor's offices asking to be prescribed certain drugs for which they have learned about via DTC advertising (SSRIs in the latter case, etc). In regards to your question about whether doctors should recommend medications or whether patients should ask to be prescribed certain medications for which they have seen DTC advertising, I believe it is a combination of the two. Patients come to doctors to get their medical expertise on what treatment is best for their given ailment. As such, doctors should recommend treatments. If these treatments fail and doctors are at a loss for / are ambivalent / conservative about what to try next, however, I do think it is fine for patients to ask their doctors to prescribe drugs, which they have seen DTC advertising for. In turn, I believe it is the doctors' responsibility to keep themselves up to date on the novel and popular treatments, which patients may be learning of via DTC advertising, educate their patients about the side effects of these drugs, which are not all always listed in explicit detail in broadcast advertising, tell patients whether this drug would interact with another drug that they are currently on, and ultimately make the decision whether or not to prescribe the drug the patient is asking for. In the latter case, if the doctor denies prescribing a drug, there are plenty of patients, who just go from doctor to doctor until they find one who will comply with their wishes. (The same is true for patients who see DTC drug advertising, think they may have X condition, and go to their doctor, who tells them that he or she does or does not have X condition. In the latter state, that patient, if persistent, will find another doctor who will diagnose him/her with X condition and prescribe the drug that was seen via DTC advertising.) Therefore, ultimately, I think the decision of which drug to use should be a joint decision based on the patient's wishes, needs, and concerns, and the doctor's medical expertise and judgment. (We must not forget though that many doctors form alliances with drug companies, affecting the drugs that they tend to prescribe to their patients though...)

    In general, I do think DTC advertising by drug companies has a particularly large influence on patients, and I also hope that their influence does not "overstep its boundaries" between the typical doctor-patient relationship (if any). I think the FDA is doing a pretty good job regulating what is and is not advertised (only allowing the advertisement of drugs which are on label for treating certain conditions) - although I do not quite agree with the fact that not all side effects are listed in explicit detail during broadcast advertising. Often times, side effects are not worth / outweigh the benefit of the curing capabilities of the drug itself. Again, in this case, I believe it is the doctor's responsibility, prior to prescribing a drug, to educate a patient about a drug's possible side effects.