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Tuesday, November 30, 2004

Time to Call Your Doctor

I was so relieved to learn that, in the wake of the Vioxx debacle, Merck's board has acted decisively to financially reward senior executives should the once revered company turn into a house of cards.  I am sure those who have lost loved ones, or who themselves face the potential of Vioxx induced heart attacks, were equally heartened to hear of their thoughtful largesse.  Reading the Merck news over breakfast turned out to be somewhat of a serendipitous coincidence.  Just the night before, I found myself once again being irritated by the ever growing number of prescription drug commercials that, thanks to a compliant FDA, have become impossible to avoid.  While watching an episode of the British mystery Walking the Dead on BBC, I was urged to treat my stomach with Nexium (proven better), rhymed into reducing my cholesterol with Crestor (recently identified as a potential future Vioxx) and, get this, consider a hip replacement with a specific Titanium/ceramic prostheses even though I had no need of such surgery. 



I've spent the last thirty plus years in the branding and marketing business, so I understand the important role advertising plays in building sales for consumer products.  As a professional, I appreciate what it can do and the often inventive executions that emanate from the many talented people in the agency world.  As a consumer, I'm like everyone else, disdaining many of the commercials I see while probably being totally susceptible to their sales pitch.  That's OK when it comes to household cleaners, soft drinks or automobiles.  I'm not sure the same can be said of prescription drugs, and the more I see of those ads the greater my concern.  In 2003, just six years after the FDA relaxed its rules, the pharmaceutical industry spent $3.2 Billion on prescription drug advertising.  Studies suggest that for every dollar spent, more that four dollars are returned in revenue.  That means that in 2003, advertising generated more than $12 Billion in drug sales.  The power of persuasion.  The thing that bothers me is that a basic role of advertising is to induce trial, make us purchase something that we may not have considered before and that we may not need.  Trial is benign when it comes to a new brand of soap or ice tea, but not for a drug that by definition is going to modify the way our body is functioning, often with dangerous side effects. One has to assume that part of that $12 Billion incremental business comes at the expense of competitive pharmaceuticals appropriately prescribed, but it would be na├»ve to think that some of it, perhaps a significant share, doesn't fall into the category of unnecessary medication.



The fact is that patients are, as the ads usually suggest, calling their doctor "today" to ask whether taking this or that wouldn't be a great idea.  Sadly, the harassed physicians often take the path of least resistance.  How many people are popping Celebrex when Aspirin or another conventional analgesic would suffice?  How many functional males are pushing their doctors to prescribe Viagra or the like when these drugs are meant to assist only the dysfunctional?  And what, from a social perspective, is this $3.5 Billion expenditure doing to further increase the mounting cost of these and other medications?  In a country where we get exercised about someone smoking a joint to alleviate nausea induced by chemotherapy, it seems quite hypocritical that we allow the hawking of prescription drugs as if they were some kind of innocuous confection.  While I certainly have to take responsibility for my own health and do, I don't quite see telling my doctor what drugs are appropriate as part of that task.  Last I checked he, not I, was the one with a medical diploma on the wall.  I'll accept being asked to rush out to the supermarket or down to my car dealer by some actor on TV, but not when and if to call my doctor.  Something about that just doesn't sit well.



We blame the fast food industry for contributing to our national obesity.  All that superfluous fat is taking its toll.  It's time we started blaming the pharmaceutical industry and the FDA for making us a nation that over medicates.  It may take years to know the full extent of damage wrought by Vioxx, once the most heavily advertised prescriptive drug, but we already know it has done harm.  Perhaps I should call my doctor today and ask him why he and his colleagues are not raising their voices against this dangerous trend, this invitation to drug abuse?  Perhaps you should call your physician with the same question.



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