This Week in Pharming…

Cambodia 244Perhaps I live day to day as an ostrich with its head stuck in the sand but I was completely unaware that pharmaceutical companies were suing for their right to market drugs for unapproved “off label” uses using the First Amendment “free speech” argument until this week when I ran across an interesting article from the New York Times: Drugs, Greed, and a Dead Boy.

Off label uses are commonly discussed among physicians. I have written prescriptions for countless drugs over the years that were not necessarily for FDA approved purposes. Drug reps are not allowed to discuss off label uses when they are calling on physicians (not that it really stops them….). It is appropriate for physicians to have control of this sort of discussion, though, rather than the pharmaceutical companies themselves.

Interestingly, those companies have already won two court battles.

At the same time, the American Medical Association called for a ban on direct to consumer pharmaceutical advertising. Bravo. You know how much the industry paid for advertising the past two years to try to get Americans to buy their drugs? $4.5 BILLION, folks. Who pays for that? You do, with higher drug and insurance prices. But will the AMA really be able to do anything about it? I wonder how many millions of dollars will be spent on lobbying. You know who pays for that? Physicians do. 

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65 thoughts on “This Week in Pharming…

  1. I’ve always been against direct to consumer drug advertising. We should understand that our doctor is the only one who can know if a drug is right for us. And more importantly, if the pros outweigh the cons. Something might be right for what we are suffering from, but worse for us in the long run. Direct to consumer ads obscure that.
    As far as off label use is concerned, I think drug reps should be able to cite real trials that show drugs may be effective for off label uses and nothing more. As a person who has benefited from off label uses, I see nothing wrong with that. But I think it should be backed up. And not direct to consumer.

    Liked by 2 people

      • Very true. If physicians notice a drug has unintended benefits for something else, they should be the ones to start the conversation. Once it is known, I don’t see an issue with the reps having that knowledge at their disposal though.

        Liked by 1 person

      • Reps are good people paid to do a bad job. Everything they say should be suspect. I keep them at arms length. Any physician who is getting their info from a drug rep should also be suspect. That is a profession that should be disposed of, quite frankly.

        Liked by 1 person

  2. Shucks, I though off label meant that I used Lantus (a people insulin) for my cat. He didn’t do well with the usual animal insulins. If anyone can take those ED ads off of the TV, I would be very grateful. After all, how many people have twin bathtubs on the front lawn for the special moments?

    Liked by 3 people

  3. Don’t they call this repatenting? Or am I misinformed?
    Seems that common asthma inhalers have gone up in price, and that a ‘must-carry’ medicine for the tropics (vermox) is becoming unavailable because of this nonsense.

    Liked by 1 person

  4. Bravo for the physicians for finally getting it together to oppose drug advertising…they won’t win though, sadly. I cannot believe drug companies are allowed to act as if pharmaceuticals are candy. Money talks, and talks and talks….(K)

    Liked by 1 person

  5. Great observation, V! But those off label uses can be enormously helpful. My husband suffers from chronic and frequently intense pain in this legs for reasons that no MD has been able to diagnose. His internist proposed he take a low dose of Cymbalta, an anti-depressant, which has been found to alleviate chronic pain. It has helped him with his pain a lot. The only problem is that it causes profuse sweating!

    Liked by 1 person

  6. The total spend on marketing, all forms, is greater than the amount spent on R&D. The R&D spend that is trotted out to explain high prices and high profit margins. I could go on and on and on but …

    We had beautiful weather today and I enjoyed a coffee sitting outdoors in the sun – now I feel better.

    Liked by 2 people

  7. I think the pharmaceutical industry are all bandits. I do not think advertising drugs is wise, I rely on my doctors advice….after I have done my own research so I am at least educated. But the cost: My last biologic was almost $2000.00 A SHOT!. My current one is even more but I do not know how much yet. Fortunately I don’t have to pay for it directly, but it is why insurance has gone through the roof.

    Liked by 1 person

  8. Great post,ma’am! While I am all for technology and patient awareness but I don’t really appreciate Dr Google. It’s annoying when people look up their symptoms on the internet,club them to the most sinister of diagnosis and bring print outs to you. They get all worked up when the internet tells them about that rarest of the rare side effect of a drug that the doctor did not tell them. Clearly the physician knows the risk benefit ratio better and patients must trust them. Thankfully we do not have those many drug ads here in India but the internet trend is fast catching up. But a little knowledge is a dangerous thing and the patient must realize this before they question their physician’s expertise and experience.

    Liked by 1 person

  9. Twice my doctor prescribed a medication for an off-label purpose. Twice the medication worked like a dream. Twice the insurance company stepped in and created problems. Once it turned my $25 /month med into a $600/month med. The other time it caused me to take a different med that didn’t work, and I’m still looking for a better substitute. Or rather, the doctor is. Sigh. Both my doctor and I are very frustrated. I feel for you.

    Liked by 1 person

  10. Are these ‘off-label’ uses not unlike the early advent of antidepressants – where drugs used to treat tuberculosis were found to elevate mood? I find it very hard to strike a balance of trust between scientific exploration/discovery and dumb luck. Add in the financial gain possible for many involved and it becomes even murkier.

    Thank you for pulling all of our heads out of the sand, too.

    Liked by 1 person

  11. I found you through Elyse at 54 and a half. I like her sense. Seems like I will like you, too.

    There are broad problems with how pharmaceuticals are advertised and paid for in the US. I’ve had several go-rounds in the last year or so trying to get things that work for me, for very simple, common problems. Migraine medicine? Oh, insurance will cover things that don’t work for me. They’ll cover narcotics. But it took several months and oh-so-much of my doctor’s (staff) time to get them to cover the one we all know works. A couple of minor, chronic skin issues? WHY OH WHY are those drugs, long-time generics with virtually no risk, so expensive? I could go on…

    At any rate, thanks for this post. I didn’t know this issue was up, too. Corporations are people, my friend.

    Liked by 1 person

  12. I am feeling bad for doctors. Between policy being dictated by a consumer driven philosophy and the mountains of money pharmaceutical companies can spend on lobbying and law suits the doctor is more and more becoming a the least important part of a service industry. A waiter that facilitates the decisions made without their input or consultation. I may be overstating the case but it seems to me the atmosphere is changing to a darker time.

    Liked by 1 person

  13. And patients pay. Everybody pays. Congress physicians invitations are accounted under “R&D expenses”. When we all know most fundamental R&D is done by universities…
    I used to have GSK as a client for OTC. I started doing (market) research for them when they were “Stirling” all the way though umpteen name changes to GSK. They never argued a budget…
    Anybody ever wonder where pharm labs get so much money for so many mergers and acquisitions?
    😦
    And 😦

    Liked by 1 person

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