Should You Get Your Drug Information From An Actor?
Sally Field is a talented actor. But what qualifies her to promote Boniva, an osteoporosis drug that is of limited benefit, has worrisome side effects, and for which there are natural alternatives that merit careful consideration?
In "What's Wrong with American Medicine?" I point out that many high-technology treatments have a shadow side. In most areas of life, technological development has made services better and cheaper, but (with a few notable exceptions) it has made health care worse and more expensive. The result: an unhealthy populace and an economy that's lurching toward disaster.
A major component of today's high-tech medical treatment is the reckless overuse of pharmaceutical drugs. An estimated 50 percent of Americans take at least one prescribed medication every day; in 2007, drug sales accounted for an astonishing $315 billion in revenue. When I was growing up, far fewer Americans took prescription drugs.
Direct-to-consumer (DTC) pharmaceutical marketing, such as Ms. Field's Boniva campaign, is a major engine behind this unfortunate change. American television, radio, internet and print are saturated with ads for every imaginable drug, typically ending with an entreaty to "ask your doctor." In 2004, American drug companies spent 24.4% of their sales revenue on promotion, versus just 13.4% for research and development.
Americans now accept these ads as a matter of course, but in my experience, visitors from other countries find them both amusing and appalling. As well they should: the United States and New Zealand are the only two developed countries that allow DTC advertising.
If this anomalous American phenomenon didn't work, it would indeed be merely amusing. Unfortunately, when you "ask your doctor," about a given drug, he or she is likely to hand over a prescription. In 2000, every $1 pharmaceutical companies spent on DTC advertising yielded an additional $4.20 in sales. This bewildering return on investment makes it easy to see why a quarter of drug company revenue is spent on advertising.
I worry about DTC ads for three reasons:
1. Drug ads strengthen our belief in pharmaceutical drugs as the cures for all of our problems. In fact, the consequences of poor lifestyle choices cannot be undone with pills.
2. Many advertised drugs are not only ineffective, but have serious side effects that are frequently played down (and occasionally concealed) by manufacturers. Because heavily advertised drugs have such vast profit potential, political and financial interests collude to speed them to market before they have received sufficient scientific scrutiny.
3. Ads circumvent better sources of information and make people believe that they are being proactive about their health when they request an advertised drug. Thirty-second TV spots that trade on emotion and celebrity contribute little or nothing of value to patient education.
The free market works well in many ways, but it has failed us here. Whether it is done independently or as part of an omnibus health care reform initiative, we need to make the same decision that the rest of the developed world has made: that is, ban direct-to-consumer advertising of prescription pharmaceutical products.
Andrew Weil, M.D., is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com.
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Weil is brilliant - love Sally Field, but he has a point. There's way too much medicating going on.
Release of Abdelbaset al-Megrahi: Repugnant or a Manifestation of Biblical Mercy?
Hardly any American voices have been raised in support of the Scottish decision to release Abdelbaset al-Megrahi, convicted for the Lockerbie bombing. Political response from the White House through the Secretary of State and politicians galore have deplored the decision. Yet many of them are Jews and Christians who surely know of the biblical injunction to be merciful. That the man is terminally ill and expected to live only a short time did not seem mitigate any of the righteous indignation that greeted his release.
Not only is Abdelbaset al-Megrahi near death with cancer, there is serious doubt about his guilt. Knowledgeable and responsible persons in Great Britain have called his conviction a great miscarriage of justice.
Given all this, surely the mercy shown him can be commended by Christians and Jews, as well as other morally sensitive people.
PS:
Have we forgotten this news item?
Sunday July 3, 1988
The USA shot down an Iranian civil aircraft with the loss of 290 passengers and crew, including 66 children.
Once again, Dr Weil brings these issues to us. He should be lobbying his own peers and colleagues and the pharmaceutical industry, not the people.
Here, here.
Of course it's stupid to get medical advice from an actor.
Look how many fools took medical advice from Ronald Reagan.
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When you were growing up, far fewer people took prescription drugs? That's partially because when you were growing up, there was no drug for diseases like hypertension and people were dying from it. Compare life span now to when you were growing up. Big difference.
No but the correct foods were more available when I was a child. Maybe that's why we didn't have a need for pills for any and all occasions. And what stupid people don't know is that eating the right foods can make your body function properly - without the drugs. I took my 10 yr old off Zertec, he's been on it since age 3 and it wasn't even tested in children. Most parents don't think to ask the doctor if the drug is even safe. He's drug free and sneezed less this spring and so far this fall then he ever has before. Is that because the drug doesn't work? Or is it because the natural method works better? People are stupid when it comes to drugs and the commercials are just dumbing them down even more.
I agree that foods were healthier 50 years ago, but not all diseases are addressed by proper dieting/exercise. Some diseases can be genetic (such as hypertension and diabetes), and modern drugs allow for management of what were once fatal diseases.
Do we over-prescribe in this day and age? Sure. Are we better of for the research and development of drugs over the last 50 years? Sure.
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In addition, the huge amount of money spent on these ads is obscene. To promote four hour erections? Vomiting? Nausea?
why advertise products that only a doctor can prescribe? it's nuts.
Absolutely! As a comedian (can't recall who) once said, "No one needs an ad to sell them hemmorroid medicine. You either need it or you don't."
When I am in a doctors office with my children (they are teens) I gently explain how the pharmaceutical reps waiting in the office with us are the unseen drug dealers of America. But I also tell them its not those individual peoples fault. I make sure they know that these dealers aren't bad people, they just depend on their suppliers to make a living. And that the suppliers are the real boggy men. The suppliers tell us their drugs will make us healthy while in fact the drugs they peddle often make people sick in a different way. I make sure they understand that even though they see a cure all in a commercial, they first have to find the root cause of their illness before turning to drugs.
There is a solid purpose for the pharmaceutical reps to visit the physicians in the office to introduce new drugs on the market, etc. They often will give free samples of other commonly prescribed drugs that physicians, in turn, give free to those who cannot afford them. This is pretty legitimate. TV advertisements to the general public are not legitimate. We do not prescribe our own meds. They will argue that it is a campaign to "educate and inform the public". However, medications and healthcare should not be considered a commodity.
One would think that the Physician, who sees the pharmaceutical rep for 5 minutes,would be relatively unaffected by the advertising of this relatively uneducated salesman or -woman. Recently, though, the effect on doctors of all forms of drug marketing has been researched and their influence on prescribing patterns were very great, so ethical standards are changing, but drug advertising is still on everything.
Whether to patients or doctors, the advertising motives are plain--to sell the most expensive products:
1; It must be your name brand drug--Patents run out on drugs, and they may be made in generic versions which are the same, only the name, appearance, and price are different. If you can make sure patients ask for your pill by name only, or make your new combination of 2 drugs in one pill, you can still sell at brand name prices.
2. Research drugs for rich people--People with malaria, or other tropical diseases, are not good customers. Heart, blood pressure, cholesterol, and diabetes medications look like growth areas with good financial backing. Psych medications, especially for depression, and children and youth are great earners
3. Don't be original--Research on a new type of drug for a disease or problem, or research on a disease which has no treatment yet, is very expensive, and may not produce a ready-to-market drug within your career. The best choice is to find a drug that already exists, and alter the shape of the molecule slightly--if it has the same effect on cells in a dish, you're on your way to marketing a copy-cat drug!! Perhaps it has fewer or different side effects than the first drug, and it hasn't been used in so many patients for so long as the first drug, but it sure will make good TV commercials!!
50% of Americans take a precription drug every day. Is he including women taking birth control? Just asking
Whenever I get sick I always turn to The Flying Nun or Gidget for advice.
Dr. Weil, I read your book, "Health and Healing". It is fascinatingly informativ
Kudos to you both.
Another important concern that should be added to Dr. Weil's list is the power over the media that spending billions annually on advertising provides to pharmaceutical companies. Any company that receives this much revenue from a market segment becomes much like a politician: bought and paid for.
and advertising costs are tax deductible
I think that has a lot to do with the medias warped portrayal of this health care reform thing. I mean there is no real coverage on the news that explains what actually is going on with it. There is some serious money involved and yet the economic effects go virtually unmentioned.
on top of it all...only 40% or so of all medications are absorbed by the body, the rest is flushed down the toilet and goes into the water supply, and water treatment plants do not screen for pharmaceutical contaminents. studies have shown that our drinking water contains traces of all these prescription drugs ( osteoperosis, birth control, blood pressure, cholesteral, etc.).
you're being "medicated" whether you're aware of it or not, as are all other living things on the planet. and with a little bit of all of them.
Excellent article Dr. Weil, I enjoyed reading and you shed light on a disturbing aspect of health care that isn't really being discussed. I wonder why, in a country that has so many restrictions on cigarette and alcohol ads (for good reason), we are so accepting of pharma ads, which are just as damaging to both our health and the relationship we enjoy with our personal physicians. They pervade nearly every aspect of our lives (television, magazines & other print, billboards
Of course you don't get drug info from your doctor. Just like you don't buy a used car from a retired football player. The celebrity makes you aware of the product, then it is up to you to practice your due diligence. That’s what grown-ups do, anyway. People who are so blinded by star power that they can’t make up their own minds- well, they may just be out of luck.
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