When I asked my cousin Lakshmi about this she said its educating the consumer.Couldnt really help wonder how a 1 minute commercial could educate you.How " ask your doctor today about XYZ" could mean an informed decision will be taken.We read in our preventive medicine books that health education and health propaganda differ in the former making the receipent to think and the latter striving to prevent him doing that are two poles no less.
And decongestants or cough medicines or even drugs for osteoporosis being advertised on TV are okay. But pray why pegfilgrastim- a colony stimulating factor?Why a antihypertensive cholesterol lowering drug combination( amlodepine+ atorvastatin)?Would consumers realise that amlodepine had vascular endothelial protective effects? How the hell would they know what endothelium is?
I have been on the other side of the doctor patient relationship and have realised how blindly patients trust their physicians in times of distress.This possibly stems out of the fact that they know very little about their own bodies- they think heat and cold can influence wellness,that guarded prognosis means I have to expect death, that old age and disease are an inevitable combo and so many other things that thier mothers and sisters and friends told them and they never read about. So when they are in a situation when they know they do not comprehend much or are helpless - cmon who thinks about which stent to use, bare metal or drug eluting when their dear ones are having a heart attack at that moment ; or even if a stenting is warranted in that situation- they trust their physician implicitly and to an extreme extent. But this could also turn into extreme mistrust and paranoia when they have a bad experience with a doctor.
In some societies which are more litiginous like this country maybe this is more prevalent than India.Maybe it has to do with the fact that the patient does get a really raw deal here. Medical care is ridiculously expensive- $200 for a tooth extraction!!. I guess thats where there comes a feeling that medicine is not about care and healing but about whether your insurance covers a commodity or service being provided, whether you can afford it, why it is so expensive, what a terrible amount of money the doc might be making.These lead a disgruntled patient population to want to be sure about every thing they receive, to know about options they have, to want to be on top of things and not be swarthed in helplessness of ignorance.And who cashes in on this emotion...the guys who are the richest - the pharma guys. They control research dollars, they make up sweet sounding advertisements that talk about "empowerment", "the power of knowledge", " tell someone". What difference does knowing that cancer of cervix is caused by a virus make? Is it really that enlightening or life changing? Or does it make you want to persuade your doctor to give you a shot?And isnt the doctor happy to oblige....the party those vaccine guys gave was great.And did he not educate himself from the pamphlet that the vaccine guys distributed to him.Did he care to search for himself? The pharma guys make it so very easy for him.They search out what they want to tell the doctor- all that is nice about their product, a few figures to get a statistically significant result, nice power point presentations with sparkly pens and diaries.
This is from an editorial from the Lancet:
US Government Accountability Office (GAO), is a non-partisan investigative and research agency of the US Congress. A report prepared by them reviews direct-to-consumer advertising in the USA and examines how well the US Food and Drug Administration (FDA) oversees these advertisements. The investigators found the oversight was lax. But their report also raises questions about the value of direct-to-consumer advertising and shows just how hard it is to regulate once this genie is out of the bottle.
The investigators showed that from 1997 to 2005, industry spending on direct-to-consumer advertising grew on average nearly 20% per year, twice as fast as spending on drug promotion to doctors, reaching US$4·2 billion in 2005. By comparison, industry spent $31·4 billion on research and development, according to the GAO report.
More than 50% of the direct-to-consumer spending went to advertisements for just 20 drugs, most for chronic conditions such as hyperlipidaemia, asthma, and allergies. Not surprisingly, these are the same drugs that drug companies are promoting directly to doctors with advertising in medical journals, drug-representative visits, and free samples. It's a smart dual-pronged strategy, because a doctor is more likely to provide a particular drug when a patient asks for it and when the doctor has free samples on hand.
Now, this is not to say that direct-to-consumer advertising does not help some patients. In many cases, patients may have been well served by advertisements that led them to discuss their concerns with their physicians. But the primary purpose of direct-to-consumer advertising remains clear: to sell lucrative, on-patent, brand-name drugs. Claims to the contrary just do not pass the straight-face test.
How well, then, does the FDA oversee this advertising? Not well, the GAO showed. Under the law, advertising materials must contain a “true statement” of information that includes a brief summary of effectiveness, side-effects, and contraindications. Broadcast materials may present only major effects and contraindications, but must provide information about where consumers can get more details. When material is shown to be in violation, FDA officials issue a regulatory letter that might call for the advertisement to be stopped or, in more serious cases, for new advertisements to correct misinformation that may have been disseminated.
In general, the FDA only reviews material after it is disseminated, although in some cases companies bring their materials to the agency for comment before dissemination. Because the FDA can review only a small proportion of advertising put out each year, FDA officials told the GAO investigators that they used informal criteria to select what to review. But the GAO investigators showed that the FDA had no written documentation detailing these criteria, no system for applying the criteria, and no record for tracking what it had reviewed. In addition, the FDA issued relatively few regulatory letters, between eight and 11 per year between 2002 and 2005. However, once the FDA began drafting a letter it took on average 4 months before it was issued. In many cases, by that time the advertising campaigns had often run their course.
Part of the FDA's performance is probably due to the influence of an industry-friendly administration that has made its antipathy towards government regulation clear.(Have clipped the rest)
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